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Objective:To analyze the incidence of stillbirth and the associated factors in pregnancy among pregnant residents in Wuhan.Methods:A previous birth cohort was retrospectively reviewed. The cohort was based on Wuhan Maternal and Child Information System, and the perinatal information of pregnant residents in Wuhan from January 1, 2011, to September 30, 2017 and information of selected cases was collected, including socio-demographic characteristics, pregnant history, and healthcare information during pregnancy and labor. Data on stillbirth, including fetal death in uterus and in labor, were selected for this study. Chi-square test was adopted for comparing the differences in pregnancy-related factors between live birth and stillbirth, and binary logistic regressions for exploring the influencing factors associated with the occurrence of stillbirth. Results:A total of 509 057 deliveries in Wuhan were included in this study, including 505 839 live births and 3 218 stillbirths (3 155 after exclusion of fetal death in labor), with an overall incidence of stillbirth of 6.32‰(3 218/509 057), and an annual incidence between 4.90‰ to 8.11‰. Statistically significant differences were found between the live birth and stillbirth group in the following items: maternal age [<25 years old: 19.28% (97 544/505 839) vs 19.36% (623/3 218); 25-30 years old: 48.45% (245 077/505 839) vs 45.15% (1 453/3 218); 30-35 years old: 26.09% (131 952/505 839) vs 26.29% (846/3 218); >35 years old: 6.18% (31 266/505 839) vs 9.20% (296/3 218)], educational background [middle school or below: 22.90% (115 833/505 839) vs 22.03% (709/3 218); high school: 36.37% (183 978/505 839) vs 38.72% (1 246/3 218); college or above: 40.73% (206 028/505 839) vs 39.25% (1 263/3 218)], occupation [brainworker or professionals: 33.51% (169 514/505 839) vs 31.54% (1 015/3 218); manual or freelance worker: 66.38% (335 763/505 839) vs 68.34% (2 199/3 218)], residential area [urban area: 70.00% (354 365/505 839) vs 76.32% (2 456/3 218); rural area: 30.00% (151 474/505 839) vs 23.68%(762/3 218)], and time of conception [spring (March to May): 24.27% (122 746/505 839) vs 24.08% (775/3 218); summer (June to August): 24.09% (121 867/505 839) vs 23.87% (768/3 218); fall (September to November): 26.69% (135 012/505 839) vs 25.08% (807/3 218); winter (December to next February): 24.95% (126 214/505 839) vs 26.97% (868/3 218)] (all P<0.05), but no significant difference was found in fetal gender ( P>0.05). Besides, gravidity [once: 49.32% (249 484/505 839) vs 47.02% (1 513/3 218); over twice: 50.68% (256 355/505 839) vs 52.98% (1 705/3 218)], parity [once: 73.60% (372 316/505 839) vs 77.07% (2 480/3 218); over twice: 26.40% (133 523/505 839) vs 22.93% (738/3 218)], history of stillbirth [0.33% (842/256 355) vs 0.65% (11/1 705)], hypertensive disorders in pregnancy [3.25% (16 464/505 839) vs 5.59% (180/3 218)], first trimester vaginal bleeding [2.02% (10 251/505 839) vs 2.61% (84/3 218)], placenta previa [0.98% (4 963/505 491) vs 2.64% (53/2 009)], and oligohydramnios [2.52% (12 764/505 839) vs 1.90% (61/3 218)] differed significantly between the two groups (all P<0.05). However, no significant difference was found between the two groups in terms of the proportion of women with gestational diabetes mellitus and previous spontaneous abortion (both P>0.05). After exclusion of fetal death in labor from the 3 218 stillbirths, the same results were achieved. Binary logistic regression analysis showed that women who were over 30 years old (30-35 years old: OR=1.42, 95% CI: 1.30-1.56; >35 years old: OR=2.59, 95% CI: 2.25-2.98), with a high school degree or below (middle school or below: OR=1.37, 95% CI: 1.21-1.55; high school: OR=1.28, 95% CI: 1.16-1.42), manual or freelance worker ( OR=1.18, 95% CI: 1.07-1.31), in the urban area ( OR=1.43, 95% CI:1.31-1.57), and gravidity ≥ 2 times ( OR=1.32, 95% CI: 1.21-1.43), primiparity ( OR=1.76, 95% CI: 1.58-1.96), gestational hypertension ( OR=2.80, 95% CI: 2.40-3.27), vaginal bleeding in the first trimester ( OR=1.35, 95% CI: 1.08-1.68), placenta previa ( OR=10.86, 95% CI: 8.84-13.35) and history of stillbirth ( OR=2.27, 95% CI: 1.30-3.98) were all risk factors of stillbirth. Conclusion:Pregnant women who were over 30 years old, less educated, manual worker or freelance or with a history of adverse pregnancy, vaginal bleeding in the first trimester, hypertension in pregnancy, and placenta previa are at higher risk of stillbirth
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ObjectiveCOVID-19 patients presenting with gastrointestinal (GI) symptoms occur in both adults and children. To date, however, no large sample size study focusing on gastrointestinal symptoms in pediatric cases has been published. We analyzed COVID-19 infected children in Wuhan who presented with initial GI symptoms to determine the GI characteristics and epidemiological trend of the disease. DesignWe retrospectively analyzed 244 children patients confirmed with COVID-19 at Wuhan Childrens Hospital from 21 Jan to 20 Mar 2020. Symptomatic cases were divided into two groups according to whether the patients presented with or without GI symptoms on admission. Demographic, epidemiological, symptoms, and laboratory data were compared. We also analyzed the respective trends of case number changes of GI cases and asymptomatic cases. Results34 out of 193 symptomatic children had GI symptoms. They had lower median age and weight, a higher rate of fever, a longer length of stay and more hematological and biochemical abnormalities than patients without GI symptoms. There was no significant difference in chest CT findings or stool SARS-CoV-2 test positive percentages between the two groups. The number of patients admitted with GI symptoms showed an overall downward trend with time. At the time of writing, 242 patients were discharged, one died, and one critically ill patient was still in the intensive care unit. ConclusionCOVID-19 infected children with GI symptoms are prone to presenting with more clinical and laboratory abnormalities than patients without GI symptoms. More attention and timely hospital admission are needed for these patients. Significance of this studyO_LSTWhat is already known on this subject?C_LSTO_LICOVID-19 is now a pandemic with more than 1.6 million people infected worldwide C_LIO_LIAlthough attacking the respiratory tract mostly, both adult and children infected with COVID-19 can present with GI symptoms C_LI O_LSTWhat are the new findings?C_LSTO_LIInfants younger than two years old and presence of fever are the two risk factors of presenting with GI symptoms C_LIO_LIA high proportion of patients without GI symptoms and asymptomatic patients will have positive RT-PCR for the virus in stool C_LIO_LIEarlier testing through contact screening of family members means more COVID-19 infected children are diagnosed when completely asymptomatic C_LI O_LSTHow might it impact on clinical practice in the foreseeable future?C_LSTO_LIThe presence of COVID-19 in stool in infected children will have a major implication for parents and carers of young infants C_LIO_LIIncreasing number of asymptomatic COVID-19 patients who are detected through screening could provide a useful lesson for other countries still experiencing the rise and peak of the pandemic C_LI
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Objective To investigate the prevalence and distribution of deafness gene mutations by the joint screening of deafness-related genes and hearing in Wuhan .Methods A total of 117930 newborns born in 2014 and 2015 volunteered to participate in this study .Besides traditional hearing screening ,heel blood of all subjects were collected to detect four sites of three common deafness genes GJB 2 (235delC ) ,SLC26A4 (919 -2A > G ) ,and DNA 12SrRNA(1555A>G ,1494C> T) .Results The total mutation rate of deafness gene was 3 .00％ in 117930 newborns .The highest spots were GJB2235delC and SLC26A4919-2 mutation .A total of 109036 newborns pas-sed the combined screenings ,and 5353 newborns passed the gene screening ,but failed hearing screening .A total of 32131 newborns passed the hearing screening with gene mutation ,while 310 newborns failed in both .Newborns with gene mutation were more likely to fail hearing screening .Conclusion This study indicates that neonatal deafness gene screening in combination with hearing screening not only can effectively improve the detection rate of hearing loss or high risk children ,but also can provide detailed genetic information to promote the popularization and application of such concurrent screenings .
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Objective To investigate the association between maternal body height and risk of preterm birth.Methods A total of 11 311 pregnant women who gave birth of live singletons were recruited from the Healthy Baby Cohort Study in Hubei province,China from September 2012 to October 2014.Finally 11 070 pregnant women were selected as study subjects.Data were collected by using questionnaires,their prenatal care records and medical records.The women were divided into 4 groups according to the quartiles distribution (＜158 cm,158-cm,160-cm,and ＞164 cm).Gestational age was estimated according to maternal last menstrual time.Preterm birth was defined as delivering a live singleton infant at 28-37 weeks' gestational age.Logistic regression was used to calculate the odds ratios (OR) and 95％ confidence intervals (CI) for the association between body height and preterm birth.Results Among the 11 070 pregnant women,the incidence of preterm birth was 5.9％.Logistic regression analysis indicated that women in group with body height ＜ 158 cm had 46％ (OR=-1.46,95％CI:1.16-1.83) higher risk of giving preterm birth than those in group with body height ＞ 164 cm after adjustment for potential confounders.Every 1-cm increase in body height was associated with 3％ lower risk of preterm birth (OR=0.97,95％CI:0.95-0.99).Conclusion Shorter body height was a risk factor for preterm birth.It is necessary to strengthen the monitoring in pregnant women with short body height to reduce the risk of preterm birth.
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Objective To investigate the association between maternal body height and risk of preterm birth.Methods A total of 11 311 pregnant women who gave birth of live singletons were recruited from the Healthy Baby Cohort Study in Hubei province,China from September 2012 to October 2014.Finally 11 070 pregnant women were selected as study subjects.Data were collected by using questionnaires,their prenatal care records and medical records.The women were divided into 4 groups according to the quartiles distribution (＜158 cm,158-cm,160-cm,and ＞164 cm).Gestational age was estimated according to maternal last menstrual time.Preterm birth was defined as delivering a live singleton infant at 28-37 weeks' gestational age.Logistic regression was used to calculate the odds ratios (OR) and 95％ confidence intervals (CI) for the association between body height and preterm birth.Results Among the 11 070 pregnant women,the incidence of preterm birth was 5.9％.Logistic regression analysis indicated that women in group with body height ＜ 158 cm had 46％ (OR=-1.46,95％CI:1.16-1.83) higher risk of giving preterm birth than those in group with body height ＞ 164 cm after adjustment for potential confounders.Every 1-cm increase in body height was associated with 3％ lower risk of preterm birth (OR=0.97,95％CI:0.95-0.99).Conclusion Shorter body height was a risk factor for preterm birth.It is necessary to strengthen the monitoring in pregnant women with short body height to reduce the risk of preterm birth.
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BACKGROUND: Genetic variations, including mitochondrial mutations, are important contributors to hearing loss, especially in children, and newborn genetic screens for hearing loss mutations are becoming increasingly common. Mitochondrial mutations have been linked with ototoxic responses to common antibiotics, therefore understanding the association of these mutations with hearing loss is of special importance. To address the usefulness of screening for these mutations in a clinical setting, we formed a collaboration of clinicians and geneticists to analyse the association of mitochondrial mutations with non-syndromic hearing loss, including the effect of ethnicity, audiological test methods and aminoglycoside exposure. METHODS: This survey identified 122 variants in 43 studies that have been assessed for an association with hearing loss, and meta-analysis was performed on clinically relevant subsets. RNA folding and conservation analysis further explored possible relevance of these variants. RESULTS: Among all studies, eight variants were found to have significant associations with hearing loss. A partially overlapping set of six variants had significant association with hearing loss when aminoglycoside exposure was assessed. Five of these variants predictive of sensitivity to aminoglycoside spatially co-localise in an RNA folding model. There was little effect of the audiological test method used to assess hearing loss on the association with the variants. CONCLUSIONS: Our results found a small set of studied variants had reproducible association with hearing loss, which will help clarify mutations useful in genetic screens for hearing loss. Several of the aminoglycoside exposure-associated mutations may co-localise on folded 12S rRNA, suggesting a functional association between these loci and aminoglycoside-induced hearing loss.
Subject(s)
Aminoglycosides/adverse effects , DNA, Mitochondrial/genetics , Genetic Predisposition to Disease , Hearing Loss/chemically induced , Hearing Loss/genetics , Mutation/genetics , Audiometry , Base Sequence , Ethnicity/genetics , Humans , Molecular Sequence Data , Nucleic Acid Conformation , RNA, Ribosomal/chemistry , RNA, Ribosomal/geneticsABSTRACT
Objective To determine contact allergens and their clinical significance in patients with dermatitis or eczema in Wuxi city.MethodsPatch test was conducted in 1065 patients with a clinical diagnosis of dermatitis or eczema.A statistical analysis was carried out.Results Positive patch test reactions were observed in 83.19％ of the patients,with no statistical differences in the frequency of positive patch test reactions between female and male patients or between patients of different age groups.The most frequent 6 allergens were potassium dichromate,cobalt chloride,nickle sulfate,formaldehyde,carba mix and fragrance mix in these patients.Female patients showed a higher frequency of positive patch test reaction to nickle sulfate and formaldehyde,but a lower frequency to potassium dichromate and carba mix compared with male patients (all P＜ 0.01 ); young,middle-aged,and old patients exhibited an increased frequency of positive reaction to cobaly chloride compared with child patients,while young and middle-aged patients showed a decreased frequency to nickel sulfate compared with child patients (all P ＜ 0.05).Conclusion Potassium dichromate,cobalt chloride,nickle sulfate,formaldehyde,carba mix and fragrance mix are the main allergens causing dermatitis and eczema in Wuxi city.
