Association between neutrophil-lymphocyte ratio and perinatal depressive symptoms among Chinese women.

OBJECTIVE: The prevalence of depression has increased dramatically in the past few decades, and pregnant women are at high risk for depression. It is widely thought that inflammation plays a critical role in the pathogenesis of depression. Therefore, we aimed to evaluate the association between the neutrophil-lymphocyte ratio (NLR), a marker of chronic immune inflammation, and perinatal depressive symptoms. METHODS: A cohort study involving 535 pregnant women was conducted based on a prospective birth cohort in Wuhan, China. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess antepartum depression (APD) and postpartum depression (PPD) during the second trimester of pregnancy and one month after delivery. The NLR during the second trimester was determined based on a routine blood test. The association between NLR and depressive symptoms was evaluated using logistic regression analysis and restricted cubic spline (RCS) regression. RESULTS: We found that the prevalence of APD and PPD was 8.4% and 15.1%, respectively. NLR levels were positively associated with APD (OR = 1.52, 95% CI: 1.20--1.91). After adjusting for potential confounders, the OR (95% CI) of APD for the highest NLR quartile was 4.56 (1.58, 13.13) compared with the lowest quartile. No significant association was found between NLR and PPD. RCS regression model analysis indicated a linear correlation between NLR and APD (P for non-linearity = 0.58). CONCLUSION: Overall, elevated mid-trimester NLR is independently associated with APD but not PPD.

Association between short- and long-term exposures to air pollutants and internalizing/externalizing behavior in children aged 4 to 7 years.

The effects of air pollutants on psychological health have attracted increasing attention worldwide. However, there is limited evidence on the association between air pollution and children's psychological development. This study explores the association between short- and long-term exposures to air pollutants and children's internalizing and externalizing behaviors. A total of 2303 children of 4-7 years were included in this study. We assessed their behavior using the Child Behavior Checklist (4-16 years). The prevalence of internalizing and externalizing behavior was 4.77% and 4.43%, respectively. For short-term exposure, CO pollution was associated with children's internalizing behaviors, with each 1 mg/m3 increment leading to an odds ratio (OR) of 1.063 (95% CI 1.005, 1.124), 1.065 (95% CI 1.009, 1.124), 1.067 (95% CI 1.007, 1.131), and 1.122 (95% CI 1.018, 1.236) at lag04, lag05, lag06, and lag0120, respectively. O3 (per 1 g[Formula: see text]/m3) was negatively associated with internalizing problems at lag2 [OR = 0.991 (95% CI 0.983, 0.999)]. NO2 (per 1 g[Formula: see text]/m3) was significantly associated with externalizing behaviors, with the ORs of 1.067 (95% CI 1.024, 1.111) at lag060 and 1.060 (95% CI 1.010, 1.113) at lag0120. For long-term exposure, it indicated that 1-year exposure to CO (per 1 mg/m3) and PM2.5 (per 1 g[Formula: see text]/m3) was positively associated with internalizing behavioral risk [OR = 1.724 (95% CI 1.187, 2.504); PM2.5: OR = 1.236 (95% CI 1.114, 1.371)], whereas NO2 (per 1 g[Formula: see text]/m3) exposure was associated with an increased risk of externalizing behavior [OR = 1.123 (95% CI 1.003, 1.256)]. In addition, the interaction analysis showed that boys were at a higher risk of abnormal behaviors associated with long-term exposure to CO, PM2.5, and NO2. Our findings reveal a potential link between air pollution exposure and abnormal behaviors in kindergarten children after short-/long-term exposure, which is an essential supplement to the studies on the association between air pollution and children's behavioral problems.

Residential greenness and air pollution concerning excessive gestational weight gain during pregnancy: A cross-sectional study in Wuhan, China.

BACKGROUND: Previous studies have indicated that exposure to residential greenness may benefit the health status of pregnant women, and air pollution may exert a mediating effect. Gestational weight gain (GWG) is an important indicator of pregnant women and fetuses' health and nutrition status. However, evidence concerning the impact of residential greenness on excessive gestational weight gain (EGWG) is scarce, and to what extent air pollution in urban settings mediates this relationship remains unclear. OBJECTIVE: This study aims to explore the association of residential greenness with EGWG, consider the mediating effect of air pollution, and estimate the combined impact of residential greenness and air pollution exposures on EGWG. METHOD: This population-based cross-sectional study involved 51,507 pregnant women with individual-level data on residential addresses in the Wuhan Maternal and Child Health Management Information System. Two spectral indexes, the normalized difference vegetation index (NDVI) and soil-adjusted vegetation index (SAVI), were used to proxy residential greenness. The air pollution data included six indicators (PM2.5, PM10, SO2, CO, NO2, O3) and used the Ordinary Kriging interpolation method to estimate overall pregnancy exposure to air pollutants. Generalized linear mixed regression models were utilized to explore the relationship between residential greenness and EGWG. Restricted cubic spline (RCS) models were developed to examine the dose-response relationships. Mediation analyses explored the potential mediating role of air pollution in the residential greenness-EGWG associations. Finally, the weighted-quantile-sum (WQS) regression model was used to investigate the association between residential greenness-air pollutants co-exposure and EGWG. RESULT: Among all participants, 26,442 had EGWG. In the adjusted model, the negative association was found significant for NDVI100-m, NDVI200-m, and NDVI500-m with EGWG. For example, each IQR increase in NDVI100-m was associated with 2.8% (95% CI: 0.6-5.0) lower odds for EGWG. The result of WQS regression showed that, when considering the six air pollutants and NDVI-100m together, both positive and negative WQS indices were significantly associated with EGWG, PM10, PM2.5, with SO2 having significant weights in the positive effect direction and CO, O3, NO2, and NDVI100-m having a negative effect. Our results also suggested that SO2, NO2, PM10, PM2.5, and CO significantly mediated the association between NDVI-100m and EGWG, and our estimates were generally robust in the sensitivity analysis. CONCLUSION: Exposure to a higher level of residential greenness is associated with a reduced risk of EGWG, in which air pollution may exert a mediating effect. Pregnant women might benefit more in gaining healthy gestational weight when greenness levels increase from low to medium than from medium to high. Given the current cross-sectional study design, large-sale prospective cohort studies are needed to confirm our findings further.

Birth and Health Outcomes of Children Migrating With Parents: A Systematic Review and Meta-Analysis.

Objective: To examine the birth and health outcomes of children migrating with parents internationally and domestically, and to identify whether the healthy migration effect exist in migrant children. Methods: Five electronic databases were searched for cross-sectional, case-control, or cohort studies published from January 1, 2000 to January 30, 2021and written by English language, reporting the risk of health outcomes of migrant children (e.g., birth outcome, nutrition, physical health, mental health, death, and substance use) We excluded studies in which participants' age more than 18 years, or participants were forced migration due to armed conflict or disasters, or when the comparators were not native-born residents. Pooled odd ratio (OR) was calculated using random-effects models. Results: Our research identified 10,404 records, of which 98 studies were retrained for analysis. The majority of the included studies (89, 91%) focused on international migration and 9 (9%) on migration within country. Compared with native children, migrant children had increased risks of malnutrition [OR 1.26 (95% CI 1.11-1.44)], poor physical health [OR 1.34 (95% CI 1.11-1.61)], mental disorder [OR 1.24 (95% CI 1.00-1.52)], and death [OR 1.11 (95% CI 1.01-1.21)], while had a lower risk of adverse birth outcome [OR 0.92 (95% CI 0.87-0.97)]. The difference of substance use risk was not found between the two groups. Conclusion: Migrant children had increased risk of adverse health outcomes. No obvious evidence was observed regarding healthy migration effect among migrant children. Actions are required to address the health inequity among these populations. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#myprospero, identifier: CRD42021214115.

The Mediation Role of Health Behaviors in the Association between Self-Regulation and Weight Status among Preschool Children: A Sex-Specific Analysis.

Previous studies have supported the link between children's self-regulation (CSR) and weight status, but the potential pathways have not been elucidated yet. We aimed to investigate whether and to what extent health behaviors mediate this association, as well as to explore the sex effect. For this study, we recruited 3740 preschoolers in Wuhan, China. The height and weight of children were measured, and a body mass index of the ≥85th percentile was defined as overweight/obesity (OWO). We used the Children's Behavior Questionnaire, with measured domains including inhibitory control, impulsivity, anger, and attentional focusing, to assess CSR. The primary caregivers' SR (PSR) was assessed with the Self-Control Scale. Information on lifestyles collected from questionnaires was utilized to construct the health behavior index (HBI). We found that Children's HBI was associated with both CSR and PSR, inhibitory control (OR = 0.81, p < 0.001), anger (OR = 1.23, p < 0.001), attentional focusing (OR = 0.70, p < 0.001), impulsivity (OR = 1.23, p < 0.001), and PSR (OR = 0.73, p < 0.001). Children's impulsivity was associated with their OWO (OR = 1.11, p = 0.013) which was partly mediated by the HBI (direct effect: ß = 0.092, p = 0.026; indirect effect: ß = 0.011, p = 0.007). The sex-specific analysis indicated that this mediation effect was only significant in boys. These results indicated that impulsivity is associated with childhood weight status, which is partially mediated by health behaviors, especially in boys.

Associations between KCNQ1 and ITIH4 gene polymorphisms and infant weight gain in early life.

BACKGROUND: An earlier meta-analysis of genome-wide association studies in Asian populations detected five novel body mass index-associated single-nucleotide polymorphisms (SNPs), including potassium voltage-gated channel subfamily Q member 1 (KCNQ1) (rs2237892), ALDH2/MYL2 (rs671, rs12229654), ITIH4 (rs2535633), and NT5C2 (rs11191580). Whether these SNPs take effect in early life, for example, affect infant rapid weight gain (RWG), is unclear. METHODS: We obtained genomic DNA from 460 term infants with normal birth weight. RWG was defined as the change of weight-for-age standardized Z-score, calculated according to the Children Growth Standard released by the World Health Organization, from birth to 3 months of age >0.67. Using genetic models, associations between the candidate SNPs and infant RWG were examined, along with the interaction between the SNPs and the potential risk factors. RESULTS: RWG was presented in 225 of 460 infants. SNP rs2535633 and rs2237892 were associated with the risk of RWG. Both additive and multiplicative interaction effects were found between infant delivery mode and rs2237892. The negative association between the rs2237892 T allele and infant RWG was only observed in vaginally delivered infants. CONCLUSIONS: Obesity-related loci rs2535633 and rs2237892 are associated with infant RWG in the first 3 months of infancy. The relationship between rs2237892 and infant RGW might be moderated by cesarean delivery. IMPACT: Genetic predisposition is an essential aspect to understand infant weight gain. Obesity-related SNPs, rs2535633 and rs2237892, are associated with RWG in very early years of life. The negative association between rs2237892 T allele and RWG is only observed in infants delivered vaginally instead of cesarean section.