Molecular Engineering Enables Hydrogel Electrolyte with Ionic Hopping Migration and Self-Healability toward Dendrite-Free Zinc-Metal Anodes.

Hydrogel electrolytes (HEs), characterized by intrinsic safety, mechanical stability, and biocompatibility, can promote the development of flexible aqueous zinc-ion batteries (FAZIBs). However, current FAZIB technology is severely restricted by the uncontrollable dendrite growth arising from undesirable reactions between the HEs with sluggish ionic conductivity and Zn metal. To overcome this challenge, this work proposes a molecular engineering strategy, which involves the introduction of oxygen-rich poly(urea-urethane) (OR-PUU) into polyacrylamide (PAM)-based HEs. The OR-PUU/PAM HEs facilitate rapid ion transfer through their ionic hopping migration mechanism, resulting in uniform and orderly Zn2+ deposition. The abundant polar groups on the OR-PUU molecules in OR-PUU/PAM HEs break the inherent H-bond network, tune the solvation structure of hydrated Zn2+, and inhibit the occurrence of side reactions. Moreover, the interaction of hierarchical H-bonds in the OR-PUU/PAM HEs endows them with self-healability, enabling in situ repair of cracks induced by plating/stripping. Consequently, Zn symmetric cells incorporating the novel OR-PUU/PAM HEs exhibit a long cycling life of 2000 h. The resulting Zn-MnO2 battery displays a low capacity decay rate of 0.009% over 2000 cycles at 2000 mA g-1. Overall, this work provides valuable insights to facilitate the realization of dendrite-free Zn-metal anodes through the molecular engineering of HEs.

Joint Developmental Trajectories of Novelty and Usefulness in Chinese Children's Creativity.

Creativity encompasses both novelty and usefulness, with novelty referring to the generation of unique and uncommon ideas, while usefulness pertains to the effectiveness and appropriateness of these ideas in addressing the given task. The comprehension of the process of coordinated development for children's novelty and usefulness, including the potential gender differences, is crucial; however, it still lacks clarity in the current academic discourse. To address these gaps, this study investigated the joint developmental trajectories of novelty and usefulness as well as the gender differences in trajectory group membership among Chinese children. A sample of primary school children (initial grade 3, N = 665; 46.4% girls; initial Mage = 8.60 years) were followed for three years. The results revealed a negative association between novelty and usefulness across all three time points. Through parallel-process latent class growth modeling, three distinct trajectories of novelty and usefulness were identified: the High Novelty Decline-Medium Usefulness Increase-Stability Group (66%), the Low Novelty Increase-High Usefulness Decline-Convergence Group (19%), and the Low Novelty Decline-High Usefulness Increase-Divergence Group (15%). These findings suggest that the development of children's creativity is influenced by a multifaceted pattern involving both novelty and usefulness. Moreover, gender differences in trajectory group membership were examined and discussed within the context of creativity development in Chinese children.

Effects of vaginal seeding on gut microbiota, body mass index, and allergy risks in infants born through cesarean delivery: a randomized clinical trial.

BACKGROUND: Vaginal seeding-exposure of neonates to maternal vaginal fluids-has been proposed to improve the microbiota of infants born through cesarean delivery, but its impacts on the infants' subsequent health outcomes remain unclear. OBJECTIVE: This study aimed to examine the impacts of vaginal seeding on gut microbiota, growth, and allergy risks in infants born through cesarean delivery. STUDY DESIGN: This randomized controlled trial was conducted at Liuyang Maternal and Child Health Care Hospital in Hunan, China. We estimated that a minimum sample size of 106 was needed by assuming a standardized effect size of 0.6 for the primary outcomes, with a statistical power of 80%, a 2-sided type I error of 0.05, and an expected loss to follow-up rate of 15%. Finally, 120 singleton term pregnant women scheduled for cesarean delivery were enrolled from November 2018 to September 2019. Infant follow-up was completed in September 2021. The participants were randomized in a 1:1 ratio to the vaginal seeding group (n=60; infants were swabbed immediately after birth using gauze preincubated in maternal vagina) or the control group (n=60; routine standard care). The first set of primary outcomes was infant body mass index and body mass index z-scores at 6, 12, 18, and 24 months of age. The other primary outcome was the total allergy risk score at 18 months for 20 common allergens (each scored from 0-6 points). Characteristics of gut microbiota, overweight/obesity, and allergic diseases and symptoms were included as secondary outcomes. The main analyses were performed according to the modified intention-to-treat principle. RESULTS: Of 120 infants, 117 were included in the analyses. Infant body mass index and body mass index z-scores did not significantly differ between the 2 groups at any of the 4 time points, with the largest difference in point estimates occurring at 6 months: the mean (standard deviation) body mass index was 17.5 (1.4) kg/m2 and 17.8 (1.8) kg/m2 in the vaginal seeding and control groups, respectively (mean difference, -0.31 kg/m2 [95% confidence interval, -0.91 to 0.28]; P=.30), and body mass index z-score was 0.2 (1.0) and 0.4 (1.1), respectively (mean difference, -0.20 [95% confidence interval, -0.58 to 0.18]; P=.31). The median total allergy risk score was 1.5 (interquartile range, 0.0-4.0) in the vaginal seeding group and 2.0 (interquartile range, 1.0-3.0) in the control group (median difference, 0.00 [95% confidence interval, -1.00 to 1.00]; P=.48). For infants from the vaginal seeding group, the relative abundance of genera Lactobacillus and Bacteroides in the gut microbiota was slightly yet nonsignificantly elevated at birth and 6 months, and the risk of overweight/obesity was lower at 6 months (0/57 vs 6/59; relative risk, 0.03 [95% confidence interval, 0.00-0.57]; P=.03) though not at subsequent time points. Other secondary outcomes did not differ between groups. No adverse events related to the intervention were reported. CONCLUSION: For infants born through cesarean delivery, vaginal seeding has no significant impacts on the gut microbiota, growth, or allergy risks during the first 2 years of life.

The Effect of Task Performance and Partnership on Interpersonal Brain Synchrony during Cooperation.

Interpersonal brain synchrony (IBS) during cooperation has not been systematically investigated. To address this research gap, this study assessed neural synchrony during a cooperative jigsaw puzzle solving task using functional near-infrared spectroscopy (fNIRS)-based hyperscanning. IBS was measured for successful and failed tasks in 31 dyads in which the partners were familiar or unknown to each other. No significant difference in IBS was observed between the different types of cooperative partnership; however, stronger IBS within regions of the pars triangularis Broca's area, right frontopolar cortex, and right temporoparietal junction was observed during task success. These results highlight the effect of better task performance on cooperative IBS for the first time and further extend understanding of the neural basis of cooperation.

Spousal Concordance of Cardiovascular Risk Factors in Newly Married Couples in China.

Importance: Several studies have shown that older married couples share a propensity for accruing the same cardiovascular risk factors such as hypertension and dyslipidemia. However, it remains unclear if these spousal associations reflect their shared home environment and lifestyle or the tendency to choose a partner with a similar perspective on lifestyle choices and behaviors (assortative mating). Evaluating these associations in young, newly married couples may help to differentiate between these 2 possibilities. Objective: To evaluate the spousal concordance of cardiovascular risk factors in young, newly married couples. Design, Setting, and Participants: This prospective cohort study recruited 831 couples around the time of marriage registration in Liuyang, China, from February 1, 2009, to November 4, 2015. Statistical analysis was performed from April to May 2021. Main Outcomes and Measures: Spousal concordance of cardiovascular risk factors. Both partners underwent systematic assessment of cardiovascular risk factors, including evaluation of anthropometrics, blood pressure, and fasting lipids. Results: Among the 831 participating couples, mean (SD) age was 24 (3) years in the women and 26 (4) years in the men. There were significant correlations between spouses in systolic blood pressure (r = 0.43; P < .001), diastolic blood pressure (r = 0.36; P < .001), total cholesterol (r = 0.13; P < .001), low-density lipoprotein cholesterol (r = 0.11; P = .003), high-density lipoprotein (HDL) cholesterol (r = 0.22, P < .001), and triglycerides (r = 0.13; P = .001). After adjustment for covariates (age, household income, education level, smoking, and either body mass index or waist circumference), significant correlations persisted between spouses in their systolic blood pressure (r = 0.42; P < .001), diastolic blood pressure (r = 0.34; P < .001), HDL cholesterol (r = 0.17; P < .001), and triglycerides (r = 0.10; P = .04). Conclusions and Relevance: This cohort study found spousal concordance of cardiovascular risk factors among young newly married couples. Assortative mating based on these concordant risk factors at the time of marriage may partially explain the shared vascular risk profile of older marital partners and raises the possibility of couple-based care.

Paternal weight prior to conception and infant birthweight: a prospective cohort study.

BACKGROUND/OBJECTIVE: Previous studies have consistently demonstrated that maternal weight status both before and during pregnancy is associated with infant birthweight. However, a fundamental limitation across this literature remains that previous studies have not evaluated the concomitant impact of paternal weight at conception, owing to the paucity of studies in which fathers were assessed prior to pregnancy. Thus, we established a cohort of preconception couples to prospectively evaluate the associations of maternal and paternal weight prior to pregnancy with infant birthweight at delivery. METHODS: In this prospective observational cohort study, 1292 newly-married women and their partners in Liuyang, China, were assessed at median of 23.3 weeks before a singleton pregnancy, thereby enabling concomitant assessment of preconception maternal and paternal body mass index (BMI) in relation to infant birthweight. RESULTS: Mean birthweight was 3294 ± 450 g with 147 neonates (11.4%) born large-for-gestational-age (LGA) and 94 (7.3%) small-for-gestational-age (SGA). After adjustment for maternal and paternal factors prior to conception (age, education, smoking, BMI, household income), length of gestation, total gestational weight gain, gestational diabetes, preeclampsia, and infant sex, it was noted that infant birthweight increased by 42.2 g (95% CI 29.5-54.8; p < 0.0001) per unit increase in maternal pregravid BMI and 10.7 g (95% CI 0.5-20.9; p = 0.04) per unit increase in paternal pregravid BMI. Maternal pregravid BMI explained 6.2% of the variance in birthweight whereas paternal BMI explained only 0.7%. Independent predictors of LGA delivery were maternal pregravid BMI (aOR = 1.91, 95% CI 1.50-2.44), maternal age (aOR = 1.48, 95% CI 1.09-2.00), and gestational weight gain (aOR = 1.80, 95% CI 1.40-2.30). Paternal pregravid BMI was not independently associated with LGA or SGA. CONCLUSION: Paternal BMI prior to conception is associated with infant birthweight but only modestly so, in contrast to the dominant impact of maternal weight.

The Pregravid Vascular Risk Factor Profile of Low-Risk Women Who Develop Pregnancy Outcomes That Predict Future Cardiovascular Disease.

Background: Women with a history of certain adverse outcomes in pregnancy (preterm birth, delivery of a small-for-gestational age [SGA] infant, preeclampsia, and gestational diabetes mellitus [GDM]) have an elevated lifetime prevalence of metabolic syndrome (MetS) and cardiovascular disease, compared with their peers. However, it is not known if MetS precedes the index pregnancy in young, nulliparous women who experience these antepartum outcomes. Thus, we sought to evaluate the relationship between pregravid cardiovascular risk factor profile and these pregnancy outcomes in low-risk women. Methods: In this prospective preconception cohort study, 1183 newly married women underwent systematic assessment of cardiovascular risk factors (anthropometry, blood pressure, lipids, glucose) at median 24.7 weeks before pregnancy, whereupon they were followed for the outcomes of preterm birth, SGA delivery, preeclampsia, and GDM. Results: Women who had pregravid MetS (harmonized definition) (n = 49) were more likely to have a Caesarean delivery than their peers (61.4% vs. 38.6%, p = 0.003). However, they did not have a higher incidence of preterm delivery, SGA, preeclampsia, or GDM. Similarly, women who had at least one of these adverse pregnancy outcomes (n = 141) did not have a higher prevalence of MetS or any of its component disorders before pregnancy. Indeed, before pregnancy, there were no significant differences between these women and their peers in waist circumference, body mass index, blood pressure, fasting glucose, triglycerides, low-density-lipoprotein, or high-density-lipoprotein cholesterol. Conclusions: The adverse cardiovascular risk factor profile that is seen in women with a history of preterm birth, SGA, preeclampsia, or GDM does not necessarily manifest before their pregnancy.

Fluorescent nanocomposites based on gold nanoclusters for metal ion detection and white light emitting diodes.

Gold nanoclusters (AuNCs) are among the most promising organic-inorganic hybrid luminescent materials for various applications. The current development of AuNCs majorly focuses on controlling their luminescence properties. Herein, we report a new strategy to facilely construct two different nanocomposites featuring enhanced photoluminescence based on mercaptopropionic acid-protected AuNCs (MPA-AuNCs). Through co-assembly with Zn2+ and 2-methylimidazole (2M-IM), the weak luminescence of MPA-AuNCs evolved into either intense blue-green or orange emission at different concentration ratios of additives. HR-TEM and spectroscopic characterization studies revealed that the intense blue-green emission was ascribed to the formation of ZnS quantum dots (QDs) on the outer surface of AuNCs (AuNCs@ZnS), while the strong orange emission originated from the primitive MPA-AuNC core encapsulated by a cubic ZIF-8 shell (AuNCs@ZIF-8). The AuNCs@ZnS nanocomposite was further applied as an exceptional chemical sensor for selective detection of Pb2+ and Fe3+via different quenching mechanisms, and the AuNCs@ZIF-8 composite was applied for fabricating light-converting devices. The co-assembly of AuNCs with Zn2+ and imidazole derivatives provides a facile strategy for acquiring differentiated nanomaterials that have versatile potential applications in chemical detection and light-converting devices.

Towards a neural model of creative evaluation in advertising: an electrophysiological study.

Although it is increasingly recognized that evaluation is a key phase for a two-fold creativity model, the neural model is not yet well understood. To this end, we constructed a theoretical model of creative evaluation and supported it with neural evidence through event-related potentials (ERPs) technology during a creative advertising task. Participants were required to evaluate the relationship between target words and advertising that systematically varied in novelty and usefulness. The ERPs results showed that (a) the novelty-usefulness and novelty-only conditions evoked a larger N1-P2 amplitude, reflecting an automatic attentional bias to novelty, and (b) these two novelty conditions elicited a larger N200-500 amplitude, reflecting an effort to process the novel content; (c) the novelty-usefulness and usefulness-only conditions induced a larger LPC amplitude, reflecting that valuable associations were formed through retrieval of relevant memories. These results propose a neural model of creative evaluation in advertising: the N1-P2, N200-500, and LPC should be the key indices to define three sub-processes of novelty perception, conception expansion, and value selection, respectively.

Pregnancy complications among nulliparous and multiparous women with advanced maternal age: a community-based prospective cohort study in China.

BACKGROUND: This study aimed to evaluate the incidence rates and risks of pregnancy complications among nulliparous and multiparous women with advanced maternal age (AMA, ≥35 years) in China. METHODS: We performed a community-based prospective cohort study of 10,171 pregnant women in selected two sub-districts and 11 towns of Liuyang from 2013 to 2015. All subjects were followed up from the first prenatal care (at ≤12 weeks) to delivery, and risks of pregnancy complications were compared by parity and maternal age groups. RESULTS: Among nulliparas, women with AMA showed significantly increased risks for gestational hypertension (OR 8.44, 95%CI 1.68-2.88), preeclampsia/eclampsia (OR 9.92, 95%CI 4.87-18.78), premature rupture of membrane (OR 6.84, 95%CI 2.00-17.69), as compared to women in the 20-29-year age group. Among multiparas with AMA, increased risks were found for gestational diabetes mellitus (OR 3.29, 95%CI 1.76-5.94), anemia (OR 1.85, 95%CI 1.25-2.69), polyhydramnios (OR 3.29, 95%CI 1.56-6.64), premature rupture of membrane (OR 5.14, 95%CI 2.12-12.29), and preterm labor (OR 1.89, 95CI 1.42-2.50). CONCLUSIONS: Women with AMA were associated with increased risks of pregnancy complications, and complications with increased risks differed in nulliparas and multiparas. Women with AMA should be identified as a high-risk group in clinical practice.

Event-related potentials support a dual process account of the Embedded Chinese Character Task.

Tests of the principles of dual process theory are typically conducted in the reasoning and judgement/decision-making literature. The present study explores dual process explanations with a new paradigm - the Embedded Chinese Character Task (ECCT). The beauty of this task is that it allows the contrast of automatic and deliberate processes without the potential for conflict. We used event-related potentials (ERPs) and behavioral measures to investigate the time course of automatic (Type 1) and deliberative (Type 2) processes on the ECCT. Thus we explored whether there were differences in processing speed in neural activation. The ECCT requires the extraction of one Chinese character from another, which requires either an automatic strategy reliant on knowledge of Chinese character formation and meaning (based on the radical), or a deliberative strategy using the shape of the components of the character (based on the stroke). Participants judged whether character elements were included or excluded in test characters. Faster response time were observed when judging 'inclusion relations' on automatic problems supporting the proposal that they required a Type 1 process. In line with the behavioral results, the hypothesized faster automatic process showed the rapid differentiation of N2 and P3b components between inclusion and exclusion responses, while no difference was shown for deliberative problems. Thus, neural differences in processing were shown between automatic and deliberate problems, and automatic processing was faster than deliberate processing.

Stable radio frequency dissemination via a 1007 km fiber link based on a high-performance phase lock loop.

In this paper, we propose an active-compensation stable radio frequency (RF) transmission scheme based on a high-performance phase lock loop (PLL). In our PLL, a new structure for phase-detection is designed with only one standard RF signal to obtain a simple structure with no interference from other signals. In addition, different optical wavelengths carrying the same RF signal are utilized in the two directions to suppress Rayleigh scattering. The low phase noise homemade bi-directional erbium doped fiber amplifier (EDFA) module is used to reduce signal-to-noise ratio (SNR) deterioration. Hence, the transmission distance is greatly improved. The effects of polarization mode dispersion and phase noise produced by the EDFA on the transmission distance are discussed. Ultimately, a stable RF signal with 2.4 GHz transmitted over a 1007 km fiber link is obtained. The experimental results demonstrate that frequency instabilities of 1.2×10- 13 at 1s and 5.1×10- 16 at 20000s. Therefore, the system can be used for atomic clocks comparisons and provides frequency standard for time transfer systems over a long-haul fiber.

Exploring the Experience of Novelty When Viewing Creative Adverts: An ERP Study.

The electrophysiological correlates of experiencing novelty in creative advertising were studied in 28 healthy subjects using event-related potentials. Participants viewed images that were difficult to interpret until a description was presented providing either a creative description (CD) featuring an unexpected description of the image based on the original advertisement, or a normal description (ND), which was a literal description of the image (and served as a baseline condition). Participants evaluated the level of creativity of the description. The results showed that the N2 amplitude was higher for CDs than for NDs across middle and right scalp regions between 240 and 270 ms, most likely reflecting conflict detection. Moreover, CDs demonstrated greater N400 than NDs in a time window between 380 and 500 ms, it is argued that this reflects semantic integration. The present study investigates the electrophysiological correlates of experiencing novelty in advertising with ecologically valid stimuli. This substantially extends the findings of earlier laboratory studies with more artificial stimuli.

Exposure to firework chemicals from production factories in pregnant women and risk of preterm birth occurrence in Liuyang, China.

In the production of fireworks, various pollutants including particles of metals and organic compounds are released into the environment. Although the adverse effects of these air pollutants are known, the impact on pregnant women residing in this area remains to be determined. The aim of this study was to examine the association between maternal exposure to fireworks production chemicals and frequency of preterm birth in Liuyang, China. Maternal exposure to fireworks production was estimated at the residential district level and assessed using factory density, which was defined as the number of fireworks factories per 1000 residents in each district. The association of maternal exposure to particulates released from fireworks production plants with frequency of preterm birth was determined using data obtained from a cohort study conducted in Liuyang, China. Data were analyzed utilizing linear regression and logistic regression. There was no significant association between factory density and spontaneous preterm or medically induced preterm birth. Unexpectedly, pregnant women residing in areas with higher density of fireworks factories were at a reduced risk of preterm premature rupture of membranes (PPROM). Data demonstrated that residential density of fireworks factories appeared to be negatively correlated with preterm birth rate as evidenced by PPROM. At present, it is difficult to reconcile the inverse relationship between firework chemical exposure and frequency of preterm births as ambient particulate inhalation is known to adversely affect preterm birth occurrence.

Association of Timing of Weight Gain in Pregnancy With Infant Birth Weight.

Importance: Gestational weight gain is a determinant of infant birth weight, but it is unclear whether its timing in pregnancy may hold implications in this regard. Previous studies have yielded conflicting findings on the association of maternal weight gain in early pregnancy with birth weight. However, as these studies have typically recruited women during the first trimester, they are inherently limited by a reliance on self-reported pregravid weight. Objective: To evaluate the associations of directly measured maternal pregravid weight and the timing of subsequent weight gain across pregnancy with infant birth weight. Design, Setting, and Participants: In this prospective, preconception, observational cohort study, 1164 newly married women in Liuyang, China, underwent pregravid evaluation at a median of 19.9 weeks before a singleton pregnancy during which they underwent serial weight measurements. The study was conducted from February 1, 2009, to November 4, 2015. Data analysis was performed between September 1, 2016, and May 6, 2017. Exposure: Maternal weight gain was calculated for the following 10 gestational intervals: from pregravid to less than 14, 14 to 18, 19 to 23, 24 to 28, 29 to 30, 31 to 32, 33 to 34, 35 to 36, 37 to 38, and 39 to 40 weeks. Main Outcomes and Measures: Associations of pregravid weight and weight gain within each of the 10 gestational intervals with the outcome of infant birth weight. Results: The mean (SD) age of the 1164 women included in the study was 25.3 (3.1) years. Pregravid weight was consistently associated with infant birth weight. However, among the 10 gestational intervals, only weight gain from pregravid to 14 weeks and from 14 to 18 weeks was associated with birth weight. Birth weight increased by 13.6 g/kg (95% CI, 3.2-24.1 g/kg) of maternal weight gain from pregravid to 14 weeks and by 26.1 g/kg (95% CI, 3.8-48.4 g/kg) of maternal weight gain from 14 to 18 weeks. Conclusion and Relevance: Maternal weight only in the first half of gestation is a determinant of infant birth weight. Before pregnancy and early gestation may be a critical window for intervention to affect subsequent birth weight.

Transforming growth factor beta 1 related gene polymorphisms in gestational hypertension and preeclampsia: A case-control candidate gene association study.

OBJECTIVES: To investigate the association between transforming growth factor beta 1 related gene polymorphisms and the occurrence of pregnancy induced hypertension, including gestational hypertension and preeclampsia. STUDY DESIGN: This is a case control candidate gene association study. A total of 130 patients with preeclampsia, 67 with gestational hypertension, and 316 controls were recruited. Eleven candidate SNPs of were examined, including four TGFß1 SNPs (rs1800469, rs4803455, rs4803457, and rs8179181), one TGFßR1 SNP (rs10739778), four TGFßR2 SNPs (rs1346907, rs3087465, rs6550005, and rs877572), and two ENG SNPs (rs10121110 and rs11792480). MAIN OUTCOME MEASURES: Logistic regression was used to estimate the OR and the 95% CI under different genetic models. Chi-square test was used to determine whether haplotype frequency distributions differed between the case and control groups and logistic regression was used to estimate ORs. To explore the associations between SNPs and blood pressure, SBP/DBP in different genotype groups in healthy women were compared by Wilcoxon rank sum test. RESULTS: We did not find significant association between investigated SNPs and pregnancy induced hypertension. The C-T-A-G haplotype of four TGFßR2 SNPs (rs877572, rs1346907, rs3087465, and rs6550005) was significantly associated with preeclampsia (OR = 4.71, 95%CI: 1.944, 11.409) and gestational hypertension (OR = 3.157, 95%CI: 1.003, 9.938). The AA genotype of TGFßR1 rs10739778 was found to be associated with higher blood pressure in healthy women (p ≤ .008). CONCLUSIONS: Polymorphisms in TGFßR2 might participate in the pathologic process of pregnancy induced hypertension, and TGFßR1 rs10739778 was associated with blood pressure in our healthy participants.

Trajectory of blood pressure change during pregnancy and the role of pre-gravid blood pressure: a functional data analysis approach.

The study aims to examine the blood pressure (BP) trajectory during pregnancy and its association with pre-gravid BP level. In a pre-conception cohort study, newly-married women in Liuyang, China underwent pre-gravid measurements and were followed throughout the pregnancy. BP was measured at pre-conception and again throughout pregnancy. The functional principal component analysis was used to examine the trajectory of BP changes during pregnancy. A total of 1282 women with a singleton pregnancy who had both pre-conception and gestational BP measurements performed were included in the final analysis. The results showed that BP decreased significantly in early pregnancy and increased thereafter, without BP drop around 20 weeks of gestation. Pre-gravid BP level was inversely associated with the BP drop in early pregnancy, such that women with higher pre-gravid BP had greater BP drop at the beginning, while women with the lowest pre-gravid BP level demonstrated no obvious BP drop throughout the entire pregnancy.

Perinatal outcomes and congenital heart defect prognosis in 53313 non-selected perinatal infants.

OBJECTIVE: To evaluate perinatal outcomes and congenital heart defect (CHD) prognosis in a non-selected population. METHODS: The population-based surveillance data used in this assessment of CHDs were based on birth defect surveillance data collected from 2010-2012 in Liuyang City, China. Infants living with CHDs were followed up for 5 years to determine their prognosis. Prevalence, prenatal diagnosis, perinatal outcomes, and total and type-specific prognosis data were assessed using SPSS 18.0. RESULTS: In total, 190 CHD cases were identified among the 53313 included perinatal infants (PIs), indicating a CHD prevalence of 35.64 per 10000 PIs in this non-selected population. The five most frequently identified types of CHDs were ventricular septal defects (VSDs, 38.95%), atrial septal defects (ASDs, 15.79%), cardiomegaly (7.89%), tetralogy of Fallot (TOF, 5.79%), and atrioventricular septal defects (AVSDs, 5.26%). Of the 190 CHD cases, 110 (57.89%) were diagnosed prenatally, 30 (15.79%) were diagnosed with associated malformations, and 69 (36.32%) resulted in termination of pregnancy (TOP). Moreover, 15 (7.89%) PIs died within 7 days after delivery, and 42 (22.10%) died within 1 year. In contrast, 79 (41.58%) were still alive after 5 years. When TOP cases were included, the 5-year survival rate of PIs with prenatally detected CHDs was lower than that of PIs with postnatally detected CHDs (25.45% vs. 63.75%). The CHD subtype associated with the highest rate of infant (less than 1 year old) mortality was transposition of the great arteries (100%). The subtypes associated with higher 5-year survival rates were patent ductus arteriosus (80%), ASD (63.33%), VSD (52.70%) and AVSD (50%). CONCLUSIONS: The rates of prenatal CHD detection and TOP were high in this study population, and the 5-year survival rate of PIs with CHDs was low. The government should strengthen efforts to educate pediatricians regarding this issue and provide financial assistance to improve the prognosis of infants living with CHDs, especially during the first year of life.