Association between Pre-pregnancy Body Mass Index and Offspring Neuropsychological Development from 1 to 24 Months of Age: A Birth Cohort Study in China

Objective To explore the interactions between pre-pregnancy body mass index(BMI) and age on offspring neuropsychological development from 1 to 24 months in China.Methods In this birth cohort study, a total of 2,253 mother-child pairs were enrolled in Tianjin, China,between July 2015 and May 2018. The China Developmental Scale for Children was used to assess developmental quotient(DQ) of children aged from 1 to 24 months.Results Mixed-models analysis revealed significant age × pre-pregnancy BMI interactions for total DQ and five neurobehavioral domains(gross motor, fine motor, adaptive, language, and social;P < 0.001).Age × pre-pregnancy BMI ≥ 25 kg/m^2 was associated with a negative effect on total DQ and five neurobehavioral domains, as compared to pre-pregnancy BMI < 25 kg/m^2(P < 0.01). Multiple comparisons showed pre-pregnancy BMI ≥ 25 kg/m^2 of mothers had a positive effect on child total DQ at the age of 1 month but a negative effect at 24 months(P < 0.05).Conclusions This study supported the age × pre-pregnancy BMI interaction on offspring neuropsychological development. It also revealed a short-term positive impact of high pre-pregnancy BMI on neuropsychological development at 1 month of age, but a long-term negative effect(from 1 to24 months).

Effect of 7 and 13-Valent Pneumococcal Conjugate Vaccines Different Number of Doses for Pneumonia Control in 2008 and 2010 Birth Cohort Children

The 7-valent pneumococcal conjugate vaccine (PCV) was introduced in Uruguay in March 2008. In April 2010, it was replaced by PCV13. Surveillance of both vaccines was performed on hospitalized children with consolidated pneumonia. The effect of different number of vaccine doses was evaluated in 2008 and 2010 birth cohorts vaccinated with PCV7 and PCV13 respectively. The study aims to estimate the effects of PCV7 and PCV13 different number of doses on consolidated pneumonia, through the study of hospitalized children from 2008 and 2010 birth cohorts. Vaccination records of every child were available providing precise vaccination data;therefore a new approach was used to estimate PCVs effect. Incidence rate was calculated for each year of the study and for the different number of vaccine doses used each year. Exposure was calculated as person per year and rate ratio values determined the decrease of consolidated pneumonias. This decrease in percentage was estimated as the difference between the incidence with no vaccine and the incidence of every one of the doses. Incidence rate ratio revealed significant values for the three vaccine doses of PCVs for both cohorts. Upon comparing incidences, significant reduction percentages of consolidated pneumonia admissions were found. The reduction percentage of consolidated pneumonia for fully vaccinated (3 doses) patients was 69.3% and 84.6 % for PCV7 and PCV13, respectively. These results confirm that PCV7 and PCV13 are highly effective for reducing pediatric hospitalizations due to consolidated pneumonia, as reported by other national publications and demonstrated by international researchers.

Associations of prenatal exposure to bisphenols with BMI growth trajectories in offspring within the first two years:evidence from a birth cohort study in China

Background Prenatal bisphenol exposure has been reported to be associated with lower birth weight and obesity-related indicators in early childhood.These findings warrant an investigation of the relationship between prenatal bisphenol exposure and the dynamic growth of offspring.This study aimed to evaluate the relationship of maternal bisphenol concentration in urine with the body mass index(BMI)growth trajectory of children aged up to two years and to identify the critical exposure periods.Methods A total of 826 mother–offspring pairs were recruited from Wuhan Children’s Hospital between November 2013 and March 2015.Maternal urine samples collected during the first,second,and third trimesters were analyzed for bisphenol A(BPA),bisphenol S,and bisphenol F(BPF)concentrations.Measurements of length and weight were taken at 0,1,3,6,8,12,18,and 24 months.Children's BMI was standardized using the World Health Organization reference,and group-based trajectory modeling was used to identify BMI growth trajectories.The associations between prenatal bisphenol exposure and BMI growth trajectory patterns were assessed using multinomial logistic regression models.Results The BMI growth trajectories of the 826 children were categorized into four patterns:low-stable(n=134,16.2%),low-increasing(n=142,17.2%),moderate-stable(n=350,42.4%),and moderate-increasing(n=200,24.2%).After adjusting for potential confounders,we observed that prenatal exposure to BPA during the second trimester[odds ratio(OR)=2.20,95%confidence interval(CI)=1.09–4.43]and BPF during the third trimester(OR=3.28,95%CI=1.55–6.95)at the highest quartile concentration were associated with an increased likelihood of the low-increasing BMI trajectory.Furthermore,in the subgroup analysis by infant sex,the positive association between the highest quartile of prenatal average urinary BPF concentration during the whole pregnancy and the low-increasing BMI trajectory was found only in girls(OR=2.82,95%CI=1.04–7.68).Conclusion Our study findings suggest that prenatal exposure to BPA and BPF(a commonly used substitute for BPA)is associated with BMI growth trajectories in offspring during the first two years,increasing the likelihood of the low-increasing pattern.

Family socioeconomic position and abnormal birth weight:evidence from a Chinese birth cohort

Background Birth weight is a strong determinant of infant short-and long-term health outcomes.Family socioeconomic position(SEP)is usually positively associated with birth weight.Whether this association extends to abnormal birth weight or there exists potential mediator is unclear.Methods We analyzed data from 14,984 mother-infant dyads from the Born in Guangzhou Cohort Study.We used multi-variable logistic regression to assess the associations of a composite family SEP score quartile with macrosomia and low birth weight(LBW),and examined the potential mediation effect of maternal pre-pregnancy body mass index(BMI)using causal mediation analysis.Results The prevalence of macrosomia and LBW was 2.62%(n=392)and 4.26%(n=638).Higher family SEP was associated with a higher risk of macrosomia(OR 1.30,95%CI 0.93-1.82;OR 1.53,95%CI 1.11-2.11;and OR 1.59,95%CI 1.15-2.20 for the 2nd,3rd,and 4th SEP quartile respectively)and a lower risk of LBW(OR 0.69,95%CI 0.55-0.86;OR 0.76,95%CI 0.61-0.94;and OR 0.61,95%CI 0.48-0.77 for the 2nd,3rd,and 4th SEP quartile respectively),compared to the 1st SEP quartile.We found that pre-pregnancy BMI did not mediate the associations of SEP with macrosomia and LBW.Conclusions Socioeconomic disparities in fetal macrosomia and LBW exist in Southern China.Whether the results can be applied to other populations should be further investigated.

Assessing the Effectiveness of Strategies in US Birth Cohort Screening for Hepatitis C Infection

Chronic hepatitis C infection in the USA is a highly morbid condition and current guidelines recommend one-time screening among the birth cohort(1945-1965).Understand-ing strategies to optimize screening can help inform future hepatitis C virus(HCV)screening guidelines.A focused literature search was performed using PubMed and manual abstract review from major hepatology conferences over the past 2 years.The search strategy involved using Medical Subject Headings terms for hepatitis C,screening,birth cohort,baby boomers,and 1945-1965.The review was limited to data from the USA.A total of 327 articles were identified and 36 abstracts were included,with studies published between 2012-2019.Strategies including clinician education,electronic medical record alerts,reflex HCV RNA testing,point-of-care testing,multisite(outpatient,inpatient,emergency department,endoscopy suite)initiatives,direct patient solicitation,and utilization of non-physician providers have increased HCV screening rates.However,broad imple-mentation remains less than optimal.Barriers include lack of patient acceptance to screening and engagement in the HCV care cascade.The Veterans Affairs Healthcare System has achieved higher birth cohort screening rates through an integrated approach requiring high-level engagement by leadership and institutional commitment.Multiple strategies for increasing birth cohort screening have been successful,but overall rates of HCV screening remain low.These strat-egies can inform public health efforts to implement emerging national recommendations for expansion of HCV screening to all U.S.adults age 18 or older.

教育对缓解多维相对贫困的影响——基于高校扩招自然实验的证据

在以多维性为贫困重要属性的后脱贫时代,高等教育减贫相较于其他扶贫方式具有显著优势,因此有必要对高等教育减贫效果进行评估。本文基于2018年中国家庭追踪调查数据,利用各省扩招政策强度差异和样本出生队列信息构造双重差分模型,考察高校扩招对个体陷入多维相对贫困概率的影响。研究发现,高等教育减贫的效果显著,高校扩招后直接受到政策影响的队列陷入多维相对贫困的概率降低17.6%。在改变关键变量度量方式后,研究结果显示高等教育减贫效果依然稳健。高校扩招过程中为个体提供的高等教育机会提高了个体的非认知能力、非农就业的概率和社会资本,从而降低个体陷入多维相对贫困的概率。但是,高校扩招的减贫效应在不同群体之间存在差异,高校扩招对非农村人口、女性、父辈教育水平高的人群的减贫效应更大。因此,需更加注重不同群体在获得高质量高等教育方面的公平,以更好地发挥高等教育的减贫效应。

“上海亲子队列”平台及其在临床研究应用中的思考

心理健康、行为生活方式及环境质量改变是社会经济飞速发展的突出性衍生问题,亟需通过出生队列长期研究,关注物质及社会环境因素对超大城市人群健康的影响,寻找新时期疾病的发病规律和危险因素。“上海亲子队列”采用“社区+产科医院+学校”的全方位精细随访方式,对6714对母婴进行了孕早-中-晚期、分娩期及子代从出生到6岁期间的13次随访,建成了含标准化问卷、母儿疾病诊断、儿童体格生长、体成分、脊柱弯曲异常、肤纹、握力、身体活动量、认知能力及语言发育水平测试和临床诊疗档案等百万条数据的随访信息数据库;以及包括外周血、脐带血、指尖血、胎粪、胎盘、尿液、粪便、颊黏膜、头发、指甲等17类60万份标本的生物样本库;并形成了21份标准化操作程序操作程序(SOP)文件,对样本采集、冷链运输、分装入库、出库、回库等进行样本库全流程管理和质控。该队列平台不仅为揭示生命早期环境暴露对人群健康影响及多组学研究提供了重要资源支撑,也推动了多学科交叉创新成果。

关注环境、立足疾病的大型出生队列研究平台

基于健康与疾病的发展起源学说,上海交通大学医学院附属新华医院启动了生命早期疾病与健康的大型科学研究——“上海优生队列”和“千天计划”,利用专业的知识和视角,聚焦生命早期1000天,关注母亲孕期和宝宝出生后的健康、社会及理化环境、营养等多方面环境因素,为发育源性疾病的预防和治疗提供研究依据。

膳食大蒜摄入与早产风险的相关性研究

目的 探析膳食大蒜摄入与早产风险之间的相关性。方法 2010—2012年甘肃省妇幼保健院出生队列研究,共纳入9 710例符合纳入标准的孕妇,调查一般人口学特征、围孕期大蒜摄入情况及其胎儿分娩时的信息。使用多因素Logistic回归模型来分析膳食中大蒜摄入与早产的关系。结果 生蒜的摄入可降低早产风险,且具有剂量依赖性(总体:OR=0.81,95%CI:0.69~0.96;孕前:OR=0.81,95%CI:0.68~0.95;<2次/周:OR=0.81,95%CI:0.69~0.97,≥2次/周:OR=0.79,95%CI:0.64~0.97;P_(trend)=0.03;孕期:OR=0.82,95%CI:0.70~0.96;<2次/周:OR=0.83,95%CI:0.71~0.98,≥2次/周:OR=0.79,95%CI:0.65~0.97;P_(trend)=0.03),尤其是与非胎膜早破型早产呈显著负相关(总体:OR=0.67,95%CI:0.53~0.85;孕前:OR=0.69,95%CI:0.55~0.88;孕期:OR=0.68,95%CI:0.55~0.85),而与医源性早产和胎膜早破型早产无显著关联。结论 膳食生蒜摄入可降低早产风险,尤其是非胎膜早破型早产,且呈明显剂量依赖性。

2016—2022年武汉市0~6岁儿童出生队列DTaP-IPV/Hib联合疫苗接种情况动态分析

目的:分析2016—2022年武汉市0~6岁儿童无细胞百白破疫苗、脊髓灰质炎灭活疫苗、b型流感嗜血杆菌疫苗联合疫苗(DTaP-IPV/Hib联合疫苗,简称五联疫苗)的接种情况和其对脊髓灰质炎疫苗(Poliovirus Vaccine,PV)的替代情况。方法:通过湖北省免疫规划信息系统儿童接种数据建立武汉市2016—2022年0~6岁出生队列,进行五联疫苗接种率和PV替代率的流行病学分析。结果:截至2022年12月31日,武汉市0~6岁儿童出生队列五联疫苗1~4剂累计接种率分别为22.87%、21.46%、20.54%和14.28%,五联疫苗覆盖率在6.94%~34.67%之间。随着出生年份的后移五联疫苗各剂次接种率均呈上升趋势,各出生队列五联疫苗1~4剂接种率逐渐降低。武汉市各辖区之间五联疫苗1~4剂接种率差异较大。五联疫苗1~4剂对PV的替代率分别为25.57%、22.45%、22.80%和14.62%,各剂次替代率随出生年份后移均逐年上升。结论:武汉市五联疫苗接种率呈逐年缓慢上升趋势,但不同辖区间分布不平衡,其对PV的替代率在合理范围,建议通过强化疫苗接种健康宣教、增加政府投入、加强疫苗管理等措施进一步提升五联疫苗全程接种率。

育龄期女性孕前膳食模式与新生儿出生体重的关联性研究

目的 前瞻性地研究中国育龄期女性孕前膳食模式与新生儿出生体重之间的关联。方法 选取在武汉市江岸区妇幼保健院进行孕前优生检查的育龄期女性为研究对象进行问卷调查和随访。使用半定量食物频率问卷收集膳食摄入信息,主成分分析提取膳食模式(dietary patterns, DPs),利用修正的泊松回归或线性回归模型分析DPs和新生儿出生体重之间的关系。结果 最终纳入的221对母婴分析结果表明,在4种膳食模式中,遵循“坚果-禽肉”模式的女性分娩大于胎龄儿(large for gestational age, LGA)的风险较低(RR:0.25;95%CI:0.08~0.79),在男婴中更为明显(RR:0.14,95%CI:0.03~0.72)。结论 以坚果和禽肉为特征的孕前DP降低了分娩LGA的风险,分娩男婴时更为明显。育龄期女性应在怀孕前保持良好的饮食习惯,以保障胎儿正常生长发育,降低不良出生结局的风险。

孕早期血清微量元素水平与胆汁酸代谢及妊娠期糖尿病关联的巢式病例-对照研究

目的 探讨孕早期血清微量元素水平与妊娠期糖尿病(GDM)之间的关联,及胆汁酸代谢变化在其中的介导效应。方法 基于广西壮族人群出生队列,采用巢式病例-对照研究设计,于2015年6月至2019年7月间在南宁市共招募248名孕妇(病例组=124,对照组=124),测定其孕早期血清中8种微量元素浓度和31种胆汁酸水平。采用条件Logistic回归和BKMR模型分析微量元素浓度与GDM风险之间的关联及联合效应;采用正交偏最小二乘法-判别分析(OPLS-DA)筛选与GDM相关的潜在胆汁酸生物标志物,再进一步使用条件Logistic回归确定特定胆汁酸水平与GDM风险之间的关联;使用多重线性回归评估血清微量元素浓度与差异胆汁酸代谢物的关联;通过中介效应分析评估胆汁酸在微量元素暴露与GDM的中介作用。结果 经混杂因素校正后血清钒(V)浓度与GDM的发生风险呈正相关,而铬(Cr)、锰(Mn)、锌(Zn)、硒(Se)和钼(Mo)与GDM的发生风险呈负相关(均P<0.05)。通过OPLS-DA和条件Logistic回归分析发现牛磺胆酸(TCA)、甘氨鹅去氧胆酸硫酸(GCDCA-3S)、甘氨鹅脱氧胆酸-3-O-β-葡糖醛酸(GCDCA-3Gln)、甘氨熊去氧胆酸-3-硫酸(GUDCA-3S)、牛磺脱氧胆酸-3-硫酸(TDCA-3S)以及鹅脱氧胆酸(CDCA)可能是GDM的潜在胆汁酸代谢标志物(均P<0.05);多种微量元素浓度也与特定胆汁酸水平存在显著性关联(均P<0.05)。中介分析表明GCDCA-3Gln、TCA分别介导了血清Zn、Se与GDM风险的关联(均P<0.05)。结论 孕妇孕早期血清V、Cr等多种微量元素与其孕期GDM的发生风险显著相关,且胆汁酸代谢变化可能先于GDM的发生,提示微量元素对孕妇胆汁酸特别是结合型胆汁酸代谢的影响,可能是影响GDM发生风险的机制之一。

Prenatal Environmental Antibiotic Exposure and Autism Spectrum Disorder Symptoms in Children at 3 Years of Age:Findings from the Ma’anshan Birth Cohort Study

ABSTRACT:Antibiotic exposure during pregnancy may affect the neurodevelopment of children,but biomonitoring-based population studies on this class of new pollutants are lacking.We conducted a prospective birth cohort study of 2860 mother−child pairs,measured the urinary concentrations of 41 antibiotics and their two metabolites over three trimesters,and assessed children’s autism spectrum disorder(ASD)symptoms at 3 years of age.We examined the associations between prenatal antibiotic exposure and children’s ASD symptoms.The least absolute shrinkage and selection operator regression screened for Tetracycline and Ofloxacin as important predictors of ASD symptoms.Modified Poisson regression models revealed that maternal Tetracycline exposure throughout pregnancy increased the risk of ASD symptoms(RR:1.66,95%CI:1.14,2.40).Maternal Tetracycline exposure during the first(RR:1.74,95%CI:1.13,2.68)and third trimesters(RR:1.86,95%CI:1.16,3.00)increased the risk of ASD symptoms in boys,and Ofloxacin exposure during the first trimester(RR:1.47,95%CI:1.07,2.02)increased the risk of ASD symptoms in girls.No dose-dependent relationships between prenatal antibiotic exposure and ASD symptoms were validated by restricted cubic splines.Prenatal exposure to Tetracycline and Ofloxacin may increase the risk of ASD symptoms in children,and the first and third trimesters might be the key windows.

2005-2021年荆州市肾综合征出血热发病率的贝叶斯年龄-时期-队列分析

目的分析2005-2021年荆州市肾综合征出血热(HFRS)病例的年龄、时期和出生队列特征。方法自传染病监测系统收集2005-2021年荆州市HFRS发病率数据。采用描述性流行病学方法描述HFRS病例的时期、年龄分布特点。采用Spearman等级相关分析HFRS变化趋势。采用贝叶斯年龄-时期-队列分析分析HFRS发病率的年龄、时期和出生队列效应。所有分析均比较不同性别差异。结果2005-2021年荆州市累计报告HFRS 1407例,年均发病率为1.43/10万。2005-2021年荆州市HFRS发病率总体呈上升趋势(r_(s)=0.94,P=0.000)。相较于2013年,2016年后发病风险均有统计学意义(RR>1,P<0.05)。年龄分布呈倒“V”型,发病高峰出现在60~64岁(4.22/10万)、65~69岁年龄组(4.12/10万)。60~64岁年龄组相较45~49岁年龄组发病风险高(RR=1.63,95%CI:1.07~2.26)。14岁及以下人群随时期构成比在0.00%~6.90%波动,发病率在0.00~0.37/10万波动;60岁及以上人群年均发病率为3.12/10万,构成比为32.62%,构成比随年份呈波动上升趋势,由2005年的13.04%上升至2021年的40.87%。不同性别时期、队列效应一致;男性(4.55/10万)发病率高于女性(1.84/10万),女性60岁及以上HFRS病例构成比(39.39%)高于男性(30.27%)。结论荆州市HFRS疫情呈高发态势,存在明显年龄、时期和出生队列特征。高发年龄以60岁以上为主,需加快该人群HFRS疫苗研发,以保护该人群。

孕妇妊娠期体重增加与新生儿出生体重的相关性

目的:探讨孕妇妊娠期体重增加与新生儿出生体重的关系。方法:选取2019年1月1日—2020年12月31日在我院建立健康档案、定期孕期体检且在本院分娩的5064例孕妇,收集资料包括人口学特征、孕期健康状况和分娩情况等。结果:5064例孕妇中,正常体重者占65.6%,低体重者占17.5%,超重者占13.7%,肥胖者占3.2%;新生儿出生体重<2500 g占0.9%,≥4000 g占5.1%,正常体重儿占94.0%。在调整混杂因素后,孕妇妊娠期体重增加与新生儿出生体重相关(P<0.05)。结论:孕妇妊娠期体重增加与新生儿出生体重有关,且受孕前体质指数的影响。

中国母乳组学队列研究与产业化应用

母乳为婴儿提供个性化、全面、均衡的营养成分以及免疫保护,是0~6月婴儿的最佳营养来源,是婴儿食物的金标准。母乳组学队列研究是全面解析中国母乳组成特征、建立中国婴儿食品规范与标准、制定婴儿营养指南、创制婴儿食品的必要前提。本文介绍了国家母婴乳品健康工程技术研究中心基于中国母婴营养健康出生队列研究(China maternal and infant nutrition health birth cohort study,MINC)的母乳脂质组学、糖组学、蛋白质组学和微生物组等组学检测技术、组成特征、与牛乳的差异及其在婴儿食品中的产业化应用等方面的研究进展,以期为母乳组学队列研究、模拟与产业化应用提供科技支撑与示范。

广西壮族人群出生队列的构建和研究进展

随着我国经济社会的发展和生育政策的改变,社会生态环境不断变化,生命早期不良暴露日益增加,我国孕产妇发生妊娠疾病及新生儿不良出生结局形势依然严峻。多哈理论认为,生命早期发生的不良事件可能会影响成年后各类疾病的发生,这种影响甚至会持续好几代人。出生队列主要是在孕前或孕期招募参与者,对孕产期母亲健康与子代近远期健康结局进行跟踪随访,进而发现影响全生命周期健康结局的多种因素,检验病因假说。目前国内已有不少具有相当规模的出生队列,但其大多数主要面向汉族人群。我国是一个多民族国家,许多疾病的发生具有地域和民族分布特点,壮族是我国人口最多的少数民族,但目前关于壮族人群的大型流行病学调查十分有限,无法系统概括壮族人群和壮族母婴健康特点,提出面向壮族人群不良健康结局的有效防治措施。因此,有必要建立一个以壮族人群为主体的大规模出生队列,系统描绘壮族人群和壮族母婴健康特点,探索生命早期暴露与孕妇及子代近远期健康结局的关系,为有效降低壮族人群不良健康结局的发生风险,提高出生人口素质和促进妇女儿童健康水平提供重要依据。本文系统介绍了广西壮族人群出生队列构建的背景、过程、主要研究进展、创新性以及未来展望。

Association of maternal hypertensive disorders in pregnancy with infant neurodevelopment

Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2 576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score (β, −0.67;95% confidence interval [CI], −1.19-−0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21;95% CI, 1.02-4.79);in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition (β, −0.49;95% CI, −0.96-−0.01), receptive communication (β, −0.55;95% CI, −1.03-−0.06), and gross motor (β, −0.44;95% CI, −0.86-−0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12;95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.

剖宫产史对IVF/ICSI-ET治疗累积活产率的影响

目的:比较既往剖宫产患者与既往阴道分娩患者接受体外受精/卵胞质内单精子注射-胚胎移植(in vitro fertilization/intracytoplasmic sperm injection-embryo transfer,IVF/ICSI-ET)治疗首个取卵周期的临床结局。方法:回顾性分析2015年1月—2020年12月在天津市中心妇产科医院生殖医学中心行首次IVF/ICSI-ET治疗且既往有1次分娩史的患者既往剖宫产史对一次取卵周期累积活产率(cumulative live birth rate,CLBR)的影响。结果:共纳入1216例患者,其中既往剖宫产者605例共1053个移植周期,既往阴道分娩者611例共947个移植周期。2组患者除基础泌乳素与不孕时间外的主要基本特征、促排卵治疗方案、获卵情况、胚胎实验室结局差异均无统计学意义(均P>0.05)。既往剖宫产组单胚胎移植周期、冻融胚胎移植周期比例更高(P<0.05)。既往剖宫产组一次取卵后CLBR为59.00%(95%CI:55.08%~62.92%),既往阴道分娩组一次取卵后CLBR为62.68%(95%CI:58.84%~66.51%),2组比较差异有统计学意义(χ^(2)=13.665,P<0.001)。校正年龄、获卵数、胚胎质量及子宫内膜厚度后,与既往阴道分娩患者相比,既往剖宫产患者一次取卵后CLBR的OR值为0.825(95%CI:0.712~0.956,χ^(2)=6.531,P=0.011)。结论:与既往阴道分娩患者相比,既往剖宫产患者接受IVF/ICSI-ET治疗后,一次取卵周期的CLBR更低。

2006—2020年中国居民胃癌死亡趋势分析——基于年龄-时期-出生队列模型

目的:分析2006—2020年我国城乡居民胃癌死亡趋势,为制定胃癌防治策略提供依据。方法:采用年龄-时期-出生队列模型分析胃癌死亡率的年龄效应、时期效应以及出生队列效应。结果:我国居民胃癌死亡率总体呈下降趋势,年龄效应上死亡风险随年龄增加而上升,时期效应上死亡风险随年份趋近而下降,出生队列效应上死亡风险随出生年份的推迟呈下降趋势。结论:加强健康教育,扩面开展早期筛查,提高低收入患者的大病补偿比例,进一步降低胃癌死亡率。