Background:Antenatal corticosteroids(ACS)can significantly improve the outcomes of preterm infants.This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units...Background:Antenatal corticosteroids(ACS)can significantly improve the outcomes of preterm infants.This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units(NICU)and to explore perinatal factors associated with ACS use,using the largest contemporary cohort of very preterm infants in China.Methods:This cross-sectional study enrolled all infants born at 24^(+0)to 31^(+6)weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st,2019 to December 30th,2019.The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery.Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage.Results:A total of 7828 infants were enrolled,among which 6103(78.0%)infants received ACS.ACS use rates increased with increasing gestational age(GA),from 177/259(68.3%)at 24 to 25 weeks’gestation to 3120/3960(78.8%)at 30 to 31 weeks’gestation.Among infants exposed to ACS,2999 of 6103(49.1%)infants received a single complete course,and 33.4%(2039/6103)infants received a partial course.ACS use rates varied from 30.2%to 100%among different hospitals.Multivariate regression showed that increasing GA,born in hospital(inborn),increasing maternal age,maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS.Conclusions:The use rate of ACS remained low for infants at 24 to 31 weeks’gestation admitted to Chinese NICUs,with fewer infants receiving a complete course.The use rates varied significantly among different hospitals.Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.展开更多
Being born with nonoptimal birth characteristics decreases the chance of becoming a father. Urogenital malformations as well as metabolic syndrome are more common in men born small for gestational age （SGA） and coul...Being born with nonoptimal birth characteristics decreases the chance of becoming a father. Urogenital malformations as well as metabolic syndrome are more common in men born small for gestational age （SGA） and could be contributing factors to the reduced fertility rate seen in these men. It could imply that men becoming fathers by assisted reproductive technology （ART） more often are born with low birth weight （LBW）, preterm, and/or SGA than men conceiving without treatment and also that men where intracytoplasmic sperm injection （ICSI） had to be performed more often are born with nonoptimal birth characteristics than men where conventional in vitro fertilization （IVF） successfully could be used. In this retrospective, case-control study using Swedish national registers, we compared the birth characteristics of 1206 men who have become fathers by ART with a control group consisting of age-matched men who became fathers without treatment. The differences in birth characteristics between men becoming fathers by IVF and ICSI were also assessed. For men becoming fathers by ART, OR of being born with LBW was 1.66 （95% CI = 1.17-2.36） compared with fathers who conceived without treatment. OR of being born prematurely was 1.32 （95% CI = 1.00-1.77）. Men becoming fathers via ICSI had a doubled increased likelihood of being born SGA compared with men who became fathers via IVF （OR = 2.12; 95% CI = 1.17-3.83）. In conclusion, we have found that men becoming fathers by ICSI treatments had more often been born SGA than men becoming fathers by conventional IVF.展开更多
The epidemiological associations between the prenatal perfluoroalkyl substances(PFASs)exposure and the reproductive outcomes remain controversial.A continuous evaluation is needed to combine the inconsistent results.I...The epidemiological associations between the prenatal perfluoroalkyl substances(PFASs)exposure and the reproductive outcomes remain controversial.A continuous evaluation is needed to combine the inconsistent results.In this study,we explored the associations between PFASs exposure and the low birth weight(LBW),preterm birth and small for gestational age(SGA).The quality of selected literature,quantitative estimates,publication bias and subgroup analysis were performed on the basis of 17 retrieved articles published before December 2020.The results showed a significant positive association between the perfluorooctane sulfonate(PFOS)exposure and the risk of LBW[Odds ratio(OR)=1.17;95%confidence interval(CI):1.01,1.36;heterogeneity:P=0.30,I2=17%].The positive association was also observed between the PFOS and the risk of preterm birth(OR=1.19;95%CI:1.01,1.39,P=0.007;I2=62%).There was a paucity of evidence regarding the negative effects of perfluorooctanoic acid(PFOA),perfluorohexanesulfonic acid(PFHxS)and perfluorononanoic acid(PFNA)on the pregnancy outcomes.The findings from the subgroup analysis(the sampling period,the birth gender and biologic specimens)did not substantially altered the results of the overall pooled estimate ORs.The increased prevalence of negative birth outcomes with gestational PFASs exposure warrants further explorations from biological process perspective.展开更多
Background Previous studies investigated the association between gestational anemia and neonatal outcomes.However,few studies explored whether the effects of gestational anemia could be eliminated by subsequent correc...Background Previous studies investigated the association between gestational anemia and neonatal outcomes.However,few studies explored whether the effects of gestational anemia could be eliminated by subsequent correction of anemia in the later stages of pregnancy.This study aimed to investigate the relationship between anemia in different trimesters and neonatal outcomes.Methods The study was conducted in Shanghai,China,with a sample of 46,578 pregnant women who delivered between January 1,2016 and July 1,2019.A multivariable logistic regression model was adopted to analyse the associations between maternal anemia and neonatal outcomes.Results The incidence of gestational anemia was 30.2%,including 4.4%in the first trimester,9.6%in the second trimester,and 16.2%in the third trimester.Only 24.5%(507/2066)of anemia that occurred in the first trimester and 29.6%(1320/4457)that occurred in the second trimester could be corrected in the later stages of pregnancy.Anemia occurring in the first trimester was associated with small for gestational age[odds ratio(OR)1.46;95%confidence interval(CI)1.20-1.78]and with fetal distress(OR 1.23;95%CI 1.08-1.40).Anemia corrected in the first trimester also was associated with a higher risk of small for gestational age.Conclusions Gestational anemia is a public health problem in China impacting neonatal health.Anemia in pregnancy could be corrected in only about a quarter of the women.Anemia in the first trimester,whether corrected or not,still led to lower birth weight;therefore,the prevention of anemia prior to pregnancy is important.展开更多
基金Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-039A)
文摘Background:Antenatal corticosteroids(ACS)can significantly improve the outcomes of preterm infants.This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units(NICU)and to explore perinatal factors associated with ACS use,using the largest contemporary cohort of very preterm infants in China.Methods:This cross-sectional study enrolled all infants born at 24^(+0)to 31^(+6)weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st,2019 to December 30th,2019.The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery.Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage.Results:A total of 7828 infants were enrolled,among which 6103(78.0%)infants received ACS.ACS use rates increased with increasing gestational age(GA),from 177/259(68.3%)at 24 to 25 weeks’gestation to 3120/3960(78.8%)at 30 to 31 weeks’gestation.Among infants exposed to ACS,2999 of 6103(49.1%)infants received a single complete course,and 33.4%(2039/6103)infants received a partial course.ACS use rates varied from 30.2%to 100%among different hospitals.Multivariate regression showed that increasing GA,born in hospital(inborn),increasing maternal age,maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS.Conclusions:The use rate of ACS remained low for infants at 24 to 31 weeks’gestation admitted to Chinese NICUs,with fewer infants receiving a complete course.The use rates varied significantly among different hospitals.Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.
文摘Being born with nonoptimal birth characteristics decreases the chance of becoming a father. Urogenital malformations as well as metabolic syndrome are more common in men born small for gestational age （SGA） and could be contributing factors to the reduced fertility rate seen in these men. It could imply that men becoming fathers by assisted reproductive technology （ART） more often are born with low birth weight （LBW）, preterm, and/or SGA than men conceiving without treatment and also that men where intracytoplasmic sperm injection （ICSI） had to be performed more often are born with nonoptimal birth characteristics than men where conventional in vitro fertilization （IVF） successfully could be used. In this retrospective, case-control study using Swedish national registers, we compared the birth characteristics of 1206 men who have become fathers by ART with a control group consisting of age-matched men who became fathers without treatment. The differences in birth characteristics between men becoming fathers by IVF and ICSI were also assessed. For men becoming fathers by ART, OR of being born with LBW was 1.66 （95% CI = 1.17-2.36） compared with fathers who conceived without treatment. OR of being born prematurely was 1.32 （95% CI = 1.00-1.77）. Men becoming fathers via ICSI had a doubled increased likelihood of being born SGA compared with men who became fathers via IVF （OR = 2.12; 95% CI = 1.17-3.83）. In conclusion, we have found that men becoming fathers by ICSI treatments had more often been born SGA than men becoming fathers by conventional IVF.
基金National Natural Science Foundation of China(No.22006010)Shanghai Sailing Program,China(No.19YF1400500)。
文摘The epidemiological associations between the prenatal perfluoroalkyl substances(PFASs)exposure and the reproductive outcomes remain controversial.A continuous evaluation is needed to combine the inconsistent results.In this study,we explored the associations between PFASs exposure and the low birth weight(LBW),preterm birth and small for gestational age(SGA).The quality of selected literature,quantitative estimates,publication bias and subgroup analysis were performed on the basis of 17 retrieved articles published before December 2020.The results showed a significant positive association between the perfluorooctane sulfonate(PFOS)exposure and the risk of LBW[Odds ratio(OR)=1.17;95%confidence interval(CI):1.01,1.36;heterogeneity:P=0.30,I2=17%].The positive association was also observed between the PFOS and the risk of preterm birth(OR=1.19;95%CI:1.01,1.39,P=0.007;I2=62%).There was a paucity of evidence regarding the negative effects of perfluorooctanoic acid(PFOA),perfluorohexanesulfonic acid(PFHxS)and perfluorononanoic acid(PFNA)on the pregnancy outcomes.The findings from the subgroup analysis(the sampling period,the birth gender and biologic specimens)did not substantially altered the results of the overall pooled estimate ORs.The increased prevalence of negative birth outcomes with gestational PFASs exposure warrants further explorations from biological process perspective.
基金This work was supported by the Special Fund for the National Key Research and Development Plan Grant(2017YFC1001300)the International Cooperation Project of China and Canada NSFC(81661128010)+2 种基金the Major Program of National Natural Science Foundation of China(81490742)the Natural Science Foundation of China(31571556)Innovative research team of high-level local universities in Shanghai,and Shanghai Municipal Key Clinical Speciality,Shanghai,China.
文摘Background Previous studies investigated the association between gestational anemia and neonatal outcomes.However,few studies explored whether the effects of gestational anemia could be eliminated by subsequent correction of anemia in the later stages of pregnancy.This study aimed to investigate the relationship between anemia in different trimesters and neonatal outcomes.Methods The study was conducted in Shanghai,China,with a sample of 46,578 pregnant women who delivered between January 1,2016 and July 1,2019.A multivariable logistic regression model was adopted to analyse the associations between maternal anemia and neonatal outcomes.Results The incidence of gestational anemia was 30.2%,including 4.4%in the first trimester,9.6%in the second trimester,and 16.2%in the third trimester.Only 24.5%(507/2066)of anemia that occurred in the first trimester and 29.6%(1320/4457)that occurred in the second trimester could be corrected in the later stages of pregnancy.Anemia occurring in the first trimester was associated with small for gestational age[odds ratio(OR)1.46;95%confidence interval(CI)1.20-1.78]and with fetal distress(OR 1.23;95%CI 1.08-1.40).Anemia corrected in the first trimester also was associated with a higher risk of small for gestational age.Conclusions Gestational anemia is a public health problem in China impacting neonatal health.Anemia in pregnancy could be corrected in only about a quarter of the women.Anemia in the first trimester,whether corrected or not,still led to lower birth weight;therefore,the prevention of anemia prior to pregnancy is important.
