Gestational weight gain in Chinese women -- results from a retrospective cohort in Changsha, China

Abstract Background The generalizability of the gestational weight gain (GWG) ranges recommended by the Institute of Medicine (IOM) to Chinese women is disputed. Methods In 2016, 16,780 pregnant women who gave birth to live singletons in Changsha, China, were enrolled. First, subjects with optimal pregnancy outcomes were identified for the GWG percentile distribution description and for comparison to the IOM recommendations. Second, all subjects with optimal GWG according to the IOM body mass index (BMI) cutoffs and those with optimal GWG according to the Asian BMI cutoffs were selected. Pregnancy outcomes were compared between those two groups. Results A total of 13,717 births with optimal pregnancy outcomes were selected to describe the GWG distribution. The height and central position of the GWG distributions determined by the Asian BMI cutoffs differed from those determined by the IOM BMI cutoffs among the overweight and obese groups. The recommended IOM GWG ranges were narrower than and shifted to the left of the observed distributions. In both BMI classification schemes, however, the IOM-recommended ranges were within the middle 70% (Pc 15th–85th) and 50% (Pc 25th–75th) of the observed distribution. A total of 6438 (38.37%) and 6110 (36.41%) women gained optimal GWG, according to the IOM and Asian BMI classifications, respectively. Compared with those with optimal GWG according to IOM BMI cutoffs, women with optimal GWG according to the Asian BMI cutoffs had lower risks of both macrosomia (adjusted OR = 0.79, 95%CI: 0.67–0.94) and large-for-gestational age (adjusted OR = 0.86, 95%CI: 0.76, 0.98). However, no significantly different risks of preterm, low birthweight, small-for-gestational age, pregnancy-induced hypertension, or gestational diabetes were found between them. Conclusions The IOM-recommended GWG ranges are within the middle 70% of the distributions in Chinese women, and pre-pregnancy weight status should be determined by the Asian BMI cut-off points for monitoring and making GWG recommendations to Chinese women

Risk factors of renal dysfunction and their interaction in level-low lead exposure paint workers

Abstract Background To explore the effect of low-level lead exposure on renal dysfunction in paint works, and analyze the interaction between low-level lead exposure and other influence factors of renal dysfunction. Methods Seven hundred forty seven workers from Sany Heavy Industry Company and Xiangjiang Kansai Paint Company who have been exposed to paint were chosen by random cluster sampling. Their blood lead level and Urine β2-micro globulin level (renal dysfunction) were tested,risk factors of renal dysfunction in paint workers and their interactions were analyzed. Results The prevalence of renal dysfunction was 12.37%. Risk factors of renal dysfunction in paint workers mainly included longer working years (OR = 1.699, 95% CI: 1.226~ 2.355), blood lead positive (OR = 2.847, 95% CI: 1.577~ 5.139) and hypertension (OR = 2.192, 95% CI: 1.103~ 4.359). Positive interaction existed between hypertension and low-level blood lead on renal dysfunction in paint workers, the RERI (Relative excess risk of interaction), API (Attributable proportions of interaction) and S(the synergy index) were 4.758, 54.5% and 2.604 respectively. Conclusions Low-level lead exposure and hypertension not only have independent effect on renal dysfunction in paint workers, but also had obvious positive interaction in paint workers. Interventions aimed at blood lead and blood pressure at the same time will better prenvent from renal dysfunction

Additional files 2: of Gestational weight gain in Chinese women -- results from a retrospective cohort in Changsha, China

Table S2. Subgroup analysis of comparison of adverse pregnancy outcome between different gestational weight gain groups in the pre-pregnancy BMI 25–29.9 strata. (DOC 47 kb

Impact of the Three Gorges project on ecological environment changes and snail distribution in Dongting Lake area

<div><p>Background</p><p>The Three Gorges Dam (TGD) is a remarkable, far-reaching project in China. This study was conducted to assess the impact of TGD on changes in the ecological environment, snail distribution and schistosomiasis transmission in Dongting Lake area.</p><p>Methods</p><p>Hydrological data were collected from 12 monitoring sites in Hunan section of Yangtze River before and after TGD was established. Data on snail distribution and human schistosomiasis infection were also collected. Correlation analyses were performed to detect the significance of snail distribution to changes in ecological environmental factors and human schistosomiasis infection.</p><p>Findings</p><p>A series of ecological environmental factors have changed in Dongting Lake area following the operation of TGD. Volume of annual runoff discharged into Dongting Lake declined by 20.85%. Annual sediment volume discharged into the lake and the mean lake sedimentation rate decreased by 73.9% and 32.2%, respectively. From 2003 to 2015, occurrence rate of frames with living snails and mean density of living snails decreased overall by 82.43% and 94.35%, respectively, with annual decrements being 13.49% and 21.29%. Moreover, human infection rate of schistosomiasis had decreased from 3.38% in 2003 to 0.44% in 2015, with a reduction of 86.98%. Correlation analyses showed that mean density of living snails was significantly associated with water level (r = 0.588, <i>p</i><0.001), as well as the mean elevation range of the bottomland (r = 0.374, <i>p</i> = 0.025) and infection rate of schistosomiasis (r = 0.865, <i>p</i><0.001).</p><p>Conclusion</p><p>Ecological environmental changes caused by the TGD were associated with distribution of snails, and might further affect the transmission and prevalence of schistosomiasis. Risk of schistosomiasis transmission still exists in Dongting Lake area and long-term monitoring is required.</p></div

Impact of the Three Gorges project on ecological environment changes and snail distribution in Dongting Lake area - Fig 4

<p>Distribution of snails in bottomlands outside the embankment of Yangtze River in Hunan section (A), in polder ditches inside the protective embankment of Yangtze River (B), and in bottomlands on diversion channels of Yangtze River (C) from 2003 to 2015.</p

Maps of Three Gorges Dam, Yangtze River and Dongting Lake.

<p>Blue arrows represented flow direction of rivers or lakes; Red dots represented diversion channels of Yangtze River, and four tributaries (Xiang, Zi, Yuan and Li rivers) into Dongting Lake; Red circles represented outlets of Dongting Lake into the Yangtze River; Red diamond and surrounding Arabic numeral represented locations of each monitoring site: 1→Songzi estuary, 2→Ouchi (middle branch) estuary, 3→Ouchi (Tuojiang river) estuary, 4→Ouchi (east branch) estuary, 5→Dongting Lake outlet, 6→Water gate of Hongshuigang, 7→Water gate of Tanzikeng, 8→Water gate of Sizhiqu, 9→Water gate of Liuzhiqu, 10→Water gate of Jingjiangmen, 11→Water gate of Bei, 12→Water gate of Aiwei.</p

Letrozole-stimulated endometrial preparation protocol is a superior alternative to hormone replacement treatment for frozen embryo transfer in women with polycystic ovary syndrome, a cohort study

Abstract Background The current routine endometrial preparation protocol for women with polycystic ovary syndrome (PCOS) is hormone replacement treatment (HRT). Letrozole is rarely used in frozen embryo cycles. Evidence confirming whether letrozole-stimulated (LS) protocol is suitable for frozen embryo transfer in patients with PCOS and for whom is suitable remains lacking. Methods This was a retrospective cohort study involving all frozen embryo transfer cycles with LS and HRT for PCOS during the period from Jan 2019 to December 2020 at a tertiary care center. Multivariate Logistic regression was used to analyze the differences in clinical pregnancy rate, live birth rate, miscarriage rate, the incidence of other pregnancy and obstetric outcomes between LS and HRT protocols after adjusting for possible confounding factors. Subgroup analysis was used to explore the population for which LS protocol was suitable. Results The results of multivariate logistic regression showed that LS was significantly associated with a higher clinical pregnancy rate (70.9% vs. 64.4%;aOR:1.41, 95%CI: 1.18,1.68), live birth rate (60.5% vs. 51.4% aOR:1.49, 95%CI: 1.27,1.76), and a lower risk of miscarriage (14.7% vs. 20.1% aOR: 0.68, 95%CI: 0.53,0.89), hypertensive disorders of pregnancy (6.7% vs. 8.9% aOR: 0.63, 95%CI: 0.42,0.95), and gestational diabetes mellitus (16.7% vs. 20.7% aOR:0.71, 95%CI: 0.53,0.93) than HRT. There were no significant differences in other outcomes such as preterm birth, cesarean delivery, small for gestational age, or large for gestational age between the two endometrial preparation protocols. Subgroup analysis showed that LS had higher live birth rates than HRT in most of the subgroups; in the three subgroups of maternal age ≥ 35 years, menstrual cycle < 35 days, and no insulin resistance, the live birth rates of the two endometrial preparation protocols were comparable. Conclusions LS protocol could improve the live birth rate and reduce the incidence of miscarriage, hypertensive disorders of pregnancy and gestational diabetes mellitus in patients with PCOS. LS protocol is suitable for all types of patients with PCOS. LS should be considered the preferred endometrial preparation protocol for women with PCOS

Snail distribution in the monitoring sites of the Yangtze River in Hunan section from 2003 to 2015.

<p>Snail distribution in the monitoring sites of the Yangtze River in Hunan section from 2003 to 2015.</p

Annual runoff volume (10⁸ m³) of Dongting Lake before and after the operation of the Three Gorges Dam.

<p>Three outlets represented Songzi, Taipin, and Ouchi. Four tributaries represented Xiang, Zi, Yuan and Li rivers.</p

Human schistosomiasis infection in Hunan province from 2003 to 2015.

<p>Human schistosomiasis infection in Hunan province from 2003 to 2015.</p