Air pollution is associated with hepatic dysfunction, but the evidence in the early childhood remains limited. This study aimed to explore the associations between maternal exposure to particulate matter and offspring liver function, as indicated by serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in children aged 1-2 years. Based on the Fujian Birth Cohort Study (FJBCS), a total of 1046 mother-offspring pairs were analyzed in this study. Maternal mean exposures to PM1, PM2.5 and PM10 were calculated for the entire gestational period and each of the three trimesters. Linear regression models were used and restricted cubic spline (RCS) models were further applied to explore the exposure-response relationships. Distributed lag models (DLMs) were conducted to examine the weekly associations throughout pregnancy. Results show that positive associations were found between maternal exposure and offspring enzyme levels in the entire pregnancy as well as the second trimester alone. After adjustment, an interquartile range (IQR) increment in PM1, PM2.5 and PM10 in the second trimester was associated with increases in ALT by 1.42 (0.82-2.03) U/L, 1.41 (0.77-2.05) U/L, 0.91 (0.35-1.46) U/L, and in AST by 1.64 (1.00-2.29) U/L, 1.56 (0.88-2.23) U/L and 0.80 (0.21-1.39) U/L, respectively. DLM analyses further indicated that the associations were the most pronounced during the second trimester. Our findings suggest that maternal exposure to particulate matter is positively associated with increased levels of ALT and AST in offspring, with the second trimester representing a potentially sensitive period.

This prospective birth cohort study, conducted in China with 21 893 singleton pregnant women, aimed to investigate the association between metabolic obesity phenotypes and the risks of gestational hypertension (GH) and preeclampsia (PE), as well as to explore the potential interaction between obesity and metabolic abnormalities in relation to these conditions. Participants were categorized according to their pre-pregnancy BMI and metabolic status into different obesity metabolic phenotypes. The diagnosis of GH and PE was based on blood pressure measurements, evidence of end-organ dysfunction, or proteinuria occurring after 20 weeks of gestation. The results indicated that, compared to metabolically healthy normal-weight women, those with metabolically unhealthy normal weight, metabolically healthy overweight/obesity, and metabolically unhealthy overweight/obesity all had significantly elevated risks for both GH (with adjusted odds ratios ranging from 1.77 to 3.89) and PE (adjusted ORs from 1.58 to 4.51). In contrast, metabolically healthy underweight women were found to have a lower risk of GH. Furthermore, an additive interaction was observed between overweight and metabolic unhealthiness, which increased the risk of GH by 1.15 times, representing a 28% relative excess risk. The combined risk for women exposed to both factors was 1.58 times greater than the risk associated with either factor alone. In conclusion, both metabolic abnormalities and overweight/obesity elevate the risks of GH and PE, and a significant interaction effect exists between these two factors.

BackgroundPregnant women exhibit a high prevalence of sleep disturbances; however, the relationships between sleep variability, sleep irregularity, and gestational metabolic syndrome (GMS) remain poorly understood. This study aimed to investigate prospective associations of sleep variability and irregularity with the odds of GMS and its individual components.MethodsFour sub-cohorts of pregnant women were established based on data from the Fujian Birth Cohort Study (FJBCS) collected from 2019 to 2021. Logistic regression models were adopted to assess the associations between sleep variability and irregularity during pregnancy and the occurrence of GMS and its components. Stratified analyses examined potential modification of effects by demographic factors. Restricted cubic spline (RCS) models were used to evaluate potential non-linear relationships.ResultsGreater sleep variability was significantly associated with increased odds of GMS (aOR 1.348; 95% CI: 1.136-1.559) and dyslipidemia (aOR 1.086; 95% CI: 1.019-1.159), although no significant associations were found for hyperglycemia or hypertension. Sleep irregularity exhibited no significant association with GMS or its components. Subgroup analyses revealed increased vulnerability in women of advanced maternal age compared to younger age groups (aOR: 1.536 vs. 1.279). Those with a history of two or more prior pregnancies and natural pregnancies were more susceptible. RCS modeling confirmed the absence of nonlinear associations.ConclusionsHigher sleep variability is prospectively associated with an increased odds of GMS and dyslipidemia, with potential modulation by maternal age, conception method, and gravidity. No significant association was found between sleep irregularity and GMS or its components.

Overweight and obesity among women of childbearing age have become a major public health challenge affecting reproductive health worldwide. Excessive gestational weight gain and obesity during pregnancy substantially elevate the risk of gestational complications, particularly gestational diabetes mellitus (GDM), which poses threats to maternal and infant safety. Consequently scientific and effective intervention strategies for gestational weight management are urgently required. Pregnant women at high risk for GDM who met the inclusion and exclusion criteria were enrolled in the study. Participants were allocated into an intervention group and a control group based on their preference. The intervention group received digital therapy management, whereas the control group received routine gestational care. Intervention effectiveness was assessed based on appropriate gestational weight gain (GWG), GDM incidence, and adherence. A total of 700 pregnant women at high risk for GDM were included, comprising 504 in the intervention group and 196 in the control group. Baseline characteristics were generally comparable between the groups, although significant differences were noted in gravidity, parity, and educational level. A higher proportion of participants in the intervention group achieved appropriate GWG during the second and third trimesters compared with in the control group, with a statistically significant between-group difference in the third trimester (P = 0.047). No statistically significant difference in the incidence of GDM was observed between the two groups. Digital therapeutics during pregnancy effectively improved gestational weight management, with greater benefits observed over time. However, this improvement did not reduce GDM incidence. Chinese Clinical Trial Registry, ChiCTR2300071496, registered 16 May 2023.

Background:Recent studies suggest first-trimester maternal haemoglobin (Hb) may be linked to gestational diabetes mellitus (GDM), but evidence remains limited. This study examined the association between high first-trimester haemoglobin and GDM risk. Methods:This prospective study included 18 484 singleton pregnant women with a gestational age of ≤14 weeks in the Fujian Birth Cohort Study. Haemoglobin of the first trimester is divided into low (<110 g/L), normal (110-130 g/L) and high (≥130 g/L). Multivariate logistic regression and restricted cubic spline (RCS) models were used to explore the association between Hb level and GDM risk, and to gradually adjust sociodemographics, lifestyle and metabolic factors. Stratified and combined analysis was performed according to maternal age, pre-pregnancy body mass index and mode of conception. Results:Mean early Hb was 127.3 ± 9.6 g/L. The crude GDM incidence was 17.7%, 19.6%, and 25.3% in the low, normal, and high Hb groups, respectively. High Hb was significantly associated with increased GDM risk in crude (odds ratio (OR) = 1.40; 95% confidence interval (CI) = 1.30-1.50, P < 0.001), Model 2 (OR = 1.31; 95% CI = 1.22-1.41, P < 0.001), and Model 3 (OR = 1.24; 95% CI = 1.15-1.34, P < 0.001), with only 5.3% attenuation after adjusting for metabolic markers. Restricted cubic spline analyses showed a linear positive dose-response relationship between Hb and GDM risk (P for nonlinearity = 0.274). The association was stronger in non-advanced maternal age (non-AMA), overweight/obese, and spontaneously conceiving women, and combined effects were observed for high Hb with AMA, overweight/obesity, and assisted reproductive technology (ART). Conclusions:Early pregnancy haemoglobin is significantly associated with GDM risk, modified by age, pre-pregnancy BMI, and conception mode. Haemoglobin screening in early pregnancy may help identify high-risk women. Further studies are needed to clarify related mechanisms and evaluate interventions.

To investigate the association between middle cerebral artery (MCA) geometric parameters and atherosclerotic plaque, and the relationship between MCA plaque and white matter hyperintensity (WMH) burden. 157 patients suspected ischemic stroke or transient ischemic attack were enrolled. MCA geometry was measured on magnetic resonance angiography. MCA plaque was assessed using high-resolution magnetic resonance imaging. WMH was graded using the modified Fazekas scale. Generalized estimating equations were used to evaluate the association between MCA geometry and plaque. Logistic regression was performed to identify factors associated with moderate-to-severe WMH. Hemispheric WMH scores were compared in patients with unilateral MCA plaque. 148 patients were analyzed. After adjusting for confounders, MCA main trunk tortuosity remained independently associated with the presence of MCA plaque (odds ratio (OR), 1.069; P = 0.017). The prevalence of MCA plaque was significantly higher in patients with moderate-to-severe WMH than in those with no-or-mild WMH ( P < 0.001). MCA plaque (OR = 2.926, P = 0.010) and stenosis severity (OR = 3.340, P < 0.001) were independently associated with moderate-to-severe WMH. The association was no longer significant after excluding patients with moderate-to-severe stenosis (OR = 1.761, P = 0.203). In patients with unilateral MCA plaque, WMH burden was significantly higher in the ipsilateral hemisphere than in the contralateral hemisphere (P = 0.006). Greater MCA main trunk tortuosity is independently associated with the presence of MCA atherosclerotic plaque. MCA plaque is significantly associated with moderate-to-severe WMH, and this association is mainly driven by moderate-to-severe luminal stenosis. The ipsilateral predominance of WMH burden supports a local, territory-specific association rather than systemic atherosclerosis alone.

BACKGROUND:Exposure to fine particulate matter (PM2.5) has been suggested to influence reproductive hormone levels, yet epidemiological evidence linking prenatal PM2.5 exposure to early-life reproductive hormone levels remains limited. This study aims to evaluate the association between prenatal PM2.5 exposure and reproductive hormone levels in offspring aged 1-2 years after minipuberty. METHODS:We investigated 1114 mother-child pairs from a prospective birth cohort in Southeast China. Daily prenatal PM2.5 was estimated using the 1-km resolution ChinaHighAirPollutants (CHAP) dataset and averaged over the whole pregnancy and by trimester. Offspring serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), and testosterone were measured at the 1-2 year follow-up. Restricted cubic splines were used to assess nonlinearity. We employed multivariable linear regression to evaluate the associations. RESULTS:We observed sex-specific patterns in associations between prenatal PM2.5 exposure and offspring hormone levels. The exposure-response relationships showed no clear evidence of non-linearity. For the entire pregnancy, the point estimates in female offspring were positive for LH (13.13%), FSH (7.95%), PRL (9.28%), and testosterone (5.90%) per interquartile-range increase in PM2.5. In male offspring, associations were observed for PRL (8.49%) and testosterone (8.09%) but not LH or FSH. Trimester-specific analyses suggested directionally heterogeneous, sex- and hormone-specific temporal patterns, with sex-specific differences most evident for LH and FSH in the second trimester. CONCLUSION:Prenatal PM2.5 exposure was associated with reproductive hormone levels in offspring aged 1-2 years, with sex-specific differences most evident for LH and FSH and positive associations for PRL and testosterone in both sexes. The trimester-specific patterns suggest temporal heterogeneity in relation to gestational timing.

BACKGROUND:We established trimester-specific reference intervals (TSRIs) for hemostatic and hematologic indices in singleton pregnancy and evaluated their abnormalities in relation to adverse pregnancy outcomes (APOs; defined in Section 2.4). METHODS:This single-center prospective cohort study at Fujian Maternity and Child Health Hospital in southeastern China included 16,923 singleton pregnancies (97.8% Han Chinese; ChiCTR2200055116). Nine indices were measured: fibrinogen (FIB), prothrombin time (PT), prothrombin activity (PTA), activated partial thromboplastin time (APTT), thrombin time (TT), D-dimer, fibrinogen degradation products (FDP), platelet count (PLT), and hemoglobin (HGB). These indices were measured at four predefined stages (9-12, 22-26, and 30-34 weeks, and within 3 days before delivery) using an STA-R Max coagulation analyzer and a BC-7500 hematology analyzer. TSRIs were established using inverse modeling (primary method), truncated maximum likelihood (TML), and Hoffmann methods, and associations between abnormalities defined by these TSRIs and APOs were evaluated. RESULTS:Inverse modeling defined TSRIs for T1, T2, T3, and delivery as follows: FIB, 2.70-4.76, 2.81-5.46, 3.15-5.60, and 3.09-5.77 g/L; PT, 9.8-12.0, 9.8-11.7, 9.8-11.9, and 9.8-11.5 s; PTA, 87.7-115.3, 89.9-120.1, 89.9-117.5, and 92.2-120.8%; APTT, 22.4-30.2, 21.9-29.6, 21.4-29.9, and 21.6-30.8 s; TT, 14.7-16.8, 14.4-16.5, 14.4-16.5, and 14.6-16.7 s; D-dimer, 0.14-0.70, 0.26-1.97, 0.56-3.07, and 0.65-3.51 mg/L; FDP, 0.57-4.00, 1.12-7.92, 2.13-11.40, and 3.50-12.92 μg/mL; PLT, 159-349, 143-319, 133-324, and 122-308 × 10^9/L; HGB, 111-144, 100-132, 99-137, and 103-144 g/L. TSRI-defined abnormalities in FIB, APTT, D-dimer, FDP, and HGB were associated with higher risks of preterm birth, low birth weight, macrosomia, and postpartum hemorrhage. CONCLUSION:We recommend using TSRIs to assess hemostatic and hematologic indices in pregnancy to enable earlier detection and reduce APO risk.

Background: Cerebrovascular hemodynamics are believed to play an important role in the development of ischemic stroke (IS). However, the relationships between hemodynamics and prognosis are not fully understood. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) enables comprehensive characteristics of cerebrovascular hemodynamics. This study aims to investigate the associations of the different hemodynamics derived from 4D flow CMR with IS functional outcomes. Methods: Ninety-one patients (median age 64 years, 62 males) with unilateral IS in middle cerebral artery (MCA) territory were included. All subjects underwent a CMR scan, including 4D flow, three-dimensional (3D) time-of-flight magnetic resonance angiography, and 3D whole brain black-blood high-resolution vessel wall imaging of the MCA. Six hemodynamic parameters, including flow rate, velocity, pulsatility index, time-averaged wall shear stress (TAWSS), oscillatory shear index, and relative residence time (RRT), were calculated for the lesion site, pre-bifurcation M1 (pM1) segment, and the distal M1 and/or first branches of M2 (dM1/M2) segments. Vessel characteristics, such as lumen area, vessel area, wall area, maximum wall thickness, and the degree of stenosis, were calculated at the most stenotic lesion site. The modified Rankin Scale (mRS) scores were assessed at 90 days and 1 year, and an mRS > 2 was considered as a poor functional outcome. Results: Lower segment-level TAWSS (odds ratio [OR]: 0.24, P = 0.006 and OR: 0.29, P = 0.014), higher RRT (OR: 2.74, P = 0.007 and OR: 2.40, P = 0.011) of dM1/M2 segments, and lower segment-and lesion-level velocity (OR: 0.40, P = 0.019 and OR: 0.41, P = 0.025; OR: 0.41, P = 0.030 and OR: 0.42, P = 0.040) of pM1 segment were observed to be associated with poor functional outcome at both 90 days and 1 year. Using the cutoff value of 3.58 Pa and 0.29, respectively, TAWSS and RRT of dM1/M2 segments showed moderate performance in distinguishing poor functional outcome from favorable outcome (area under the curve ranging from 0.642-0.687) both at 90 days and 1 year. Conclusion: Distal segmental TAWSS and RRT of dM1/M2 segments were associated with poor functional outcomes. Such alterations in hemodynamics might help in the identification of patients with potentially unfavorable prognosis.

Trimester-specific reference intervals (TSRIs) for maternal lipid profiles should be determined, and the impact of dyslipidemia on adverse pregnancy outcomes (APOs) should be estimated. Data from 25,081 pregnant women in a large Southeast Chinese cohort were collected. Serial lipid profiling was performed throughout gestation, with measurements obtained during the first, second, and third trimesters, as well as within 24 h of delivery. The truncated maximum likelihood (TML) method, the Hoffman method, and inverse modelling were employed to establish TSRIs for lipids, with TML as the primary method. The associations of dyslipidemia with APOs were investigated by logistic regressions within the setting of TSRIs for various lipids. The TSRIs established by the TML method were as follows: 3.36–6.06, 4.19–7.89, 4.60–8.97, and 4.41–8.79 mmol/L for total cholesterol; 0.66–2.32, 1.11–3.75, 1.49–4.77, and 1.61–6.14 mmol/L for triglycerides; 1.42–3.61, 1.94–5.13, 1.95–5.39, and 1.86–5.50 mmol/L for low-density lipoprotein cholesterol; 1.11–2.31, 1.30–2.75, 1.24–2.59, and 1.20–2.65 mmol/L for high-density lipoprotein cholesterol; 1.89–4.20, 2.59–5.85, 2.87–6.17, and 2.88–6.78 mmol/L for non-high-density lipoprotein cholesterol; 1.04–1.96, 1.25–2.41, 1.23–2.46, and 1.25–2.47 g/L for apolipoprotein A1; 0.43–0.82, 0.63–1.17, 0.65–1.55, and 0.79–1.77 g/L for apolipoprotein B; and 0.27–0.79, 0.35–0.94, 0.39–1.11, and 0.40–1.15 for the apolipoprotein B and apolipoprotein A1 ratio from the first trimester to the delivery period, respectively. The results of the Hoffman and inverse modelling methods closely aligned with those of the TML method. In pregnant women, lipid levels that deviate above or below the established TSRIs are significantly associated with the occurrence of APOs. TSRIs are recommended for the identification and management of dyslipidemia during pregnancy. Inappropriate maternal blood lipid levels are associated with an increased risk of APOs.

BACKGROUND:The effect of prenatal ozone exposure on early childhood bone mineral density (BMD) remains to be explored. METHODS:This study was based on the pediatric subcohort of the Fujian Birth Cohort Study. The mean ozone exposure concentration was calculated for the entire pregnancy, as well as for each trimester (first, second, and third) and for every gestational week. BMD was assessed using quantitative ultrasonography (QUS). Low BMD was defined as a z-score of less than -1. Linear and logistic regression models were used to assess the effect of maternal ozone exposure. Distributed lag models (DLMs) were applied to identify the sensitive windows of ozone exposure. RESULTS:1345 mother-offspring pairs were included in this study. We found that for every interquartile range (IQR) increase in ozone levels of different exposure durations (entire pregnancy, first, second, and third trimester), BMD z-scores decreased by 0.12 (95 % CI: 0.18, -0.07), 0.07 (95 % CI: 0.11, -0.02), 0.08 (95 % CI: 0.14, -0.02), and 0.07 (95 % CI: 0.13, -0.01), respectively. For low BMD, an IQR increase in ozone levels was associated with 1.47 times higher odds of low BMD (95 % CI: 1.09, 1.98) in the second trimester. The most pronounced negative association with BMD z-scores was observed between the 9th and 16th gestational weeks. For low BMD, the highest OR was observed between the 15th and 17th gestational weeks. CONCLUSIONS:Prenatal exposure to ozone was inversely associated with BMD in early childhood, with early to mid-pregnancy identified as the susceptible window.

Background The purpose of this research was to investigate the association between the first trimester metabolic score for insulin resistance (METS-IR) index and offspring congenital heart disease (CHD), and to pay special attention to the mediating role of gestational diabetes mellitus (GDM). Methods A total of 21,401 women without pre-existing diabetes were enrolled in a prospective birth cohort study conducted in China. The participants were categorized into four groups based on their METS-IR index scores. Multivariate logistic regression models were used to assess the association between the first trimester METS-IR and CHD in their offspring. Mediation analysis was conducted to determine if GDM mediates this association. Results The increase in the METS-IR index in the first trimester was positively correlated with a significantly increased risk of CHD in offspring. Compared with the low METS-IR level group, the CHD risk in the high METS-IR group increased by 40 %. There was a positive linear dose-response relationship between METS-IR and CHD risk. Joint exposure to GDM and an elevated first-trimester METS-IR index significantly increased the risk of CHD in offspring, with evidence of a synergistic interaction on both multiplicative and additive scales. The estimated mediation proportion was 20.15 %. Conclusions The first-trimester METS-IR index was associated with an increased risk of CHD, and GDM partially mediated the association between the METS-IR index in the first trimester and CHD.

Background:Hemodynamics is crucial for the assessment of atherosclerotic development. However, flow alterations due to plaque existence and increased plaque number in different intracranial arterial segments have not been fully understood. This study aimed to investigate the relationship of wall shear stress (WSS) parameters between middle cerebral arteries (MCAs) with and without plaque and explore the potential discrepancy between multiple- and single-plaque existence. Methods:Consecutive patients with MCA atherosclerosis were recruited and underwent four-dimensional (4D) flow magnetic resonance imaging (MRI) and three-dimensional (3D) vessel wall imaging (VWI). Time-averaged WSS (TAWSS), time-averaged WSS coefficient variation (TAWSSCV), and oscillatory shear index (OSI) were measured at five cross-sectional slices [initial, upstream, the most narrowed lumen (MNL), downstream, and terminal] of plaque and reference (REF) sites to describe lesion-level hemodynamics. Segment-level hemodynamics of M1 and M2 segments were also analyzed. MCA geometry and plaque characteristics were calculated. The MCAs were then classified into four groups according to plaque presence in different segments: Group I, without plaque; Group II, with plaque only in M1; Group III, with plaque in both M1 and M2; Group IV, with plaque only in M2. The above parameters were compared in MCA with and without plaque as well as single- and multiple-plaque (≥2) MCAs. Results:A total of 150 MCAs with 231 plaques from 79 patients were investigated. TAWSSmin showed a relatively larger value at the proximal portion compared to the distal portion across plaque in both M1 and M2 segments. Lower lesion-level TAWSSmin was found in the M1 plaque presence of Group III compared to Group I and Group II (P=0.026 and P=0.014). Similar association was also observed in the M2 plaque presence of Groups III and IV compared to Group I (P=0.010 and P=0.008), whereas lower segment-level TAWSSmin was only seen in the M2 segment of Group III compared to Group I (P=0.039). Lower OSImean was found both in the M1 presence of Group II and III compared to Group I (P=0.013 and P=0.048) and OSImax was found in the M1 plaque presence of Group II compared to Group I (P=0.036). Lower stenosis was found in single-plaque compared to multiple-plaque groups (P=0.045 and P=0.049). Lower lesion-level highest/initial TAWSSmean ratio (P=0.037) and highest/initial TAWSSmax ratio (P=0.013) were found in the single-plaque M1 group compared to the multiple-plaque M1 group. The M1 geometry and positive remodeling (PR) were different between single- and multiple-plaque M1 groups whereas maximum wall thickness (maxWT) and normalized wall index (NWI) showed differences between the single- and multiple-plaque M2 groups (all P<0.05). Conclusions:Hemodynamic alterations are observed under the impacts of atherosclerosis and are different between M1 plaque and M2 plaque. Single- and multiple-plaque MCAs exhibit different geometry, plaque characteristics, and hemodynamics, and these vary according to segments. The interplay of arterial segment, plaque number, and characteristics as well as hemodynamics could provide insight for the mechanisms of atherosclerotic existence.

To investigate the association between maternal liver enzyme concentrations during pregnancy and the risk of abnormal birth weight. This is a prospective birth cohort study querying the pregnant women from Fujian Maternal and Child Health Hospital, affiliated with Fujian Medical University, China. Liver enzyme levels, including gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST), were measured in the first and third trimesters, and changes in liver enzyme levels were calculated based on these measurements. The outcomes were birth weight, small for gestational age (SGA), large for gestational age (LGA), low birth weight (LBW), and macrosomia. The study analyzed 19,003 singleton pregnancies with live births. The mean age of the pregnant individuals was 30.3 ± 3.9 years, 18,594 patients (97.8

ObjectiveTo investigate the relationship between the morphology of posterior cerebral artery (PCA) and the basilar artery (BA) atherosclerosis disease based on the High-Resolution Magnetic Resonance Vessel Wall Imaging (HR-MRI).MethodsA total of 321 patients presented with cerebrovascular symptoms (posterior circulation ischemic stroke or transient ischemic attack <2 weeks) at the Department of Neurology were collected from July 2017 to June 2020. We systematically collected clinical information, encompassing demographics, medical histories (smoking, alcohol consumption, diabetes, hypertension, hyperlipidemia, and coronary heart disease), and relevant mediation histories. BA curvature, mean lumen area, mean normalized wall index and the morphology of PCA were accessed with HR-MRI and magnetic resonance angiography. The binary logistic regression analysis was used to identify the risk factors of BA plaque formation. Spearman’s bivariate method and correlation coefficients were calculated to analyze the correlations between the morphology of PCA and BA plaque burden. The relationship between different PCA morphologies and posterior circulation infarction was analyzed by Chi square test.ResultsHypertension, diabetes and fetal-type posterior cerebral artery (FTP) were independent risk factors for BA plaque formation in Walking and Lambda geometry subtypes (p < 0.05). For the parameters of BA plaque burden, the PCA morphological type was positively correlated with Mean NWI (r = 0.252, p = 0.03), and that was negatively correlated with mean lumen area (r = −0.35, p = 0.002) and mean vessel area (r = −0.275, p = 0.018) in Lambda subtype. The incidence rate of posterior circulation infarction was statistically significant among different PCA morphologies (p = 0.018).ConclusionFTP was a risk factor of BA plaque formation and it was correlated with BA burden, and which could be used to explain the posterior circulation infarction in patients with FTP.

Background:Global maternal health progress stagnated during the Sustainable Development Goal era, while the impact of meteorological conditions on maternal-infant outcomes remains contentious. We aimed to investigate the relationship between the season of conception and adverse perinatal outcomes. Methods:We conducted a prospective cohort study, collecting basic demographic characteristics of pregnant women and estimating the season of conception based on the date of the last menstrual period. We did a follow-up until delivery to monitor pregnancy health issues, such as gestational diabetes mellitus (GDM), gestational hypertension (GH), premature rupture of membranes (PROM), and postpartum haemorrhage (PPH), as well as neonatal health indicators such as birth weight and other relevant outcomes. Results:We included data from 26 341 pregnant women in our analysis. The average age of pregnant women was 30.3 years (standard deviation (SD) = 4.0), and 60.9% were primiparas. Compared to conception in spring (reference group), conception in summer was associated with a 15% reduction in GDM risk (odds ratio (OR) = 0.85; 95% confidence interval (CI) = 0.77-0.94) and a 10% lower PROM risk (OR = 0.90; 95% CI = 0.82-0.99), but a 46% increased PPH risk (OR = 1.46; 95% CI = 1.07-1.99). Conceptions in autumn and winter demonstrated even more pronounced protective effects, with the former showing a GDM risk reduction of 23% (OR = 0.77; 95% CI = 0.70-0.85) and 26% lower GH risk (OR = 0.74; 95% CI = 0.61-0.90), and the latter a 14% GDM risk reduction (OR = 0.86; 95% CI = 0.79-0.94) and 20% lower GH risk (OR = 0.80; 95% CI = 0.68-0.96). Conclusions:We found that conception in spring was associated with an increased risk of GDM, GH, and PROM, while conception in summer was linked to a higher risk of PPH. However, the preliminary nature of our findings suggests that further research is needed to confirm causality and assess the feasibility of any potential interventions.

IntroductionThe purpose of this research was to examine the relationship between metabolic obesity phenotypes and preterm birth (PTB) as well as the impact of obesity and metabolic abnormalities on PTB.MethodsA total of 20,259 pregnant singleton women participated in prospective birth cohort research conducted in China. Obesity metabolic phenotypes were categorized using pre-pregnancy body mass index (BMI) and metabolic state. Any delivery before 37 full weeks of gestation, as determined by the best obstetric estimate available, was considered PTB.ResultsAs the number of metabolically unfavorable components grows, so does the risk of developing PTB. Compared to women with a metabolically healthy normal weight, those who are normal weight and overweight (including obese) with metabolically unwell had an increased chance of having PTB (adjusted OR: 1.33 and 1.62, respectively). Additionally, additive interaction analysis revealed a significant interaction between overweight and metabolic unhealthiness for PTB risk (RERI = 0.41, AP = 0.24, SI = 2.22). People who are overweight and metabolically unwell have a 0.41 relative excess risk (which accounts for 24%) of PTB, and their combined risk is 2.22 times higher than that of those who are exposed to either risk alone.ConclusionPTB risks are increased by metabolic abnormalities and overweight (including obese), and there are notable interaction effects between metabolic abnormalities and overweight (including obese) and PTB.

BACKGROUND:The impact of residential greenness exposure during pregnancy on early childhood bone mineral density (BMD) remains poorly understood. This study aimed to examine the association between residential greenness exposure during pregnancy and BMD in early childhood (0-3 years). METHODS:Data on participants, including demographics, health status, exposures, and outcomes, were derived from the pediatric subcohort within the Fujian Birth Cohort Study, recruited from 2019 to 2021. Greenness exposure was quantified using the Normalized Difference Vegetation Index within 500-m buffer range. BMD was measured via quantitative ultrasonography (QUS), with low BMD defined as z-score below -1. To assess the associations of NDVI500m with BMD and low BMD, linear regression and logistic regression models were applied. RESULTS:The median maternal age was 30.50 years (IQR = 5.00). We found that higher NDVI500m exposure was consistently linked to higher BMD z-scores. An IQR increase in NDVI500m during the entire pregnancy resulted in a 0.04 (95 % CI: 0.01, 0.06) increase in BMD z-scores. For the first, second, and third trimesters, each IQR increase in NDVI500m exposure led to a 0.03 (95 % CI: 0.00, 0.06), 0.04 (95 % CI: 0.00, 0.07), and 0.04 (95 % CI: 0.01, 0.07) increase in BMD z-scores, respectively. However, no significant relationship was observed between NDVI500m and low BMD risk. CONCLUSIONS:This study revealed a positive association of residential greenness exposure across the entire pregnancy and all trimesters with BMD in early childhood. These findings underscore the potential benefits of enhancing maternal access to greenness during pregnancy for improving offspring bone health.

Little is known about the relationship between sleep quality trajectories during pregnancy and preterm birth. To address this issue, we conducted a longitudinal assessment of maternal sleep quality to examine the relationship between sleep quality trajectories across all trimesters and the risk of preterm birth. A prospective birth cohort study was conducted in China, and a total of 15,042 women who had singleton births were included, including 647 who subsequently developed preterm birth. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) scale at each study visit (8-14, 22-27 and 32-37 weeks of gestation). Preterm birth was defined as birth less than 37 weeks of gestation. Latent class trajectory models were applied to identify different sleep quality trajectories, and multivariate logistic regression models were applied to examine the associations between the determined trajectories and preterm birth. This study identified three distinct sleep quality trajectories: stable good group, stable poor group and increasing poor group. After adjusting for covariates, the odds ratio for preterm birth in the increasing poor group was 1.32 (95% confidence interval: 1.05-1.66) compared to the stable good group. Positive associations of the increasing poor group with preterm birth were exhibited only among women aged less than 30 years, those with normal BMI, or mothers of female infants. Our findings revealed that an increasing poor sleep quality trajectory was associated with an increased risk of preterm birth and emphasised the imperative to identify the high-risk groups as a priority target for intervention and treatment.