Genetic variation in TRPM6 and TRPM7 contributes to magnesium (Mg) absorption defects. We aimed to verify the combined influence of Mg intake and these genetic polymorphisms on plasma Mg concentrations and the risk of gestational diabetes mellitus (GDM). We involved 1323 pregnant women from Tongji Maternal and Child Health Cohort. Two single nucleotide polymorphisms (SNPs) in TRPM6 (rs2274924 and rs3750425) and one SNP in TRPM7 (rs8042919) were genotyped through Asian Screening Array bead chip. Mg intake was evaluated using food frequency questionnaires before GDM diagnosis. Plasma Mg was measured using inductively coupled plasma mass spectrometry when 75 g oral glucose tolerance test was conducted to identify GDM. The summed number of mutant alleles for rs2274924 (T>C), rs3750425 (C>T) and rs8042919 (G>A) was associated with GDM risk, with an adjusted relative risk (RR) of 1.65 (95% confidence interval [CI]: 1.21, 2.23) for women with higher number of mutant alleles compared to those with fewer than two alleles. A significant interaction was observed between gene variants and Mg intake on GDM risk (P-interaction = .039). Notably, insufficient Mg intake (<370.0 mg/d) significantly decreased plasma Mg concentrations (15.34 mg/L vs 15.80 mg/L; P < .001) and increased GDM incidence (adjusted RR = 2.14; 95% CI, 1.24, 3.68) among participants with fewer mutant alleles. Sufficient Mg intake may be more beneficial to increase plasma Mg concentrations and decrease GDM risk among pregnant women with fewer mutations on TRPM6, TRPM7 gene variants.

Objective: To evaluate the association between patterns of gestational weight gain (GWG) and allergic diseases in offspring.Design: Prospective cohort study.Setting: Prenatal clinics in Wuhan, China. Population: A cohort of 2546 mother and offspring pairs were enrolled before 16 weeks of gestation and followed up to 24 months postpartum.Methods: Maternal body weights were measured regularly during pregnancy, and their GWG patterns were estimated using the growth mixture model. Robust Poisson models were used to evaluate relative risk (RR) and 95% CI after multivari-able adjustment.Main outcome measures: Offspring atopic allergy and allergic contact dermatitis were defined according to a physician's diagnosis reported by the mother, and food allergy was reported by the mother.Results: Three GWG patterns were identified: 18.1% (461) of the women were de-scribed as pattern 1, characterised by rapid GWG earlier in pregnancy; 56.6% (1442) of the women were described as pattern 2, with steady GWG throughout pregnancy; and 25.3% (643) of the women was described as pattern 3, with rapid GWG later in pregnancy. By the age of 24 months, 360 (14.1%), 109 (4.3%) and 757 (29.7%) offspring had atopic allergy, allergic contact dermatitis or food allergy, respectively. Compared with women in GWG pattern 2, the RRs (95% CIs) among women in pattern 1 were 0.74 (0.55- 0.99) for atopic allergy, 0.64 (0.36- 1.15) for allergic contact dermatitis and 0.95 (0.81- 1.12) for food allergy.Conclusions: Maternal GWG pattern characterised by rapid GWG earlier in pregnancy was associated with a lower risk of atopic allergy in offspring.

Background: Breastfeeding has numerous effects on maternal and child health. The effect of breastfeeding on infant sleep remains inconclusive.Objectives: We aimed to examine whether full breastfeeding (FBF) during the first 3 mo is associated with longitudinal infant sleep tra-jectories in their first 2 y of life.Methods: The study was embedded in the Tongji Maternal and Child Health Cohort study. Information on infant feeding practices was collected at 3 mo of age, and maternal/child pairs were assigned to the FBF or the non-FBF group (including partially breastfeeding and exclusive formula feeding) on the basis of feeding practices during the first 3 mo of life. Sleep data of infants were obtained at 3, 6, 12, and 24 mo. Total, night, and day sleep trajectories across 3 to 24 mo were estimated with group-based models. Each sleep trajectory was differentiated on the basis of sleep duration at 3 mo (long/moderate/short) and the interval from 6 to 24 mo (moderate/short). Multinomial logistic regression was used to investigate the association of breastfeeding practices with infant sleep trajectories.Results: Among the 4056 infants studied, 2558 (63.1%) received FBF for 3 mo. When compared with FBF infants, non-FBF infants had shorter sleep duration at 3, 6, and 12 mo (P < 0.01). Non-FBF infants were more likely to experience Moderate-Short (OR: 1.31; 95% CI: 1.06, 1.61) and Short-Short (OR: 1.56; 95% CI: 1.12, 2.16) total sleep trajectories and more likely to experience Moderate-Short (OR: 1.84; 95% CI: 1.22, 2.77), and Short-Moderate (OR: 1.40; 95% CI: 1.06, 1.85) night sleep trajectories than FBF infants.Conclusions: Full breastfeeding for >= 3 mo were positively associated with longer infant sleep duration. Infants fully breastfed were more likely to experience better sleep trajectories characterized by longer duration in their first 2 y of life. Full breastfeeding may benefit infants through healthy sleep.

We present a program, SCHNArP, for rebuilding double-helical nucleic acid structures from a set of helical parameters. The parameter sets are based on mathematically reversible schemes that allow direct comparison of data from experimental X-ray crystal structures analyzed using the analysis program, SCHNAaP (see accompanying paper), and structures built using the rebuilding program, SCHNArP. The program uses either local CEHS helical parameters or global helical parameters. A number of standard parameter sets from the literature are included that allow comparison of oligomer and polymer structures generated using different models for sequence-dependent DNA bending. Exact atomic models are provided for the bases. Schematic models that trace the path of the backbone and use rectangular blocks for the bases can be generated.

Abstract Maternal gestational weight gain (GWG) is an important determinant of infant birth weight, and having adequate total GWG has been widely recommended. However, the association of timing of GWG with birth weight remains controversial. We aimed to evaluate this association, especially among women with adequate total GWG. In a prospective cohort study, pregnant women’s weight was routinely measured during pregnancy, and their GWG was calculated for the ten intervals: the first 13, 14–18, 19–23, 24–28, 29–30, 31–32, 33–34, 35–36, 37–38 and 39–40 weeks. Birth weight was measured, and small-for-gestational-age (SGA) and large-for-gestational-age were assessed. Generalized linear and Poisson models were used to evaluate the associations of GWG with birth weight and its outcomes after multivariate adjustment, respectively. Of the 5049 women, increased GWG in the first 30 weeks was associated with increased birth weight for male infants, and increased GWG in the first 28 weeks was associated with increased birth weight for females. Among 1713 women with adequate total GWG, increased GWG percent between 14 and 23 weeks was associated with increased birth weight. Moreover, inadequate GWG between 14 and 23 weeks, compared with the adequate GWG, was associated with an increased risk of SGA (43 (13·7 %) v. 42 (7·2 %); relative risk 1·83, 95 % CI 1·21, 2·76). Timing of GWG may influence infant birth weight differentially, and women with inadequate GWG between 14 and 23 weeks may be at higher risk of delivering SGA infants, despite having adequate total GWG.

Background Progesterone is widely used to improve the adverse pregnancy outcomes related to vaginal bleeding during early pregnancy. However, the evidence of its effectiveness is equivocal. Methods Six thousand six hundred fifteen mother-infant pairs from Tongji Maternal and Child Health Cohort (TMCHC) were involved in the study. Information on vaginal bleeding, progesterone administration in early pregnancy were obtained at enrolment. Birth outcomes were obtained from the hospital notes. Body weight of the infants at 12 months of age was collected by telephone interview. Multivariable logistic regression was conducted to estimate the effect of vaginal bleeding and progesterone administration in early pregnancy on birth outcomes and weight status of infants at 12 months of age. Results 21.4% (1418/6615) participants experienced bleeding in early pregnancy, and 47.5% (674/1418) of them were treated with progesterone. There were no significant associations between progesterone supplementation in early pregnancy and offspring outcomes. Compared to women without bleeding or any therapy, women with bleeding and progesterone therapy experienced increased risk of preterm (OR 1.74, 95% CI 1.21–2.52), and delivering a small-for-gestational-age (SGA) (OR 1.46, 95% CI 1.07–1.98) or low birth weight (LBW) (OR 2.10, 95% CI 1.25–3.51) neonate, and offspring of them had an increased risk of weight for age z-score (WAZ) < -1 at 12 months of age (OR 1.79, 95%CI 1.01–3.19). Conclusions Offspring of mothers with bleeding and progesterone therapy were more likely to be a premature, SGA or LBW neonate, and had lower weight at 12 months of age. Progesterone supplementation may have no beneficial effect on improving adverse offspring outcomes related to early vaginal bleeding. Trial registration TMCHC was registered at clinicaltrials.gov as NCT03099837 on 4 April 2017.

Abstract Purpose: To evaluate the clinical implication of metabolic score for insulin resistance (METS-IR) during early midpregnancy on subsequent risk of gestational diabetes mellitus (GDM) in Chinese women.Methods: A total of 1747 pregnant women without pre-existing diabetes from the Tongji Maternal and Child Health Cohort (TMCHC) were included in this analysis. Blood glucose and lipid profiles (triglyceride [TG], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C]) were measured during 15-19 weeks and 75-g 2-h oral glucose tolerance test was conducted during 24-28 weeks to diagnose GDM. METS-IR was calculated by a modified formula which originally as follows: Ln(2×FPG[mg/dl]+TG[mg/dl])×BMI[kg/m2] /Ln(HDL-C[mg/dl]).Results: The median (interquartile range) of age was 28 (26-30) years, and 19.7% of them were underweight and 11.7% were overweight/obese before pregnancy. The overall incidence of GDM was 9.4% and median (interquartile range) of METS-IR was 27.36 (24.57-31.07). The median METS-IR was significantly increased with the increasing pre-pregnancy BMI categories (22.92 vs 27.72 vs 35.55, P＜0.001). Based on quartiles of METS-IR in women with normal pre-pregnancy BMI, participants were classified into 4 groups. Compared with women in the lowest quartile of METS-IR (＜25.52) , the adjusted RRs (95% CIs) of GDM were 2.15 (1.23-3.74), 1.34 (0.72-2.49), and 3.63 (2.22-5.95) for women in quartile 2 (25.52-27.71), quartile 3 (27.72-30.39) and quartile 4 (≥30.40) after adjusting potential confounds. In addition, a significant increase risk of GDM (adjusted RR [95% CI]: 2.55 [1.83-3.55]) was found in women within the highest quartile of METS-IR (≥30.40) compared to the other 3 lower quartiles (＜30.40).Conclusions: Women with METS-IR (≥30.40) during early midpregnancy were more likely to develop GDM, thus the index might be a reliable early indicator for identifying women at high risk of GDM.

Current results regarding the effect of folic acid (FA) supplement use on gestational hypertension (GH) and preeclampsia are limited and inconsistent. We aimed to investigate whether FA supplement use was associated with GH and preeclampsia. Participants from the Tongji Maternal and Child Health Cohort with information on periconceptional FA supplement use and diagnosis of GH/preeclampsia were included (n=4853). Robust Poisson regression was used to assess the association of FA supplement use and GH and preeclampsia. Among the 4853 participants in this study, 1161 (23.9%) and 161 (3.3%) women were diagnosed with GH and preeclampsia, respectively. The risk ratio of developing GH was higher in women who used ≥800 µg/d FA supplement from prepregnancy through midpregnancy than nonusers (risk ratio, 1.33 [1.08–1.65]). After adjusting for social-demographic, reproductive, lifestyle factors, family history of hypertension, other supplement use, and gestational weight gain, the adverse association remained significant (risk ratio, 1.32 [1.06–1.64]). Restricting the analysis among women with normal weight, without family history of hypertension, and without gestational diabetes mellitus, the positive FA-GH association still existed. We did not find any significant association between FA supplement use and preeclampsia regardless of adjustment. High-dose (≥800 µg/d) FA supplement use from prepregnancy through midpregnancy was associated with increased risk of GH. Attention should be given to avoid the potential risk of GH due to inappropriate FA supplement use in women who are planning or capable of pregnancy.