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Objective: To report the experience with first-trimester prenatal detection of pregnancies complicated by trisomy 18. Study design: Proven cases of trisomy 18 identified between 11 and 14 weeks of gestation were retrospectively reviewed. Information on maternal demographics, prenatal sonographic findings, indications for prenatal diagnosis and chromosomal analysis results was obtained by reviewing medical records. Results: During the 7-year period from January 2011 to December 2017, 89 cases of full trisomy 18 had first-trimester indications for prenatal diagnosis at Guangzhou Women and Children's Medical Center. Eighty-five (95.5%) had abnormal sonographic findings in the first trimester. The most common finding was increased nuchal translucency (55.1%), followed by cystic hygroma (18.0%), omphalocele (14.6%), and fetalis hydrops (11.2%). Four cases (4.5%) were not associated with any abnormal first-trimester sonographic finding, and were diagnosed because of routine positive screening results for trisomy 18. A single case was diagnosed because of a positive cell-free DNA (cfDNA) result. Conclusion: These results demonstrate that a large number of fetuses with trisomy 18 have abnormal sonographic findings in the first trimester, and support the continued utility of first-trimester sonographic examination in the diagnosis of this trisomy even with the availability of cfDNA. [ABSTRACT FROM AUTHOR]

The acute effects of ambient air pollution on recurrence of ischemic cerebrovascular events (ICEs) remains largely unknown. We therefore conducted a time-stratified case-crossover study of 43,896 patients who were 60 years or older and were admitted to hospital for recurrent ICEs including ischemic stroke and transient ischemic attack in Guangzhou, China during 2016-2019. Based on each patient's home address and pollutant data from its neighboring air quality monitoring stations, we used an inverse distance weighting method to assess exposures to particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5), particulate matter with an aerodynamic diameter ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3). Conditional logistic regression models were used to quantify exposure-response associations. During the study period, there were 43,896 case days and 149,131 control days. In single-pollutant models, each 10 μg/m3 increase in exposure to PM10, NO2 and CO (mean exposure on date of admission and 1 day prior) was significantly associated with a 0.74% (95% confidence interval [CI]: 0.13-1.36%), 2.15% (1.38-2.93%) and 0.14% (0.07-0.21%) increase in odds of hospital admissions for recurrent ICEs, respectively, and no significant departures from linearity were detected. The association for NO2 exposure remained consistent in 2-pollutant models, while the associations for PM10 and CO disappeared or changed materially with adjustment for other pollutants. Stronger association for NO2 exposure was observed in cool season than that in warm season. We found that short-term exposure to ambient air pollutants, especially NO2, was associated with increased risk of hospital admissions for recurrent ICEs in older adults. [ABSTRACT FROM AUTHOR]

Ambient air pollution has been linked to an increased risk of various acute cardiovascular outcomes; however, its effects on hospital admissions for angina are yet to be evaluated. We conducted a time-stratified case-crossover study with conditional logistic regression models among 46,687 adults 60 years or older who were admitted to hospital for angina in Guangzhou, China during 2016–2019 to investigate the association of exposure to ambient particulate matter with an aerodynamic diameter ≤2.5 μm (PM 2.5), particulate matter with an aerodynamic diameter ≤10 μm (PM 10), sulfur dioxide (SO 2), nitrogen dioxide (NO 2), carbon monoxide (CO), and ozone (O 3) with hospital admissions for angina. Daily residential air pollutant exposures were extracted from a grid dataset. Each 10 μg/m3 increase of lag 0-day exposure to PM 10 , SO 2 , NO 2 , CO, and O 3 was significantly associated with a 0.80% (95% confidential interval: 0.32%, 1.28%), 4.04% (0.34%, 7.89%), 2.47% (1.81%, 3.12%), 0.13% (0.07%, 0.19%), and −0.38% (−0.74%, −0.01%) increase in odds of admission, respectively. The association for NO 2 exposure remained stable, while the associations for PM 10 , SO 2 , CO, and O 3 became insignificant with adjustment for other air pollutants. The association for NO 2 exposure was stronger in cool season. We estimated that up to 9.12% of angina admissions were attributable to NO 2 exposure. Our findings suggest that ambient NO 2 may trigger hospital admissions for angina in Chinese older adults, which highlights the importance to prevent angina by reducing individual NO 2 exposures. • Short-term exposure to ambient NO 2 was associated with an increased odds of angina admissions in older adults. • The association for NO 2 was stronger in cool season. • Reducing traffic-related air pollution may be helpful in preventing angina admissions. [ABSTRACT FROM AUTHOR]