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Objective: To describe the epidemiology of holoprosencephaly (HPE) in China with special reference to prevalence and associated anomalies. Methods: Data were abstracted from the Chinese Birth Defects Monitoring Network for the period 2007–2014. Birth prevalence of HPE were assessed by birth year, fetal/infant sex, maternal age, and maternal residential area. Poisson regressions were used to calculate the crude and adjusted prevalence ratios (PR) and their 95% confidence intervals, and linear chi-square test was used to explore time trend for the prevalence of HPE. Results: A total of 1222 HPE cases were identified in 13,284,142 births, yielding an overall prevalence of 0.92 per 10,000 births. The annual prevalence of HPE presented an upward trend (P<0.001), from 0.54 per 10,000 births in 2007 to 1.21 per 10,000 births in 2014. Higher prevalence was found in older maternal-age groups (30–34 years, adjusted PR: 1.19, 95% CI: 1.02–1.40; ≥35 years, adjusted PR: 1.53, 95% CI: 1.26–1.86) in comparison with the maternal-age group of 25 to 29 years. Higher prevalence was also found in infants born to mothers resided in urban areas (adjusted PR: 1.23, 95% CI: 1.08–1.39) and female infants (adjusted PR: 1.30, 95% CI: 1.15–1.47). Conclusions: HPE is an important perinatal health issue because of its poor prognosis. This is the first study depicting a picture of epidemiological characteristics of HPE in China, which can provide useful references for future studies. [ABSTRACT FROM AUTHOR]

In preterm infants (i.e. the gestational age less than 37 weeks), postnatal growth remains a concern. This study used multicenter longitudinal data from China’s Under 5 Child Nutrition and Health Surveillance System to investigate the postnatal growth in the weight and length of preterm infants. Gender-stratified differences in weight and length were assessed between preterm and term infants. 1221 preterm infants and 1221 matched term infants were included. The rates of growth in weight and length in preterm infants was greater than those in term infants, especially from the first to sixth month. The rates were higher in males compared to females in the first 3 months. The differences of weight and length between preterm and term infants decreased with increasing age, however, these measurements did not reach the level of their term peers until 12 months before adjusting for gestational age. The median values of weight and length were even larger in preterm infants in the first month after adjusting for gestational age. [ABSTRACT FROM AUTHOR]

Objective: The accuracy of a population-based sex ratio at birth (SRB) in China has long been questioned. To depict a more accurate profile, the present study used data from a national surveillance system for health facility births to explore the characteristics of SRB in China. Methods: Data from China’s National Maternal Near Miss Surveillance System between 2012 and 2015 were used. We restricted the analysis to live births of ≥28 completed gestational weeks or ≥1000 g birth weight. The strength of association between obstetric characteristics and SRB was examined using logistic regression, taking into account the sampling strategy and clustering of births within health facilities. Results: There were 2,785,513 boys and 2,549,269 girls born alive between 2012 and 2015 in 441 health facilities. The SRB was 111.04 in 2012, 110.16 in 2013, 108.79 in 2014, and 109.53 in 2015. The SRB was high in the eastern region, especially in rural areas. The SRBs increased with mother’s age and decreased with mother’s education. The SRB in women who were pregnant for the first time was 104.30. The SRB in primipara was normal (104.35), but it was extremely high in non-primipara, especially for women with three or more parities (141.76); only 5.26% of live births fell within this group. The SRBs increased significantly by the number of parities, especially in the rural areas of the central region. After adjustment for sociodemographic factors, women with three or more parities were 1.39 (95% CI 1.34, 1.43) times more likely to give birth to a boy compared with primiparae who were pregnant for the first time. Conclusion: Our analysis suggests that the SRB was lower than what was reported officially but higher than normal. The government should keep strengthening supervision to prevent sex-selection, especially in the wake of the two-child policy implemented in 2015. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the mortality rate of pneumonia (PMR) among children under 5 and its time trend from 1996 to 2013 to determine the priorities for ending preventable deaths from pneumonia in children under 5, and share China’s successful experience in reducing PMR with other developing countries. Methods: We used data from China’s Under 5 Child Mortality Surveillance System (U5CMSS) to calculate the PMR and the proportion of pneumonia deaths to total deaths of children under 5. The data were grouped by urban and rural areas with Cochran-Mantel-Haensel (CMH) test and Chi-square test to examine the differences of PMR and proportion. The time trend was tested by Cochran-Armitage trend test. Results: The overall PMR of children under 5 was reduced by 85.5% (from 1053.2 to 153.2 per 100,000 live births) from 1996 to 2013, with the urban and rural areas reduced by 69.1% (from 188.4 to 58.2 per 100,000 live births) and 84.7% (from 1252.8 to 191.9 per 100,000 live births), respectively. The overall proportion of pneumonia deaths to total deaths was also declined from 23.4% in 1996 to 12.8% in 2013, with the rural areas decreased from 24.4% to 13.2% and the urban areas decreased from 11.1% to 9.7%. The PMRs in neonates (0-27 days), post-neonates (1-11 months), and childhood (12-59 months) were reduced by 80.7%, 77.4%, and 80.1%, respectively in rural areas, and 71.7%, 69.6%, and 39.0%, respectively in urban areas. During 1996-2013, the PMR in children under 5 years was 4.9 fold higher in rural areas relative to that in urban areas, with relative risk (RR) of 3.6 and 6.4 in neonates and 1- to 59-month-old children, respectively. Conclusions: PMR in children under 5 significantly declined in China from 1996 to 2013, especially in rural areas. However, huge disparities still existed between rural and urban areas. Infants had the highest PMR, which indicated that interventions aiming at prevention and control of infant pneumonia should be the priority for further reducing PMR in China. [ABSTRACT FROM AUTHOR]

Objective: To develop a reference of population-based gestational age-specific birth weight percentiles for contemporary Chinese. Methods: Birth weight data was collected by the China National Population-based Birth Defects Surveillance System. A total of 1,105,214 live singleton births aged ≥28 weeks of gestation without birth defects during 2006–2010 were included. The lambda-mu-sigma method was utilized to generate percentiles and curves. Results: Gestational age-specific birth weight percentiles for male and female infants were constructed separately. Significant differences were observed between the current reference and other references developed for Chinese or non-Chinese infants. Conclusion: There have been moderate increases in birth weight percentiles for Chinese infants of both sexes and most gestational ages since 1980s, suggesting the importance of utilizing an updated national reference for both clinical and research purposes. [ABSTRACT FROM AUTHOR]