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To explore the differential expression of messenger RNA (mRNA) in myocardial tissues of rats with sudden coronary death (SCD), and to provide ideas for the forensic identification of SCD.The rat SCD model was established, and the transcriptome sequencing was performed by next-generation sequencing technology. Differentially expressed genes (DEGs) in myocardial tissues of SCD rats were screened by using the R package limma. A protein-protein interaction (PPI) network was constructed by using the STRING database and Cytoscape 3.8.2 on DEG, and hub genes were screened based on cytoHubba plug-in. Finally, the R package clusterProfiler was used to analyze the biological function and signal pathway enrichment of the selected DEG.A total of 177 DEGs were associated with SCD and were mainly involved in the renin-angiotensin system and PI3K-Akt signaling pathway. The genes including angiotensinogen (AGT), complement component 4a (C4a), Fos proto-oncogene (FOS) and others played key roles in the development of SCD.Genes such as

Summary Background & aims Maternal depression has been reported to be harmful to maternal and child health, and nutrition-mental health interactions may play a key role, but evidence from longitudinal studies throughout pregnancy remains insufficient. This study aimed to investigate the association of maternal dietary patterns with depressive symptoms throughout pregnancy. Methods This study was based in the Born in Guangzhou Cohort Study. Dietary patterns were defined by cluster analysis based on validated food frequency questionnaires in mid-pregnancy. A healthy diet score was also developed based on predefined criteria of existing dietary guidelines. Depressive symptoms were measured by Self-rating Depression Scale (SDS) in both early and late pregnancy, with SDS scores ≥53 defined as having depressive symptoms. Associations of dietary patterns with SDS scores were examined by linear-mixed models; associations of dietary patterns with the odds of having depressive symptoms were examined by mixed-effects logistic models. The associations of the healthy diet score with both dietary patterns and depressive symptoms were also explored. Results Six dietary patterns were identified in 17,430 pregnant women, namely ‘Varied’ (n = 3902, 22.4%), ‘Vegetables’ (n = 3269, 18.8%), ‘Meats’ (n = 2951, 16.9%), ‘Cereals’ (n = 2719, 15.6%), ‘Milk’ (n = 2377, 13.6%), and ‘Fruits’ (n = 2212, 12.7%). There were 19.3% and 15.7% of participants with depressive symptoms in early and late pregnancy, respectively. Compared with the ‘Varied’ pattern, all other patterns were associated with lower SDS scores during pregnancy except for ‘Cereals’ (‘Vegetables’: adjusted β [aβ] −0.78, 95% CI −1.16, −0.40; ‘Meats’: aβ −0.48, 95% CI −0.87, −0.09; ‘Milk’: aβ −0.52, 95% CI −0.94, −0.10; ‘Fruits’: aβ −0.85, 95% CI −1.27, −0.42). The ‘Vegetables’ (adjusted OR [aOR] 0.79, 95% CI 0.67, 0.93), ‘Milk’ (aOR 0.76, 95% CI 0.63, 0.91), and ‘Fruits’ (aOR 0.77, 95% CI 0.64, 0.93) patterns were associated with lower odds of having depressive symptoms during pregnancy than the ‘Varied’ pattern. Results for the healthy diet score revealed the healthiness of the ‘Vegetables’, ‘Fruits’, and ‘Milk’ patterns and supported an inverse association between healthy dietary patterns and depressive symptoms throughout pregnancy. Conclusions Diets rich in vegetables, fruits, nuts, and dairy products had an inverse association with depressive symptoms throughout pregnancy. Our findings add support to the existing dietary guidelines that healthy diets might also have potential benefits to maternal mental health.

To identify the specific glucose metrics derived from maternal continuous glucose monitoring (CGM) data, which were associated with a higher percentile of offspring birth weight. In this cohort study, we recruited singleton pregnant women with GDM who underwent CGM for 5–14 days at a mean of 28.8 gestational weeks between Jan 2017 and Nov 2018. Commonly used single summary glucose metrics of glucose exposure (including mean 24-h, daytime, and nighttime glucose level) and variability (including J-index and mean amplitude of glycaemic excursions) were derived from CGM data. A novel comprehensive glucose metric—hours per-day spent in a severe variability glucose mode (HSSV)—was identified using the spectral clustering method, which reflects both glucose level and variability. Multiple linear regression models were used to estimate the associations of sex- and gestational age-adjusted birth weight percentile with CGM parameters. Ninety-seven women comprising 127,279 glucose measurements were included. Each 1-SD increase in maternal nighttime mean glucose level and HSSV was associated with 6.0 (95% CI 0.4, 11.5) and 6.3 (95% CI 0.4, 12.2) percentage points increase in birth weight percentile, respectively. No associations were found between other glucose metrics and birth weight percentile. Nighttime mean glucose level has a comparable effect size to HSSV in association with fetal growth, suggesting that endogenous hyperglycemia might drive the association between maternal hyperglycemia and birth weight. Further studies need to examine the effect of lowering nighttime glucose level and/or HSSV on preventing fetal overgrowth in GDM women.

Objective To assess potential risk factors in identifying women at risk for gestational diabetes mellitus (GDM). Methods The present study included data collected as part of a prospective cohort study, and included women with singleton pregnancies who underwent initial prenatal examination at a tertiary women and children's hospital in Guangzhou, China between February 1, 2012, and December 31, 2015. Maternal characteristics and medical history were investigated to evaluate associations with GDM. A risk factor scoring system for the prediction of GDM was generated using logistic regression. Results Overall, 1129 (13.5%) of 8381 women were diagnosed with GDM. Women older than 35 years had a 3.95‐fold increased risk of GDM (95% confidence interval 2.80–5.58) compared with women aged 16–25 years; obese women had a 6.54‐fold higher risk (95% confidence interval 3.50–12.23) compared with underweight women. A risk scoring system was established based on age, body mass index, family history of diabetes, weight gain, and history of GDM. Screening for women with a score of 12 or more would have reduced the number undergoing oral glucose tolerance testing by 2131 (25.4%) patients with a sensitivity of 87% for GDM detection. Conclusion The assessment of risk factors for GDM could provide a foundation for improving risk‐based screening strategies in this and similar populations.

The human gut microbiome can modulate metabolic health and affect insulin resistance, and it may play an important role in the etiology of gestational diabetes mellitus (GDM). Here, we compared the gut microbial composition of 43 GDM patients and 81 healthy pregnant women via whole-metagenome shotgun sequencing of their fecal samples, collected at 21–29 weeks, to explore associations between GDM and the composition of microbial taxonomic units and functional genes. A metagenome-wide association study identified 154 837 genes, which clustered into 129 metagenome linkage groups (MLGs) for species description, with significant relative abundance differences between the 2 cohorts. Parabacteroides distasonis, Klebsiella variicola, etc., were enriched in GDM patients, whereas Methanobrevibacter smithii, Alistipes spp., Bifidobacterium spp., and Eubacterium spp. were enriched in controls. The ratios of the gross abundances of GDM-enriched MLGs to control-enriched MLGs were positively correlated with blood glucose levels. A random forest model shows that fecal MLGs have excellent discriminatory power to predict GDM status. Our study discovered novel relationships between the gut microbiome and GDM status and suggests that changes in microbial composition may potentially be used to identify individuals at risk for GDM.

Preterm birth is the leading cause of mortality and morbidity in infants. Its etiology is multifactorial with genes and immune homeostasis. The authors investigated whether prostaglandin (PG) synthesis related single nucleotide polymorphisms (SNPs) PLA2G4C rs1366442 and PLA2G4D rs4924618 were associated with the risk of spontaneous preterm birth (SPTB) in a Chinese population of 114 cases of SPTB and 250 controls of term delivery. The risk associations were determined by odds ratios (ORs) and their 95% confidence intervals (CIs) calculated using multivariate logistic regression. Homology modeling was performed to elucidate potential mechanism of the SNP function. The maternal AT/TT genotype of PLA2G4D rs4924618 was associated with a reduced risk of SPTB (OR, 0.61; 95% CI, 0.37‑0.99), while no significant association between PLA2G4C rs1366442 and SPTB risk was identified. Structure and sequence analysis revealed that the amino acid substitution introduced by this SNP located at the conserved central core of the catalytic domain of cytosolic phospholipase A2 δ and was close to the active site. These findings suggested that the polymorphism of PLA2G4D rs4924618 may have a protective influence on the SPTB susceptibility in a Chinese population, supporting a role for genetics in the association between PG synthesis and preterm birth.

The Born In Guangzhou Cohort Study (BIGCS) is a large-scale prospective observational study investigating the role of social, biological and environmental influences on pregnancy and child health and development in an urban setting in southern China. Pregnant women who reside in Guangzhou and who attend Guangzhou Women and Children’s Medical Center (GWCMC) for antenatal care in early pregnancy (less than 20 weeks’ gestation) are eligible for inclusion. Study recruitment commenced in February 2012, with an overall participation rate of 76.3%. Study recruitment will continue until December 2018 to achieve the target sample size of 30 000 mother-child pairs. At 30 April 2016, a total of 75 422 questionnaires have been collected, while 14 696 live births have occurred with planned follow-up of cohort children until age 18 years. During the same period a total of 1 053 000 biological samples have been collected from participants, including maternal, paternal and infant blood, cord blood, placenta, umbilical cord, and maternal and infant stool samples. The dataset has been enhanced by record linkage to routine health and administrative records. We plan future record linkage to school enrolment and national examination records.

Background Syphilis is responsible for a substantial burden of preventable adverse outcomes in pregnancy. The purpose of this study was to compare the frequency of adverse pregnancy outcomes among syphilis-seropositive women who received different treatment regimens at different times in Guangzhou, China. Methods Pregnant women with syphilis infection who received prenatal and delivery services in Guangzhou between January 2014 and December 2016 were included. Association between treatment status and the composite adverse outcomes (preterm birth, infant smaller than gestational age, stillbirth, and spontaneous abortion) was estimated. Results Of 1187 syphilis-seropositive pregnant women included in the analysis, 900 (75.8%) syphilis-seropositive pregnant women received treatment, and 287(24.2%) did not receive treatment. Adverse pregnancy outcomes were observed among 16.3% (147/900) of women with treatment and 33.8% (97/287) of women without treatment. Syphilis-seropositive pregnant women treated with one or two courses of penicillin had a similar risk of adverse pregnancy outcomes (adjusted RR = 1.36, 95% CI: 0.94–1.96). Adverse outcomes were more common among women whose non-treponemal serum test titer was >1:8 and received treatment after 28 weeks compared to before 28 weeks (adjusted RR = 2.34, 95% CI: 1.22–4.48). Conclusions Women who received one course of penicillin and women who received two courses of penicillin had a similar risk of adverse pregnancy outcomes. Syphilis treatment before 28 weeks of pregnancy is critical. Strategies to promote high-quality prenatal services are needed.

Background Chlamydia trachomatis (CT) infection is considered to be related to adverse pregnancy outcomes, but we are still not sure whether prenatal screening and treatment of CT infection can prevent these. We conducted a pilot study to investigate the feasibility and acceptability of prenatal CT screening and treatment in China, in order to collect preliminary data for a RCT. Methods We recruited pregnant women at a gestational age between 12–14 weeks in a hospital in Guangzhou, China in April and May of 2018. All participants were screened for CT using Nucleic Acid Amplification Testing at the registry. Chlamydia-positive patients were provided one dose of azithromycin for treatment, and they were re-tested one-month after the treatment. We followed up every participant until delivery or end of pregnancy. We included nine adverse pregnancy outcomes (preterm birth (PTB), smaller than gestational age (SGA), birth defect, infant death, etc.). Results Of 453 women reached, 306 agreed for the screening and provided urine samples for testing. 302 (98.7%) of the collected samples were valid for testing, and 283 (92.5%) of questionnaires were obtained, but one was withdrew before delivery. Finally, we included 282 participants in this analysis whose mean age was 30.46 year (SD: 3.88). 14(5%) women were CT-positive at the registry. Eleven cases received treatment and three refused. All treated women was re-tested as negative after treatment. In treatment group (N=11), neither adverse pregnancy outcomes nor side effect of treatment was observed. In the non-treatment group (N=3), one still birth was found. Among 268CT-negative pregnant women, we observed 13 PTBs, 20 SGAs and 1 heart birth defect. Conclusion It is feasible and acceptable to conduct CT screening study among pregnant women. Although the sample size is limited, the study provided useful information for planning a RCT aimed to evaluate the efficacy of the testing and treatment strategy. Disclosure No significant relationships.

Objective: The overall impact of maternal hyperglycemia on maternal and birth outcomes is largely underestimated, therefore quantifying the true burden of hyperglycemia in a whole population it is a challenging task. This study aims at examining the association between blood glucose concentration during pregnancy and a composite score of adverse maternal-birth outcomes in a large-scale prospective cohort study in China. Methods: Pregnant women within “the Born in Guangzhou Cohort Study” China who underwent a standard 75-g oral-glucose-tolerance-test (OGTT) between 22 and 28 gestational weeks were included. A composite score of stillbirth, duration of pregnancy, birth weight, preeclampsia, and cesarean section was developed based on a published maternal-fetal outcomes scale, weighed by the relative severity of the outcomes. Multiple linear regression models were used to assess the associations between OGTT glucose measurements and log composite score. Logistic regression models were used to assess relations with outcome as a categorical variable (0, 1– ≺ 3, and ≥3). Findings: Among 12,129 pregnancies, the composite score ranged from 0 to 100 with a median of 2.5 for non-zero values. Elevated fasting glucose level was associated with higher composite score (adjusted coefficients 0.03 [95% CI, 0.02–0.04] for 1-SD increase). For 1-SD increase in fasting glucose, the risk of having a composite score 1– ≺ 3 and ≥3 rises by 13% (95% CI, 8–17%) and 15% (95% CI, 7–23%), respectively. Similar association and increase in risk was found for 1 and 2-h glucose. Conclusion: Elevated fasting, 1 and 2-h glucose levels are associated with a range of adverse maternal-birth outcomes. The composite score model can be applied to the risk assessment for individual pregnant women and to evaluate the benefits for controlling glucose levels in the population.

Few studies have explored the relationship between dietary patterns and the risk of gestational diabetes mellitus (GDM). Evidence from non-Western areas is particularly lacking. In the present study, we aimed to examine the associations between dietary patterns and the risk of GDM in a Chinese population. A total of 3063 pregnant Chinese women from an ongoing prospective cohort study were included. Data on dietary intake were collected using a FFQ at 24–27 weeks of gestation. GDM was diagnosed using a 75 g, 2 h oral glucose tolerance test. Dietary patterns were determined by principal components factor analysis. A log-binomial regression model was used to examine the associations between dietary pattern and the risk of GDM. The analysis identified four dietary patterns: vegetable pattern; protein-rich pattern; prudent pattern; sweets and seafood pattern. Multivariate analysis showed that the highest tertile of the vegetable pattern was associated with a decreased risk of GDM (relative risk (RR) 0·79, 95 % CI 0·64, 0·97), compared with the lowest tertile, whereas the highest tertile of the sweets and seafood pattern was associated with an increased risk of GDM (RR 1·23, 95 % CI 1·02, 1·49). No significant association was found for either the protein-rich or the prudent pattern. The protective effect of a high vegetable pattern score was more evident among women who had a family history of diabetes (P for interaction = 0·022). These findings suggest that the vegetable pattern was associated with a decreased risk of GDM, while the sweets and seafood pattern was associated with an increased risk of GDM. These findings may be useful in dietary counselling during pregnancy.

Objective The relationship between dietary patterns and gestational weight gain (GWG) in different pregnancy stages has rarely been reported among the Asian population. The aim of this study was to examine the relationship between dietary patterns and GWG in Chinese pregnant women. Methods Participants were women from the Born in Guangzhou Cohort Study who completed a validated food frequency questionnaire at 24 to 27 wk gestation (N = 5733). Dietary patterns were generated by cluster analysis. Maternal prepregnancy weight was self-reported; weights during pregnancy were extracted from medical records. Regression analyses were performed to test the associations between dietary patterns and total GWG and GWG rates (linear regression), and the adequacy of GWG (logistic regression). Results According to food consumption frequency, six dietary patterns were generated: “richer in cereals,” “richer in vegetables,” “richer in meats,” “richer in fruits,” “richer in fish, beans, nuts, and yogurt,” and “richer in milk and milk powder.” Compared with women following the richer in cereals pattern, those who followed the richer in fruits pattern had a significantly higher GWG (β = 0.592; 95% confidence interval [CI], 0.166–1.018) and total rate of GWG; those who followed the richer in fish, beans, nuts, and yogurt” pattern had a greater GWG rate in the second trimester, and also had a decreased risk for inadequate GWG (odds ratio, 0.797; 95% CI, 0.638–0.997). Conclusion Consuming a variety of foods and frequent consumption of fruits during pregnancy contributes to a more rapid increase in GWG among pregnant women in China. Findings may be useful in pregnancy weight monitoring.

Background Tea, a common beverage, has been suggested to exhibit a number of health benefits. However, one of its active ingredients, caffeine, has been associated with preterm birth and low birthweight. We investigated whether tea consumption during early pregnancy is associated with an increased risk of preterm birth and abnormal foetal growth. Methods A total of 8775 pregnant women were included from the Born in Guangzhou Cohort Study. Tea consumption (type, frequency and strength) during their first trimester and social and demographic factors were obtained via questionnaires administered during pregnancy. Information on birth outcomes and complications during pregnancy was obtained from hospital medical records. Results Overall habitual tea drinking (≥1 serving/week) prevalence among pregnant women was low, at 16%. After adjustment for potential confounding factors (e.g. maternal age, educational level, monthly income) tea drinking during early pregnancy was not associated with an increased risk of preterm birth, small or large for gestational age (p>0.05). Conclusions We did not identify a consistent association between frequency of tea consumption or tea strength and adverse birth outcomes among Chinese pregnant women with low tea consumption. Our findings suggest that occasional tea drinking during pregnancy is not associated with increased risk of preterm birth or abnormal foetal growth. Given the high overall number of annual births in China, our findings have important public health

Background Gestational diabetes mellitus affects 5–18% of pregnant women worldwide. Good blood glucose control is required to decrease the risk of macrosomia and long-term adverse effects for mothers and their offspring. Although continuous glucose monitoring (CGM) has been increasingly used for glucose management, little evidence has been reported in patients with gestational diabetes. We aimed to estimate and compare the effects of CGM parameters and routine oral glucose tolerance test (OGTT) measurements on fetal growth. Methods In this observational study, we recruited pregnant women with gestational diabetes who underwent CGM for 5–14 days after OGTT. We collected OGTT glucose measurements (including fasting, 1-h, and 2-h glucose concentrations), CGM time-series data, and birthweight. Parameters extracted from CGM data were glucose exposure metrics (including mean of day and night glucose and estimated HbA1c levels), glucose variability metrics (including J index and mean amplitude of glycaemic excursions), and a comprehensive glucose metric that captures both increasing mean glucose and glucose variability (ie, hours per day spent in severe glucose variability). We calculated birthweight percentiles using the INTERGROWTH-21st birthweight standard and used multiple linear regression models to estimate the association of birthweight percentile with OGTT measurements and CGM glucose features. We calculated adjusted mean difference and their 95% CIs for a 1 SD increase in glucose metrics. Findings Between Jan 11, 2017, and Nov 15, 2018, we enrolled 97 women with gestational diabetes. For OGTT measures, each 1 SD increase in maternal fasting glucose was associated with a 5·62 (95% CI 0·39–10·85) percentile increase in neonatal birthweight. Among CGM parameters, each 1 SD increase in mean glucose concentration at night and hours per day spent in severe glucose variability were associated with a 5·81 (95% CI 0·34–11·29) and 6·45 (0·73–12·17) percentile increase in birthweight. None of the levels of other glucose metrics either from OGTT or CGM measurements were associated with birthweight percentile. Interpretation Fasting glucose has a comparable effect on fetal growth to glucose metrics obtained from CGM data, indicating that fasting glucose measurement is an effective and low-cost option for the management of gestational diabetes. Funding The National Natural Science Foundation of China.

BACKGROUND: The insulin‐like growth factor (IGF) pathway was involved in the occurrence of spontaneous preterm birth (SPTB), but little is known regarding the relationship between genetic variations in IGF pathway and the risk of SPTB. We aimed to investigate the associations of IGF1 rs972936 and IGF1 receptor (IGF1R) rs2229765 polymorphisms with SPTB risk in a Chinese population. METHOD: A total of 114 cases of SPTB and 250 controls of term delivery were included from Guangzhou Women and Children's Medical Center, China. The odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were calculated using multivariate logistic regression. RESULTS: We found that the GA and GA/AA genotypes of IGF1 rs972936 were associated with an increased risk of SPTB, and the adjusted ORs (95% CI) were 1.74 (1.01‐3.02) and 1.75 (1.04‐2.93) respectively. Women carrying GA and GA/AA genotypes of IGF1R rs2229765 had a reduced risk compared to those with the GG genotype (0.60 [0.37‐0.98] and 0.64 [0.40‐1.00] respectively). There were significant interactions between IGF1 rs972936 and GDM status (P for interaction=.02), as well as between IGF1R rs2229765 and pre‐pregnancy BMI (P for interaction

This study aimed to examine the reproducibility and validity of a new food frequency questionnaire (FFQ) used in a birth cohort study to estimate the usual consumption frequencies of foods during pregnancy. The reference measure was the average of three inconsecutive 24 h diet recalls (24 HR) administrated between two FFQs, and the reproducibility was measured by repeating the first FFQ (FFQ1) approximately eight weeks later (FFQ2). A total of 210 pregnant women from the Born in Guangzhou Cohort Study (BIGCS) with full data were included in the analysis. The Spearman’s correlation coefficients of FFQ1 and FFQ2 ranged from 0.33 to 0.71. The intraclass correlation coefficients of the two FFQs ranged from 0.22 to 0.71. The Spearman’s correlation coefficients of the 24 HR and FFQ2 ranged from 0.23 to 0.62. Cross-classification analysis showed 65.1% of participants were classified into same and contiguous quintiles, while only 3.2% were misclassified into the distant quintiles. Bland-Altman methods showed good agreement for most food groups across the range of frequencies between FFQ1 and FFQ2. Our findings indicated that the reproducibility and validity of the FFQ used in BIGCS for assessing the usual consumption frequencies of foods during pregnancy were acceptable.

Preterm birth (PTB, &lt, 37 weeks) is the leading cause of death in children &lt, 5 years of age. Early risk prediction for PTB would enable early monitoring and intervention. However, such prediction models have been rarely reported, especially in low- and middle-income areas. We used data on a number of easily accessible predictors during early pregnancy from 9044 women in Born in Guangzhou Cohort Study, China to generate prediction models for overall PTB and spontaneous, iatrogenic, late (34&ndash, 36 weeks), and early (&lt, 34 weeks) PTB. Models were constructed using the Cox proportional hazard model, and their performance was evaluated by Harrell&rsquo, s c and D statistics and calibration plot. We further performed a systematic review to identify published models and validated them in our population. Our new prediction models had moderate discrimination, with Harrell&rsquo, s c statistics ranging from 0.60&ndash, 0.66 for overall and subtypes of PTB. Significant predictors included maternal age, height, history of preterm delivery, amount of vaginal bleeding, folic acid intake before pregnancy, and passive smoking during pregnancy. Calibration plots showed good fit for all models except for early PTB. We validated three published models, all of which were from studies conducted in high-income countries, the area under receiver operating characteristic for these models ranged from 0.50 to 0.56. Based on early pregnancy characteristics, our models have moderate predictive ability for PTB. Future studies should consider inclusion of laboratory markers for the prediction of PTB.

To determine the presence of C1q and tumor necrosis factor-related protein 3 (CTRP3) in cord blood and its relationship with fetal growth among Chinese newborns.This pilot study recruited 126 infants (small for gestational age [SGA], n=34; appropriate for gestational age [AGA], n=60; large for gestational age [LGA], n=32); cord blood CTRP3 levels were measured, and fetal growth parameters were collected.Median (25-75th percentile) CTRP3 levels in the SGA, AGA, and LGA groups were 297.2 (236.4-360.2), 297.5 (261.0-369.9), and 368.6 (298.5-507.1) ng/ml, respectively (P=0.01). LGA infants had higher CTRP3 levels than AGA infants (multiple linear regression analysis; P=0.01). The CTRP3 levels were positively correlated with birth weight (r=0.25, P0.01), Ponderal index (r=0.28, P0.01), and placental weight (r=0.20, P=0.03) in the total study population. In the subgroup analysis, CTRP3 levels were negatively correlated with birth length z scores (r=-0.39, P=0.03) and were positively correlated with the Ponderal index (r=0.43, P=0.02) only in the SGA group; no other significant correlations were observed. The CTRP3 levels were similar between the sexes (P=NS).CTRP3 is present in cord blood and might be involved in fetal growth.

Background Gestational hypertension and pre-eclampsia are major causes of perinatal mortality. Prediction of gestational hypertension and pre-eclampsia is of great interest because it enables early intervention, thus improving prognosis. Most existing prediction models consist of biomarkers, which might be unavailable in low-resourced countries. We aimed to establish a prediction model of gestational hypertension and pre-eclampsia using data at early pregnancy. Methods We studied women with singleton delivery from Born in Guangzhou Cohort Study (BIGCS), China. Predictors included maternal age, educational level, income level, prepregnancy weight, height, passive smoking, and blood pressure collected at the first antenatal-care visit (around 16 weeks' gestation). Information on diagnosis of gestational hypertension or pre-eclampsia was extracted from medical records using international classification of disease code (ICD-10). We used logistic regression to develop prediction models. Discrimination and calibration were assessed with receiver operation characteristics (ROC) and calibration plot, respectively. Findings Between Feb 1, 2012, and Jan 1, 2016, we recruited 12 915 women, of which 326 (2·52%) women were diagnosed with gestational hypertension and 82 (0·66%) had pre-eclampsia. The prediction model for gestational hypertension with maternal characteristics alone had an area under the ROC-curve of 0·67 (95% CI 0·62–0·72). Maternal mean arterial pressure (MAP) had an area under the curve (AUC) of 0·74 (95% CI 0·70–0·79), whereas the AUC of the model with MAP and maternal characteristic combined was 0·76 (0·72–0·81), which was slightly better than for MAP alone (p=0·03). Results for prediction of pre-eclampsia were very similar to those of gestational hypertension. Calibration plots showed that the prediction model with MAP had good fit. Interpretation Our findings show that MAP has acceptable predictive ability of gestational hypertension and pre-eclampsia and can be used to triage further care. Our relatively large sample size ensured stronger statistical power. Model validation need to be performed in a separate population. Funding National Natural Science Foundation of China (81673181), Guangzhou Science and Technology Bureau, Guangzhou, China (2011Y2-00025, 201508030037)

Background The prevalence of gestational diabetes mellitus has increased markedly in recent years in China, mainly because of the introduction of new diagnostic criteria. We aimed to evaluate whether in the diagnosis of gestational diabetes mellitus, 1h and 2h glucose measurements have additional value compared with a single fasting plasma glucose measurement. Methods We included data from 6993 pregnant women who underwent a 2h 75g oral glucose-tolerance test at 22–28 weeks' gestation in the Born in Guangzhou Cohort Study in China. Outcomes included having a large for gestational age baby (≥90th percentile), caesarean section, spontaneous preterm birth, and pre-eclampsia. We calculated the area under the receiver operator characteristic curves (AUC) to assess the capacity of oral glucose-tolerance test values to predict outcomes. Findings The prevalence of large for gestational age babies was 10·8% (695 of 6448). The AUC for prediction of large for gestational age was greater for fasting plasma glucose than for 1h (0·604 vs 0·556, p=0·0002) and 2h glucose tests (0·604 vs 0·552, p vs 9·7% [566 of 5807], adjusted odds ratio 2·04, 95% CI 1·62–2·56), and post-load glucose concentrations had limited effect on that probability. Similarly, post-load glucose concentrations contributed little to the prediction of preeclampsia, spontaneous preterm birth, and caesarean section. Interpretation In the diagnosis of gestational diabetes mellitus in a Chinese population, a single fasting plasma glucose measurement can predict whether women are at increased risk of having a large for gestational age baby. Funding Guangzhou Science and Technology Bureau, Guangzhou, China

There was limited evidence revealing the association of Chinese maternal dietary patterns with fetal growth. We aimed to examine the relationship of maternal dietary patterns during pregnancy to neonatal birth weight and birth weight for gestational age in a Chinese population. A total of 6954 mother-child pairs were included from the Born in Guangzhou Cohort Study. Maternal diet during pregnancy was assessed using a self-administered food frequency questionnaire. Cluster analysis was used to identify dietary patterns. The following six dietary patterns were identified: "Cereals, eggs, and Cantonese soups" (n 1026, 14.8%), "Dairy" (n 1020, 14.7%), "Fruits, nuts, and Cantonese desserts" (n 799, 11.5%), "Meats" (n 1066, 15.3%), "Vegetables" (n 1383, 19.9%), and "Varied" (n 1224, 17.6%). The mean neonatal birth weight Z scores of women in the above patterns were 0.02, 0.07, 0.20, 0.01, 0.06, and 0.14, respectively. Women in the "Fruits, nuts, and Cantonese desserts" and "Varied" groups had significantly heavier infants compared with those in the "Cereals, eggs, and Cantonese soups" group. Compared with women in the "Cereals, eggs, and Cantonese soups" group, those in the "Varied" group had marginally significantly lower odds of having a small-for-gestational age (SGA) infant after adjustment for other confounders (OR 0.77, 95% CI 0.57, 1.04, p = 0.08). These findings suggest that compared to a traditional Cantonese diet high in cereals, eggs, and Cantonese soups, a diet high in fruits, nuts, and Cantonese desserts might be associated with a higher birth weight, while a varied diet might be associated with a greater birth weight and also a decreased risk of having a SGA baby.

Objectives Men who have sex with men (MSM) are an at-risk population for HIV/AIDS . Accurately estimating the size of MSM is important to monitor the HIV/AIDS epidemic and to implement HIV/AIDS prevention in the MSM population. None of the current methods for MSM population size estimation is satisfactory, especially for internet samples. We try to use the modified Laska, Meisner and Siegel (LMS) method to estimate the size of MSM in tangible venues and internet virtual venues. Methods Laska, Meisner and Siegel developed an unbiased estimator for the size of a population in a single venue based on a single sample (LMS method). In this study, we modified the LMS method for the estimation of population size of MSM (LMS* procedure). Specially, we integrated the MSM size of traditional tangible venue with internet virtual venue. Currently, the latter is an important source of socialisation for MSM population. To do this, we added a few parameters to the original LMS method. Then we applied the LMS* procedure to estimate the size of MSM in Changsha, the capital city of the Chinese Province of Hunan. Results The LMS* procedure handled the complexity of socialisation among MSM population well. According to the LMS* procedure, the total number of MSM was 65 657 (95% CI 57 922 to 73 388), constituting a proportion of 5.43% (95% CI 4.79% to 6.07%) in the sexually active male population (15–64-year-olds) in Changsha. Conclusions We conclude that the LMS* procedure is suitable for the estimation of a hard-to-reach population, such as MSM, in tangible venues and internet virtual venues.

To study the features, safe sex behavior and the size of men who have sex with men (MSM) population in actual and virtual venues in one city.We carried out a cross-sectional study in actual and virtual venues, using the Estimated Size of Population from a Single Sample (LMS method) to estimate the size of MSM population.Most MSM in actual venues were 24 - 43 year olds and had received high school education, whereas in virtual venues, the majority of this population were younger than 29 years old and had higher education, including some college students. The awareness of AIDS of the two groups from different venues showed no statistically significant difference, neither the safe sex behaviors. Proportions of the MSM population in actual and virtual venues were 21.22% (16 383, 95%CI: 11 514 - 21 252) and 78.78% (60 830, 95%CI: 57 327 - 64 329), respectively. After adjusting the overlapping part of the MSM from both venues, the total number was between 60 830 and 77 213, constituting a proportion of 5.03% - 6.38% in the sexually active male population (15 - 64 year olds) in this city.The size of the MSM population was large but the characteristics were different in the actual or virtual venues. As most MSM preferred going to the virtual venues, intervention program on AIDS-specific strategy in this area, in particular dealing with the Internet, should be strengthened.

Thermal paint is widely used for measuring surface temperature of devices in aeronautics and space industry, such as space shuttle's engine, airplane's skin etc. The segmentation for the thermal paint's image is the fundamentals of the digital and automated temperature measuring process. A new method for thermal paint image segmentation is proposed in this paper, which based on color and spatial information. First, PGF algorithm is selected to reduce image's noises and keep the edge feature of image. Furthermore, using K-Means cluster algorithm, colors in the image are quantized to several representing classes that can be used to differentiate regions in the image. Finally, a region growing and merge method is then used to segment the image. Experimental results demonstrate that good segmentation is obtained by our algorithm, and our algorithm is suitable for segmenting the thermal paint image.