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The rate of preterm birth of singletons conceived through in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is increased, being as high as 15% to 16% across Europe and the United States. However, the underlying etiology, phenotype, and mechanisms initiating preterm birth (PTB) are poorly understood. To quantify the PTB risk and examine supposed etiology in IVF/ICSI singleton pregnancies compared to naturally conceived. Overview of reviews including all available systematic reviews with meta-analysis comparing PTB risk in IVF/ICSI and naturally conceived singletons. A comprehensive search of PubMed/MEDLINE, Embase, Scopus, and Cochrane Library databases was performed up to December 31, 2023. Information available on etiology, phenotype, initiation of PTB, and relevant moderators was retrieved and employed for subgroup analyses. Random-effects meta-analysis models were used for pooling effect measures. Estimates were presented as odds ratios (ORs) with 95% confidence intervals (CIs). The extent of overlap in the original studies was measured using the corrected covered area assessment. The quality of the included reviews was evaluated with the AMSTAR 2 tool. The Grading of Recommendations Assessment, Development and Evaluation approach was applied to rate evidence certainty. The protocol was registered on PROspective Register of Systematic Reviews (CRD42023411418). Twelve meta-analyses (16,522,917 pregnancies; ˃433,330 IVF/ICSI) were included. IVF/ICSI singletons showed a significantly higher PTB risk compared to natural conception (PTB ˂37 weeks: OR: 1.72, 95% CI: 1.57–1.89; PTB<32 weeks: OR: 2.19, 95% CI: 1.82–2.64). Influential analysis reinforced the strength of this association. Subgroup analyses investigating supposed etiology revealed a comparable risk magnitude for spontaneous PTB (OR: 1.79, 95% CI: 1.56–2.04) and a greater risk for iatrogenic PTB (OR: 2.28, 95% CI: 1.72–3.02). PTB risk was consistent in the subgroup of conventional IVF (OR: 1.95, 95% CI: 1.76–2.15) and higher in the subgroup of fresh only (OR: 1.79, 95% CI: 1.55–2.07) vs frozen-thawed embryo transfers (OR: 1.39, 95% CI: 1.34–1.43). There was minimal study overlap (13%). The certainty of the evidence was graded as low to very low. Singletons conceived through IVF/ICSI have a 2-fold increased risk of PTB compared to natural conception, despite the low certainty of the evidence. There is paucity of available data on PTB etiology, phenotype, or initiation. The greater risk increase is observed in fresh embryo transfers and involves iatrogenic PTB and PTB ˂32 weeks, likely attributable to placental etiology. Future studies should collect data on PTB etiology, phenotype, and initiation. IVF/ICSI pregnancies should undertake specialistic care with early screening for placental disorders, cervical length, and growth abnormalities, allowing appropriate timely follow-up, preventive measures, and therapeutic interventions strategies. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the association of maternal factors with low birth weight (LBW) newborns at King Abdullah Teaching Hospital, Mansehra. METHODOLOGY: This descriptive cross-sectional study was done at the Department of Pediatrics and labor room of King Abdullah Teaching Hospital, Mansehra, Pakistan, from June to November 2021. A total of 171 women aged 18-30 who had a singleton pregnancy ≥37 completed weeks of gestation were enrolled and evaluated for the presence of risk factors associated with the incidence of LBW in infants. The outcome regarding the frequency of low birth weight and its associations with Maternal factors were recorded. RESULTS: In a total of 171 women, 77(45.0%) had short stature, while 57(33.3%) weighed 50 kg or less. The frequency of anemia was noted in 56 (32.7%). Out of 171 women who gave a singleton live birth, 63(36.8%) newborns were LBW. A significantly less proportion of mothers had maternal age between 18-25 who delivered LBW babies (74.6% vs. 44.4%, p=0.0001). Short stature among mothers was significantly associated with LBW (58.7% vs. 37.0%, p=0.0060). Maternal weight less than or equal to 50 kg was also linked with LBW (42.9% vs. 27.8%, p=0.0436). Anemia is significantly associated with LBW (49.2% vs 23.1%, p=0.0005). CONCLUSION: The frequency of LBW was noted to be high. Maternal age between 18-25 years, short stature, low maternal weight (>50 kg), and anemia during pregnancy can significantly raise the risk of LBW.

Introduction: This study aimed to explore the effect of cryopreservation duration after blastocyst vitrification on the singleton birth-weight of newborns to assess the safety of long-term preservation of frozen--thawed blastocyst transfer (FBT) cycles. Methods: This was a retrospective observational study conducted at the Gynecological Endocrinology and Assisted Reproduction Center of the Peking Union Medical College Hospital. Patients who gave birth to singletons between January 2006 and December 2021 after undergoing FBT cycles were included. Five groups were formed according to the duration of cryopreservation of embryos at FBT: Group I included 274 patients with a storage time < 3 months. Group II included 607 patients with a storage time of 3--6 months. Group III included 322 patients with a storage time of 6--12 months. Group IV included 190 patients with a storage time of 12--24 months. Group V included 118 patients with a storage time of > 24 months. Neonatal outcomes were compared among the groups. Multivariate linear regression analysis was performed to evaluate birthweights and other birth-related outcomes. Results: A total of 1,511 patients were included in the analysis. The longest cryopreservation period was 12 years. The birth-weights of neonates in the five groups were 3344.1 ± 529.3, 3326.1 ± 565.7, 3260.3 ± 584.1, 3349.9 ± 582.7, and 3296.7 ± 491.9 g, respectively (P > 0.05). The incidences of preterm birth, very preterm birth, low birth-weight, and very low birth-weight were similar in all groups (P > 0.05). The large-for-gestational-age and small-for-gestational-age rates did not differ significantly among the groups (P > 0.05). After adjusting for confounding factors that may affect neonatal outcomes, a trend for an increased risk of low birth-weight with prolonged cryopreservation was observed. However, cryopreservation duration and neonatal birth-weight were not significantly correlated (P > 0.05). [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the association of maternal factors with low birth weight (LBW) newborns at King Abdullah Teaching Hospital, Mansehra. METHODOLOGY: This descriptive cross-sectional study was done at the Department of Pediatrics and labor room of King Abdullah Teaching Hospital, Mansehra, Pakistan, from June to November 2021. A total of 171 women aged 18-30 who had a singleton pregnancy =37 completed weeks of gestation were enrolled and evaluated for the presence of risk factors associated with the incidence of LBW in infants. The outcome regarding the frequency of low birth weight and its associations with Maternal factors were recorded. RESULTS: In a total of 171 women, 77(45.0%) had short stature, while 57(33.3%) weighed 50 kg or less. The frequency of anemia was noted in 56 (32.7%). Out of 171 women who gave a singleton live birth, 63 (36.8%) newborns were LBW. A significantly less proportion of mothers had maternal age between 18-25 who delivered LBW babies (74.6% vs. 44.4%, p=0.0001). Short stature among mothers was significantly associated with LBW (58.7% vs. 37.0%, p=0.0060). Maternal weight less than or equal to 50 kg was also linked with LBW (42.9% vs. 27.8%, p=0.0436). Anemia is significantly associated with LBW (49.2% vs 23.1%, p=0.0005). CONCLUSION: The frequency of LBW was noted to be high. Maternal age between 18-25 years, short stature, low maternal weight (>50 kg), and anemia during pregnancy can significantly raise the risk of LBW. [ABSTRACT FROM AUTHOR]

The gene B4GALNT2, with 12 Exons, is located on chromosome 11. This gene is associated with the production of the B4GALNT2 protein, which functions as a transferase in the final step of synthesizing the Sda antigen. In the Lacaune breed, a mutation known as FecLL (g.36938224T>A) in intron 7 of this gene has been found to have a positive effect on fertility and multiple births. Considering the effect of multiple births in the small ruminant industry, an investigation was conducted to explore the presence of the FecLl mutation and other potential mutation near its location in part of the intron 7 of B4GALNT2 gene. Two groups of multiple birth and single birth, each containing 20 shal ewes were selected for blood collection, DNA extraction and sanger sequencing, based on their reproductive histories of last 5 year of lambing records and the current breeding season. The sequence analysis revealed the absence of the FecLL mutation in the samples. However, three other mutations were identified: g.37129493 T>C, g.37129812 C>A, and g.37130289 T>A. No significant differences were observed between the two study groups regarding these mutations (P > 0.05). Based on these findings, it appears that the FecLL mutation may not be present in the Shal breed. However, due to the occurrence of the mutations in the intron and their potential low impact on the final protein, further investigation of the gene network and a larger sample size is recommended to explore other phenotypic associations and detect additional mutation. [ABSTRACT FROM AUTHOR]

Many contemporary metaphysicians believe that the existence of a contingent object such as Socrates metaphysically explains the existence of the corresponding set {Socrates}. This paper argues that this belief is mistaken. The argument proposed takes the form of a dilemma. The expression "{Socrates}" is a shorthand either for the expression "the set that contains all and only those objects that are identical to Socrates" or for the expression "the set that contains Socrates and nothing else". However, Socrates' existence does not explain the existence of the set that contains all and only those objects that are identical to Socrates, because there is such a set no matter whether or not Socrates exists. And although Socrates' existence does explain that of the set that contains Socrates and nothing else, this explanation is a conceptual rather than a metaphysical one. Both these claims rely on a deflationary account of the use of set theoretic vocabulary that is explained, though not properly justified, in the paper. [ABSTRACT FROM AUTHOR]

Background: Assisted reproductive technology (ART) has revolutionized infertility treatment, leading to a surge in ART-conceived children. Despite its success, ART-born offspring face higher risks of preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). The mechanisms behind these outcomes remain unclear, partly attributed to multiple embryo transfers. Recent advancements advocate single blastocyst transfers for improved outcomes. However, the influence of blastocyst quality and development speed on neonatal outcomes is underexplored. Objective: This study investigated whether blastocyst development speed and quality affect singleton birthweight when the blastocyst is selected for single frozen-thawed blastocyst transfer (FBT). Methods: Data from patients who performed an FBT cycle at our center from July 2011 to June 2021 were collected and analyzed. Based on the inclusion and exclusion criteria, 420 single FBT cycles were assessed. The women were divided into four groups, Group A (day 5, good-quality blastocysts), Group B (day 5, nongood-quality blastocysts), Group C (day 6, good-quality blastocysts), and Group D (day 6, non-good-quality blastocysts) according to the developmental speed and quality of the transferred blastocyst. Results: The birthweight was relatively the highest in Group A, which developed rapidly and transferred good quality blastocysts. However, no significant difference existed among the groups (P>0.05). The prevalence of premature birth (PTB), low birth weight (LBW), very low birth weight (VLBW), or high birth weight (HBW) was similar among the four groups (P > 0.05). No correlation existed between birth weight and blastocyst development speed or quality after adjusting for possible confounders (P > 0.05 respectively). However, the difference in the proportion of males born among the four groups was significant, especially in Group D, which was significantly lower than that in Group A (adjusted odds ratio = 0.461, 95% confidence interval: 0.230–0.921, P < 0.05). Conclusions: This retrospective cohort study suggests that the combined effect of blastocyst development speed and quality on neonatal birthweight is insignificant. The transfer of slow-growing, non-good-quality blastocysts increases the chance of a female baby being born. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are the predominant pregnancy complications among singleton and twin pregnancies worldwide. Our primary objective was to explore the adverse effect of GDM and HDP on maternal–perinatal outcomes compared with non-GDM and non-HDP in singleton and twin pregnancies. The secondary objective was to find the risk of adverse maternal–perinatal outcomes in twin pregnancies compared with singleton pregnancies complicated with GDM and HDP in Hubei, China. Methods: A tertiary hospital-based retrospective study was conducted at Wuhan University Renmin Hospital, Hubei Province, China, from 2011 to 2019. A chisquare test was used to determine the difference in adverse maternal–perinatal outcomes between singleton and twin pregnancies. A multiple binary logistic regression model and a joinpoint regression model were used to determine the association of GDM and HDP with adverse maternal–perinatal outcomes and GDM and HDP temporal trend among singleton and twin pregnancies. Results: The trend of HDP [average annual percentage change (AAPC) 15.1% (95% confidence interval (95%CI): 5.3, 25.7)] among singleton pregnancies and GDM [AAPC 50.4% (95%CI: 19.9, 88.7)] among twin pregnancies significantly increased from 2011 to 2019. After adjusting for confounding factors, GDM is associated with an increased risk of C-section (adjusted odds ratio (aOR), 1.5; 95%CI: 1.3, 1.6) and macrosomia (aOR, 1.3; 95%CI: 1.1, 1.6) in singleton and preterm birth (PTB) (aOR, 2.1; 95%CI: 1.2, 3.3) in twin pregnancies compared with non-GDM. HDP was associated with a higher risk of C-section, PTB, perinatal mortality, and low birth weight (LBW) in both singleton and twin pregnancies compared with the non-HDP. Compared with singleton pregnancies complicated with GDM and HDP, twin pregnancies showed higher odds of C-section [(aOR, 1.7; 95%CI: 1.1, 2.7), (aOR, 4.6; 95%CI: 2.5, 8.7), respectively], PTB [(aOR, 22.9; 95%CI: 14.1, 37.3), (aOR, 8.1; 95%CI: 5.3, 12.3), respectively], LBW [(aOR, 12.1; 95%CI: 8.2, 18.1), (aOR, 5.1; 95%CI: 3.6, 7.4), respectively], and low Apgar score [(aOR, 8.2; 95%CI: 4.4, 15.1), (aOR, 3.8; 95%CI: 2.4, 5.8), respectively] complicated with GDM and HDP. Conclusion: In conclusion, GDM showed an increased risk of a few adverse maternal–perinatal outcomes and HDP is associated with a higher risk of several adverse maternal–perinatal outcomes in singleton and twin pregnancies compared to non-GDM and non-HDP. Moreover, twin pregnancies complicated with GDM and HDP showed higher odds of adverse maternal–neonatal outcomes compared with singleton pregnancies complicated with GDM and HDP. [ABSTRACT FROM AUTHOR]

BackgroundAssisted reproductive technology (ART) has revolutionized infertility treatment, leading to a surge in ART-conceived children. Despite its success, ART-born offspring face higher risks of preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). The mechanisms behind these outcomes remain unclear, partly attributed to multiple embryo transfers. Recent advancements advocate single blastocyst transfers for improved outcomes. However, the influence of blastocyst quality and development speed on neonatal outcomes is underexplored.ObjectiveThis study investigated whether blastocyst development speed and quality affect singleton birthweight when the blastocyst is selected for single frozen-thawed blastocyst transfer (FBT).MethodsData from patients who performed an FBT cycle at our center from July 2011 to June 2021 were collected and analyzed. Based on the inclusion and exclusion criteria, 420 single FBT cycles were assessed. The women were divided into four groups, Group A (day 5, good-quality blastocysts), Group B (day 5, non-good-quality blastocysts), Group C (day 6, good-quality blastocysts), and Group D (day 6, non-good-quality blastocysts) according to the developmental speed and quality of the transferred blastocyst.ResultsThe birthweight was relatively the highest in Group A, which developed rapidly and transferred good quality blastocysts. However, no significant difference existed among the groups (P>0.05). The prevalence of premature birth (PTB), low birth weight (LBW), very low birth weight (VLBW), or high birth weight (HBW) was similar among the four groups (P > 0.05). No correlation existed between birth weight and blastocyst development speed or quality after adjusting for possible confounders (P > 0.05 respectively). However, the difference in the proportion of males born among the four groups was significant, especially in Group D, which was significantly lower than that in Group A (adjusted odds ratio = 0.461, 95% confidence interval: 0.230–0.921, P < 0.05).ConclusionsThis retrospective cohort study suggests that the combined effect of blastocyst development speed and quality on neonatal birthweight is insignificant. The transfer of slow-growing, non-good-quality blastocysts increases the chance of a female baby being born.

Objective: To characterize differences in the prenatal detection of congenital anomalies (CAs) associated with singleton and multiple births. Methods: This observational study covered all births registered in the CA surveillance system in Zhejiang Province of China during 2012–2018. Differences in the incidence and characteristics between singletons and multiple births with CAs were tested. Multivariate logistic regression models were performed to explore the associations of prenatal detection rate of CAs with multiple births. Results: Totals of 49 872 singletons and 3324 multiple births with CAs were analyzed. The mean incidences of CA for single and multiple births were 27.12 and 54.42 per 1000 births, respectively. After adjustment for covariates, CAs associated with multiple births were less likely to be diagnosed prenatally (adjusted odds ratio [OR] 0.38, 95% confidence interval [CI] 0.34–0.43), as were congenital heart defects, congenital hydrocephalus, cleft lip with cleft palate, cleft lip without cleft palate, limb reduction defects, congenital diaphragmatic hernia, trisomy 21 syndrome, congenital malformation of the urinary system, and other chromosomal malformation, compared with singletons with CAs. Conclusion: Multiple birth is associated with a significantly higher risk of CA, but a significantly lower prenatal diagnosis rate. Therefore, the healthcare of women with multiple pregnancy and their fetuses should be strengthened. Synopsis: Multiple birth is associated with a significantly higher risk of congenital anomalies, but a significantly lower prenatal diagnosis rate. [ABSTRACT FROM AUTHOR]

Species richness is a widely used measure for assessing the diversity of a particular area. However, observed richness often underestimates the true richness due to resource limitations, particularly in a small-sized sample or highly heterogeneous assemblage. To estimate the number of different species (species richness) present across several different sites (communities), researchers often use a combined collection of data (an integrated dataset). This dataset is created by collecting samples from each site individually and independently. However, the pooled sample of integrated data is no longer a random sample from the entire area, and the use of different sampling schemes results in different collected data formats. Consequently, employing a single sampling distribution to model the pooled sample becomes unfeasible, rendering existing richness estimators inadequate. This study provides a theoretical explanation for the applicability of Chao's lower bound estimator in assessing species richness across multiple sites based on the pooled sample. Additionally, a new non-parametric estimator is introduced, which adjusts the bias of Chao's lower bound estimator by leveraging the Good–Turing frequency formula. This proposed estimator only utilizes the richness of singletons, doubletons, and tripletons in the pooled sample to estimate undetected richness. Simulated datasets across various models are employed to demonstrate the statistical performance of the estimator, showcasing its ability to reduce the bias of observed richness and provide accurate 95% confidence intervals. Real datasets are also utilized to illustrate the practical application of the proposed approach. [ABSTRACT FROM AUTHOR]

To compare perinatal outcomes between singleton live births after blastocyst-stage and cleavage-stage fresh embryo transfer using data from all United Kingdom licensed fertility clinics. A cohort study. Not applicable. A total of 60,926 in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles resulting in a singleton live birth after blastocyst-stage and cleavage-stage fresh embryo transfer between 2012 and 2018. Baseline characteristics between IVF/ICSI blastocyst and cleavage-stage transfer groups were compared using the χ2 test for categorical/dichotomized variables and the Mann-Whitney test for continuous variables. Statistical significance was set at <.05. Association between perinatal outcomes and blastocyst transfer compared with cleavage-stage transfer was assessed using multinomial logistic regression, adjusting for confounders selected using directed acyclic graphs (95% confidence interval [CI], adjusted relative risk ratio [aRRR]). A subgroup analysis included cycles in women undergoing their first IVF/ICSI cycle. Gestational age at birth and birth weight. The blastocyst group comprised 42,677 IVF/ICSI cycles and cleavage-stage group 18,249 cycles. There was likely little to no difference in the risk of preterm (aRRR, 1.07; 95% CI, 1.00–1.15) and very preterm birth (aRRR, 1.05; 95% CI, 0.91–1.21) in singleton live births after fresh blastocyst and cleavage-stage transfer. Risks of low birth weight (aRRR, 1.02; 95% CI, 0.95–1.09), very low birth weight (aRRR 0.96; 95% CI, 0.83–1.11), high birth weight (aRRR, 0.97; 95% CI, 0.90–1.04), and very high birth weight (aRRR, 0.91; 95% CI, 0.77–1.08) were likely similar between the groups. The findings were consistent in the subgroup analysis. Fresh blastocyst transfer does not appear to have a negative impact on gestational age at birth and birth weight in singleton live births compared with fresh cleavage-stage transfer. [ABSTRACT FROM AUTHOR]

Expressed sequence tags of simple sequence repeats (EST-SSRs) are used to investigate genetic diversity and develop molecular markers for plants under biotic and abiotic stresses. However, there are a limited number of molecular markers based on the ESTs in rice to cope with the abiotic stresses including salinity, for use in breeding programs. Among 8299 ESTs, available in the NCBI database for salinity stress, 525 contigs, and 1139 singleton sequences were obtained. Twenty EST-SSR markers could be introduced for the selection of tolerant varieties to salt stress in rice by analysis of contigs and singletons. In contigs and singletons, significant common gene ontology terms are mainly related to the single-organism cellular process and response to abiotic stresses. The highest percentage of transcription factors for contigs and singletons was related to ERF, Dof, MYB, C2H2, BBR-BPC, bZIP, and WRKY. Moreover, the HSP81-2 (heat shock protein 81-2) and regulators of complement activation were identified as proteins of hub genes that were related to the salt stress tolerance mechanisms. Three uncharacterized hub genes (OS02T0161900-01, OsJ_19443, and OsJ_04035) including EST-SSRs for function identification were investigated by the 3D protein structure homology-modeling. OS02T0161900-01 as tetra ubiquitin, OSj-19443 as a serine/threonine-protein kinase/endoribonuclease, and OSj-04035 as a triosephosphate isomerase were identified. Most of the hub genes were related to environmental stresses and our findings provided candidate genes and transcription factors involved in salinity stress. The development of functional markers associated with abiotic stress tolerance will be helpful to facilitate rice breeding programs. However, before using these markers, laboratory confirmation is necessary. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to develop an explanatory model of assertiveness based on parenting styles mediated by anxiety and self-esteem. Methods: This study is descriptive-correlational modeling with partial least squares. The statistical population included singleton children of the sixth grade of the elementary school in the 3rd District of Tehran in the academic year 2017-18. The sampling method was multi-stage sampling; eight schools (four all-boys and four all-girls) were randomly selected from all primary schools in the 3rd District of Tehran, then, a sixth-grade class was randomly selected in each school. The singleton students of those classes participated in the present study as the study sample. The sample size was 118 students (81 girls and 37 boys). The instruments of this research included the Persian forms of adaptive and aggressive assertiveness scales (AAA-S), the Baumrind parenting scale, Beck anxiety inventory (BAI), and Rosenberg self-esteem scale (RSES). To analyze the data, the SPSS software, version 26. Results: The results indicated that authoritative and permissive parenting styles had a significant effect on assertiveness among the parenting styles. The total effects indicated that authoritative and permissive parenting styles explained 0.22 and 0.20 of the variances of assertiveness. The results also showed that the authoritarian parenting style had no significant effect on assertiveness. Discussion: The suggested model was acceptably fit, according to the results of the study. Permissive and authoritative parenting styles had impact on assertiveness.

Background: The incidence of extrauterine growth retardation (EUGR) varies considerably in different countries due to the distinct definitions and inclusion criteria of individual studies. Most studies included small for gestational age (SGA) very preterm infants (VPIs), resulting in a higher incidence of EUGR. Experts have suggested the accurate definition of “EUGR” in SGA infants is not “true EUGR”. The postnatal growth curve of multiple premature births also differs from that of singletons. As far as we know, there is no study about relationship between singleton-non-SGA preterm infants and EUGR. Objectives: To analyze the factors influencing EUGR among VPIs who were singleton-non-SGA in China. Methods: A prospective-multicenter study was conducted in 28 hospitals distributed through China from September 2019 to December 2020. The clinical data on singleton-non-SGA among VPIs were divided into EUGR group (n = 692) and non-EUGR group (n = 912). Results: Compared to non-EUGR group, the mean gestational age (GA), mean birth weight (BW) and percentage of BW in Fenton curve in EUGR group were lower (P < 0.001 for all). The incidence of EUGR among distinct GA groups (classifications of GA < 28weeks, 28–28+6 weeks, 29–29+6 weeks, 30–30+6 weeks and 31–31+6 weeks) and distinct BW groups (classifications of BW

Whether the decline of birth weight (BW) reported in developed countries in the early 2000s is ongoing remains unknown. Furthermore, despite recent sharp increases in twin births, comparing secular trends of BW between singletons and twins is difficult, as studies have rarely examined secular trends of BW in twins and singletons simultaneously. Therefore, this study aimed to investigate the most recent 20-year trends (2000–2020) of BW in twins and singletons in South Korea. Annual natality files from 2000 to 2020 obtained from the Korean Statistical Information Service were analyzed. A yearly decrease of BW was 3 g among singletons and 5 to 6 g in twins from 2000 to 2020, indicating a widening gap of BW between twins and singletons with increasing years. Gestational age (GA) also decreased in twins and singletons with yearly decreases of 0.28 days in singletons and 0.41 days in twins. Whereas BW decreased in term (GA ≥ 37 weeks), and very preterm groups (28 weeks ≤ GA < 32 weeks) from 2000 to 2020 in twins and singletons, it increased in moderate to late preterm (32 weeks ≤ GA < 37 weeks) groups, indicating a non-linear relationship between BW and GA. The prevalence of macrosomia (BW > 4000 g) in singletons decreased from 2000 to 2020, whereas low birth weight (LBW; BW < 2500 g) increased in twins and singletons. LBW is associated with adverse health outcomes. Effective public health strategies aiming at reduction in the incidence of LBW in the population should be developed. [ABSTRACT FROM AUTHOR]

Introduction: Singleton normal fetus with partial hydatidiform mole (PHM) pregnancy is a rare phenomenon. No previous reports have investigated the risk factors of gestational trophoblastic neoplasia (GTN) progression following this condition. Methods: We retrospectively enrolled cases of singleton normal fetuses with PHM pregnancies at West China Second University Hospital, Sichuan University, from 2005 to 2017. Other cases were identified from PubMed databases during 1975 to 2021 for the cohort study. Cox proportional hazards models were applied to evaluate risk factors for GTN progression based on the patient's clinical characteristics. Results: Overall, 36 cases of singleton normal fetuses with PHM pregnancies were enrolled. After a median follow‐up of 4.0 (0.8–12.0) months, nine (25.0%) patients progressed to GTN. Gestational age at pregnancy termination (hazard ratio [HR] 0.88; 95% confidence interval [CI] 0.78–0.99, p = 0.032), hyperthyroidism (HR 5.75; 95% CI, 1.16–28.50, p = 0.032), and reasons for pregnancy termination (medical indications vs. patients' choice; HR 0.25; 95% CI, 0.06–0.99, p = 0.049) were significantly correlated with GTN progression. Area under the receiver operating characteristic curve (AUC) of gestational age at pregnancy termination to predict non‐progression to GTN was 0.784 (95% CI, 0.615–0.903, p < 0.001). A clinically significant cutoff value, that is, gestational age of 24 weeks, was determined by comprehensively considering the cutoff values of AUC and clinical significance of gestational age. Conclusions: Compared to gestational age of pregnancy termination <24 weeks, ≥24 weeks was a protective factor for GTN. Therefore, there is enough evidence to continue pregnancy, except for uncontrolled severe complications, without increasing the risk of GTN progression. [ABSTRACT FROM AUTHOR]

Objective: To explore the association between endometrial thickness (EMT) and adverse neonatal outcomes in frozen in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles. Methods: This retrospective study involved a total of 8,235 women under the age of 35 years who underwent IVF/ICSI cycles and received frozen embryo transfer (FET) at a tertiary-care academic medical from January 2015 to December 2019, resulting in a live singleton newborn. Patients were categorized into three groups depending on EMT: =7.5 mm, 7.5-12 mm and >12 mm. The primary outcome was low birthweight (LBW). The secondary outcomes were preterm birth (PTB), small-for-gestational age (SGA), large-for-gestational age (LGA) and high birthweight (HBW). Result(s): Compared with EMT >7.5-12mmgroup, the risk of being born LBWwas statistically significantly increased in the EMT =7.5 mm group (adjusted odds ratio [aOR] 2.179; 95% confidence interval [CI], 1.305-3.640; P=.003), while dramatically decreased in the EMT >12 mm group (aOR 0.584; 95% CI, 0.403-0.844; P=.004). Moreover, newborn gender and pregnancy complications were all independent predictors for LBW. Furthermore, a significant decrease in birthweightwas found in the EMT =7.5 mm group as compared with EMT >7.5-12 mm group and EMT >12 mmgroup (3,239 ± 612 vs. 3,357 ± 512 and 3,374 ± 479 g, respectively), and similar result was found in termof gestational age (38.41 ± 2.19 vs. 39.01 ± 1.68 and 39.09 ± 1.5 weeks, respectively). Conclusion(s): After frozen IVF/ICSI-ET, EMT =7.5 mm is independently associated with increased risk of LBW among women with singleton newborns. Therefore, we suggest that women with EMT =7.5 mm after achieving pregnancy by IVF/ICSI-ET treatment should warrant more attention to reduce the risk of delivering a LBW newborn. [ABSTRACT FROM AUTHOR]

Objectives: This study was designed to reveal structural abnormalities in singleton and twin pregnancies in the Chinese population. Methods: This retrospective study spanned 8 years and included 1228 singleton pregnancies (112,919 examinees) and 49 twin pregnancies (1865 examinees) with structural anomalies diagnosed by ultrasound. Detailed descriptions of anomalies, gestational weeks at diagnosis, and maternal age were recorded. The odds ratio was evaluated in twin pregnancies with detectable structural anomalies. Results: The annual average "ultrasound prevalence of fetal anomalies" among singleton and twin pregnancies were 1.09 and 3.06%, respectively. Mothers with twin anomalies were older (P <.001), and twin pregnancies were diagnosed with anomalies in earlier gestational weeks than singleton (P =.011). No differences were found in the types of anomalies between singleton and twin pregnancies. Central nervous system anomaly was the most common type in singleton and twin pregnancies. Twin pregnancies had higher rates of major anomalies than singleton (total OR 2.45), especially cardiovascular, central nervous, and gastrointestinal systems and ear/eye/face/neck disorders. Conclusions: Compared with singleton, twin pregnancies had higher odds of detectable structural anomalies. Twin pregnancies with structural anomalies were diagnosed at earlier gestational age and associated with older maternal age. Central nervous system anomaly was the most common type in singleton and twin pregnancies. [ABSTRACT FROM AUTHOR]

Objective To investigate whether high estrogen (E2) levels caused by controlled ovarian hyperstimulation affect the birth defect rate in singleton assisted reproductive technology (ART) birth after conceived by fresh embryo transfer and frozen embryo transfer (FET). Methods This was a retrospective cohort study. A total of 581 women with singletons, as well as those who have become pregnant and have had an unwanted abortion under high E2 levels on trigger day were divided into three groups. Group A received FET and the E2 levels on trigger day were higher than 5000 pg/ml. Group B received fresh embryo transfer and the E2 levels were between 3000 and 5000 pg/ml. Group C received FET and the E2 levels were between 3000 and 5000 pg/ml. Results There were no significant differences in birth weight, delivery mode, preterm birth rate, and fetal sex between the three groups (p > .05). Birth defect rate in Group B was higher than that in Group A and C, and the rate between Group B and C had significant differences (p < .05). After adjusting for maternal age, BMI, and type of infertility, only a FET cycle is significantly associated with decreased birth defect rate. Conclusion Fresh embryo transfer under supraphysiological level of estrogen exposure may increase the birth defect rate of ART singletons. Even after prenatal screening and diagnosis, a part of birth defect could not be detected during pregnancy. When the estrogen levels on trigger day were no lower than 3000 pg/ml, FET should be advocated to reduce the occurrence of such risk. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to develop an explanatory model of assertiveness based on parenting styles mediated by anxiety and self-esteem. Methods: This study is descriptive-correlational modeling with partial least squares. The statistical population included singleton children of the sixth grade of the elementary school in the 3rd District of Tehran in the academic year 2017-18. The sampling method was multistage sampling; eight schools (four all-boys and four all-girls) were randomly selected from all primary schools in the 3rd District of Tehran, then, a sixth-grade class was randomly selected in each school. The singleton students of those classes participated in the present study as the study sample. The sample size was 118 students (81 girls and 37 boys). The instruments of this research included the Persian forms of adaptive and aggressive assertiveness scales (AAA-S), the Baumrind parenting scale, Beck anxiety inventory (BAI), and Rosenberg self-esteem scale (RSES). To analyze the data, the SPSS software, version 26. Results: The results indicated that authoritative and permissive parenting styles had a significant effect on assertiveness among the parenting styles. The total effects indicated that authoritative and permissive parenting styles explained 0.22 and 0.20 of the variances of assertiveness. The results also showed that the authoritarian parenting style had no significant effect on assertiveness. Discussion: The suggested model was acceptably fit, according to the results of the study. Permissive and authoritative parenting styles had impact on assertiveness. [ABSTRACT FROM AUTHOR]

Species richness is a widely used measure for assessing the diversity of a particular area. However, observed richness often underestimates the true richness due to resource limitations, particularly in a small-sized sample or highly heterogeneous assemblage. To estimate the number of different species (species richness) present across several different sites (communities), researchers often use a combined collection of data (an integrated dataset). This dataset is created by collecting samples from each site individually and independently. However, the pooled sample of integrated data is no longer a random sample from the entire area, and the use of different sampling schemes results in different collected data formats. Consequently, employing a single sampling distribution to model the pooled sample becomes unfeasible, rendering existing richness estimators inadequate. This study provides a theoretical explanation for the applicability of Chao’s lower bound estimator in assessing species richness across multiple sites based on the pooled sample. Additionally, a new non-parametric estimator is introduced, which adjusts the bias of Chao’s lower bound estimator by leveraging the Good–Turing frequency formula. This proposed estimator only utilizes the richness of singletons, doubletons, and tripletons in the pooled sample to estimate undetected richness. Simulated datasets across various models are employed to demonstrate the statistical performance of the estimator, showcasing its ability to reduce the bias of observed richness and provide accurate 95% confidence intervals. Real datasets are also utilized to illustrate the practical application of the proposed approach.

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The incidence of extrauterine growth retardation (EUGR) varies considerably in different countries due to the distinct definitions and inclusion criteria of individual studies. Most studies included small for gestational age (SGA) very preterm infants (VPIs), resulting in a higher incidence of EUGR. Experts have suggested the accurate definition of "EUGR" in SGA infants is not "true EUGR". The postnatal growth curve of multiple premature births also differs from that of singletons. As far as we know, there is no study about relationship between singleton-non-SGA preterm infants and EUGR. To analyze the factors influencing EUGR among VPIs who were singleton-non-SGA in China. A prospective-multicenter study was conducted in 28 hospitals distributed through China from September 2019 to December 2020. The clinical data on singleton-non-SGA among VPIs were divided into EUGR group (n = 692) and non-EUGR group (n = 912). Compared to non-EUGR group, the mean gestational age (GA), mean birth weight (BW) and percentage of BW in Fenton curve in EUGR group were lower (P < 0.001 for all). The incidence of EUGR among distinct GA groups (classifications of GA < 28weeks, 28–28+6 weeks, 29–29+6 weeks, 30–30+6 weeks and 31–31+6 weeks) and distinct BW groups (classifications of BW<1000 g, 1000–1249 g, 1250–1499 g, 1500–1999g and 2000–2500 g) were statistically significant (P = 0.004 and P <.001). Logistic regression analysis indicated that later addition of human milk fortifier (HMF), later attainment of HMF sufficient fortification, later return to BW, more accumulative days of fasting, longer duration of parenteral nutrition, total duration of oxygen support and moderate/severe bronchopulmonary dysplasia (BPD) were risk factors for the development of EUGR in singleton-non-SGA VPIs (P < 0.001, P = 0.002, P < 0.001, P = 0.002, P = 0.017, P = 0.003 and P = 0.002, respectively). The use of full-course antenatal steroids, greater BW as a percentile of the Fenton curve, breastfeeding initiation and faster average velocity of weight growth effectively protected against EUGR (P = 0.008, P < 0.001, P < 0.001 and P < 0.001, respectively). The overall incidence of EUGR was 43.1% among singleton-non-SGA VPIs in China. Raising the full-course antenatal steroids usage, reducing the incidence of moderate and severe BPD, attaching importance to the management of enteral nutrition in VPIs and increasing the weight growth velocity can reduce the incidence of EUGR. [ABSTRACT FROM AUTHOR]

Objective: To explore the association between endometrial thickness (EMT) and adverse neonatal outcomes in frozen in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles. Methods: This retrospective study involved a total of 8,235 women under the age of 35 years who underwent IVF/ICSI cycles and received frozen embryo transfer (FET) at a tertiary-care academic medical from January 2015 to December 2019, resulting in a live singleton newborn. Patients were categorized into three groups depending on EMT: =7.5 mm, 7.5-12 mm and >12 mm. The primary outcome was low birthweight (LBW). The secondary outcomes were preterm birth (PTB), small-for-gestational age (SGA), large-for-gestational age (LGA) and high birthweight (HBW). Result(s): Compared with EMT >7.5-12mmgroup, the risk of being born LBWwas statistically significantly increased in the EMT =7.5 mm group (adjusted odds ratio [aOR] 2.179; 95% confidence interval [CI], 1.305-3.640; P=.003), while dramatically decreased in the EMT >12 mm group (aOR 0.584; 95% CI, 0.403-0.844; P=.004). Moreover, newborn gender and pregnancy complications were all independent predictors for LBW. Furthermore, a significant decrease in birthweightwas found in the EMT =7.5 mm group as compared with EMT >7.5-12 mm group and EMT >12 mmgroup (3,239 ± 612 vs. 3,357 ± 512 and 3,374 ± 479 g, respectively), and similar result was found in termof gestational age (38.41 ± 2.19 vs. 39.01 ± 1.68 and 39.09 ± 1.5 weeks, respectively). Conclusion(s): After frozen IVF/ICSI-ET, EMT =7.5 mm is independently associated with increased risk of LBW among women with singleton newborns. Therefore, we suggest that women with EMT =7.5 mm after achieving pregnancy by IVF/ICSI-ET treatment should warrant more attention to reduce the risk of delivering a LBW newborn. [ABSTRACT FROM AUTHOR]

Context: The optimal 50 g-glucose challenge test (GCT) cutoff for the diagnosis of gestational diabetes mellitus (GDM) in twin pregnancies is unknown. Objective: This work aimed to explore the screening accuracy of the 50 g-GCT and its correlation with the risk of large for gestational age (LGA) newborn in twin compared to singleton pregnancies. A population-based retrospective cohort study (2007-2017) was conducted in Ontario, Canada. Participants included patients with a singleton (n = 546 892 [98.4%]) or twin (n = 8832 [1.6%]) birth who underwent screening for GDM using the 50 g-GCT. Methods: We compared the screening accuracy, risk of GDM, and risk of LGA between twin and singleton pregnancies using various 50 g-GCT cutoffs. Results: For any given 50 g-GCT result, the probability of GDM was higher (P = .0.007), whereas the probability of LGA was considerably lower in the twin compared with the singleton group, even when a twin-specific growth chart was used to diagnose LGA in the twin group (P < .001). The estimated false-positive rate (FPR) for GDM was higher in twin compared with singleton pregnancies irrespective of the 50 g-GCT cutoff used. The cutoff of 8.2 mmol/L (148 mg/dL) in twin pregnancies was associated with an estimated FPR (10.7%-11.1%) that was similar to the FPR associated with the cutoff of 7.8 mmol/L (140 mg/dL) in singleton pregnancies (10.8%). Conclusion: The screening performance of the 50 g-GCT for GDM and its correlation with LGA differ between twin and singleton pregnancies. [ABSTRACT FROM AUTHOR]

Objective: To develop a nomogram to predict preterm birth before 28 weeks in pregnant women undergoing cervical cerclage. Study design: We retrospectively studied the medical records on pregnant women who underwent cervical cerclage in January 2016 to September 2020. We developed the model from a development cohort in Women's Hospital, Zhejiang university, School of medicine, which randomly divided by 7:3 into training cohort for nomogram development, and internal validation cohort to confirm the model's performance. We then tested the nomogram in an external validation cohort over a similar period. The Harrell's C-index, calibration curve, decision curve analyses (DCA) were performed to assess the model. Results: 528 patients formed the development cohort, and 97 patients formed the external validation cohort. The model initially incorporated 10 baseline variables, while 5 variables were estimated in the nomogram at last: history of prior second-trimester loss, use of in-vitro fertilization (IVF), cervical dilation at cerclage, C-reactive protein (CRP) and platelet-lymphocyte ratio (PLR). The nomogram achieved good concordance indexes of 0.82(95%CI 0.77–0.88), 0.80(95%CI 0.72–0.88) and 0.79 (95%CI 0.68–0.90) in the training, internal and external validation cohort, respectively. And the nomogram had well-fitted calibration curves. Decision curve analysis demonstrated that the nomogram was clinically useful. Conclusions: The well-performed nomogram graphically represents the risk factors and a pre-operative predicted model in predicting the risk of preterm birth at

ObjectiveHypertensive disorders of pregnancy (HDP) are associated with an increased risk of adverse neonatal outcomes. Although twin pregnancies had a higher risk of developing HDP, it is not known whether HDP in twins will increase the risk of adverse neonatal outcomes. We aimed to assess whether this association differed in singleton and twin pregnancies in women who conceived with assisted reproductive technology (ART).MethodsWe finally included 193,590 live births born via ART from the National Vital Statistics System (NVSS) for the years 2015–2019. We used Log-binomial regression to evaluate the associations between HDP and the risk of adverse neonatal outcomes in ART mothers.ResultsAmong 193,590 ART-treated mothers, there were 140,870 and 52,720 mothers who had singleton pregnancies and twin pregnancies, respectively. Those ART mothers with twin pregnancies had a higher rate of HDP than singleton pregnancies (20.5% vs. 11.0%). In singleton pregnancies, the risks of preterm birth [adjusted risk ratio (aRR)): 2.80, 95% CI 2.67–2.93], low birth weight (aRR: 2.80, 95% CI 2.67–2.93), small for gestational age (aRR: 1.41, 95% CI 1.34–1.49), 5 min Apgar

Objective: To evaluate outcomes of fetal reduction in twin pregnancy. Search strategy: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar were searched from 1980 through December 2020. Selection criteria: Prospective or retrospective studies of pregnant women with twin gestations who had a transabdominal reduction of twin to singleton pregnancy with a comparison group of ongoing twin gestations. Data collection and analysis: Outcomes were meta-analyzed only if reported in at least three studies. Main results: Six studies with a pooled sample of 2867 women with a twin pregnancy of whom 624 underwent 2-to-1 reduction and 2243 did not. In the fetal reduction group, the odds of preterm birth before 34 and 37 weeks of pregnancy were lower by 36% (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.48-0.86, P < 0.003) and 77% (OR 0.23, 95% CI 0.12-0.44, P < 0.001), respectively, than in the control group, and the odds of hypertensive disorders and cesarean delivery were lower by 75% (OR 0.25, 95% CI 0.15-0.43, P < 0.001) and 65% (OR 0.35, 95% CI 0.20-0.62, P < 0.001), respectively. Conclusion: Twin reduction to singleton pregnancy decreased the possibility of preterm birth, hypertensive disorders in pregnancy and cesarean delivery. Sufficiently powered prospective studies are needed to support these findings. [ABSTRACT FROM AUTHOR]

Aim: Twins may have additional clinical problems compared to singletons, but there is insufficient information about whether preterm twins (especially those born before 32 weeks of gestation) are at greater risk than singletons. This study aimed to compare morbidity and mortality in twins and singletons born before 32 weeks of gestation. Materials and Methods: Infants whose gestational age (GA) = 32 weeks were followed in our unit between July 2017 and December 2020 were examined retrospectively. The clinical and demographic characteristics of the infants were recorded and compared between twins and singletons. Results: 770 preterm infants were included in the study, 584 singletons and 186 twins. The singleton group had higher rates of maternal hypertension and small for GA status, while the rate of cesarean delivery was higher in the twins group (p<0.05). Other demographic characteristics and clinical outcomes were the same in the singleton and twin groups (p<0.05). Conclusion: Preterm morbidity and mortality were similar in the twin and singleton groups in this study. This can be attributed to the similar GA and birth weight (BW) in both groups. Therefore, our results suggest that the main determinants of mortality and morbidity in preterm infants are GA and BW rather than twin pregnancy. [ABSTRACT FROM AUTHOR]

BackgroundAnogenital distance (AGD) is a biomarker used for the evaluation of fetal androgen action. The disruption of fetal androgen action can affect the development of the reproductive system and adversely affect future reproductive functions. However, AGD may differ by race. Currently, there is a lack of data regarding the evaluation of AGD in large Han Chinese samples.ObjectiveAGD for neonates in Shanghai, China, was measured, and relevant factors that influenced AGD were analyzed.MethodsThe AGD of full-term singleton neonates was measured within 3 days of birth, and the results were grouped according to gestational age and body weight at birth. In addition, relevant factors that influenced AGD were investigated.ResultsA total of 1,867 full-term singleton neonates were enrolled in this study. All the neonates were Han Chinese; among them, 986 were male, and 881 were female. Male AGD was 23.18 ± 3.17 mm, and female AGD was 11.65 ± 1.53 mm. Male AGD was 1.99 times longer than female AGD. With the increase in gestational age and body weight, AGD gradually increased. AGD was correlated with gestational age, body weight, and head circumference. The correlation between body weight at birth and AGD was highly significant.ConclusionThis study, for the first time, reported AGD measurement data for Chinese Han neonates. The results indicated that AGD was correlated with gestational age, body weight, and head circumference. The correlation between body weight at birth and AGD was highly significant.

Abstract Background Gene duplication and alternative splicing (AS) are two distinct mechanisms generating new materials for genetic innovations. The evolutionary link between gene duplication and AS is still controversial, due to utilizing duplicates from inconsistent ages of duplication events in earlier studies. With the aid of RNA-seq data, we explored evolutionary scenario of AS divergence between duplicates with ohnologs that resulted from the teleost genome duplication event in zebrafish, medaka, and stickleback. Results Ohnologs in zebrafish have fewer AS forms compared to their singleton orthologs, supporting the function-sharing model of AS divergence between duplicates. Ohnologs in stickleback have more AS forms compared to their singleton orthologs, which supports the accelerated model of AS divergence between duplicates. The evolution of AS in ohnologs in medaka supports a combined scenario of the function-sharing and the accelerated model of AS divergence between duplicates. We also found a small number of ohnolog pairs in each of the three teleosts showed significantly asymmetric AS divergence. For example, the well-known ovary-factor gene cyp19a1a has no AS form but its ohnolog cyp19a1b has multiple AS forms in medaka, suggesting that functional divergence between duplicates might have result from AS divergence. Conclusions We found that a combined scenario of function-sharing and accelerated models for AS evolution in ohnologs in teleosts and rule out the independent model that assumes a lack of correlation between gene duplication and AS. Our study thus provided insights into the link between gene duplication and AS in general and ohnolog divergence in teleosts from AS perspective in particular.

Abstract Background Obstetrical outcomes in assisted reproduction techniques (ART) were compared with naturally conceived pregnancies and among each other in multiple reports. However, many important changes in the practice of in vitro fertilization (IVF) over the years, including single embryo transfers (sET) and the introduction of modified natural IVF (mnIVF), and the advances in the frozen embryo transfer (FET) might have impacted the outcomes. Our study is the first to our knowledge to assess four different groups, including spontaneous pregnancies, mnIVF, stimulated IVF (sIVF), and FET altogether in a head-to-head comparison. This is a retrospective study on perinatal outcomes of singleton babies conceived naturally or using three different ART protocols between 2011 and 2014. The primary objective was the comparison of gestational age and birth weight between spontaneously conceived pregnancies (NAT, n= 15,770), mnIVF (n=235), sIVF (n=389), and FET (n=222). Results Our results show a significant difference in favor of naturally conceived pregnancies over ART in term of gestational age. In fact, the gestational age of babies in the NAT group was statistically higher compared to each one of the ART groups alone. Regarding the birth weight, the mean was significantly higher in the FET group compared to the other categories. Conclusion Differences in perinatal outcomes are still found among babies born after different modes of conception. However, there is still need for well-designed high-quality trials assessing perinatal outcomes between naturally conceived pregnancies and different ART protocols based on different maternal and treatment characteristics.

To develop the birth weight curve of singleton neonates with a gestational age of 24-42 weeks, and to investigate the regional differences of the birth weight curve. Methods A total of 11 maternal and child health hospitals with more than 7 000 neonates delivered annually were selected in 11 cities of China (Haikou, Guangzhou, Shenzhen, Liuzhou, Guilin, Quanzhou, Chongqing, Chengdu, Changsha, Ningbo, and Lianyungang), and all live singleton neonates delivered in the 11 hospitals from January 1, 2017 to December 31, 2020 were enrolled for the development of birth weight curves. Results A total of 93 720 singleton neonates with a gestational age of 24-42 weeks from the 11 cities were included in the study. The reference values of the 3rd-97th percentiles of birth weight of singleton neonates for the total of the 11 cities and for each of the 11 cities were established, and the birth weight percentile curves were drawn. The birth weight curve level of singleton neonates in Shenzhen and Quanzhou was almost the same as the average level of the 11 cities; the birth weight curve level of singleton neonates in Haikou, Guangzhou, Guilin, and Liuzhou was slightly lower than the average level of the 11 cities; the birth weight curve level of singleton neonates in Chongqing, Chengdu, and Changsha was slightly higher than the average level of the 11 cities; the birth weight curve level of singleton neonates in Ningbo and Lianyungang was higher than the average level of the 11 cities. The average birth weight curve level of singleton neonates in the 11 cities were very close to that of China Neonatal Cooperation Network in 2011-2014. Conclusions The reference values of the 3rd-97th percentiles of birth weight of singleton neonates for the total of the 11 cities and for each of the 11 cities are developed, which can be used as a reference for evaluating the intrauterine growth of singleton neonates in the region. The level of intrauterine growth of neonates in some cities is different from the national level. [ABSTRACT FROM AUTHOR]

Objective: The use of twin-specific vs singleton growth charts in the assessment of twin pregnancy has been controversial. The aim of this study was to assess whether a diagnosis of small-for-gestational age (SGA) made using twin-specific estimated-fetal-weight (EFW) and birth-weight (BW) charts is associated more strongly with adverse neonatal outcomes in twin pregnancies, compared with when the diagnosis is made using singleton charts.Methods: This was a cohort study of twin pregnancies delivered at St George's Hospital, London, between January 2007 and May 2020. Twin pregnancies complicated by intrauterine death of one or both twins, fetal aneuploidy or major abnormality, twin-twin transfusion syndrome or twin anemia-polycythemia sequence and those delivered before 32 weeks' gestation, were excluded. SGA was defined as EFW or BW below the 10th centile, and was assessed using both twin-specific and singleton EFW and BW charts. The main study outcome was composite adverse neonatal outcome. Mixed-effects logistic regression analysis with random pregnancy-level intercepts was used to test the association between SGA classified using the different charts and adverse neonatal outcome.Results: A total of 1329 twin pregnancies were identified, of which 913 (1826 infants) were included in the analysis. Of these pregnancies, 723 (79.2%) were dichorionic and 190 (20.8%) were monochorionic. Using the singleton charts, 33.3% and 35.7% of pregnancies were classified as SGA based on EFW and BW, respectively. The corresponding values were 5.9% and 5.6% when using the twin-specific charts. Classification as SGA based on EFW using the twin charts was associated significantly with composite adverse neonatal outcome (odds ratio (OR), 4.78 (95% CI, 1.47-14.7); P = 0.007), as compared with classification as appropriate-for-gestational age (AGA). However, classification as SGA based on EFW using the singleton standard was not associated significantly with composite adverse neonatal outcome (OR, 1.36 (95% CI, 0.63-2.88); P = 0.424). Classification as SGA based on EFW using twin-specific standards provided a significantly better model fit than did using the singleton standard (likelihood ratio test, P < 0.001). When twin-specific charts were used, classification as SGA based on BW was associated significantly with a 9.3 times increased odds of composite adverse neonatal outcome (OR, 9.27 (95% CI, 2.86-30.0); P < 0.001). Neonates classified as SGA according to the singleton BW standard but not according to the twin-specific BW standards had a significantly lower rate of composite adverse neonatal outcome than did AGA twins (OR, 0.24 (95% CI, 0.07-0.66); P = 0.009).Conclusions: The singleton charts classified one-third of twins as SGA, both prenatally and postnatally. Infants classified as SGA according to the twin-specific charts, but not those classified as SGA according to the singleton charts, had a significantly increased risk of adverse neonatal outcome compared with infants classified as AGA. This study provides further evidence that twin-specific charts perform better than do singleton charts in the prediction of adverse neonatal outcome in twin pregnancies. The use of these charts may reduce misclassification of twins as SGA and improve identification of those that are truly growth restricted. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

The purpose of the study was to explore the life circumstances of singletons and first-born children, and the importance of the size of the sibling group, by focusing on scholastic aspirations, both on part of the children themselves, but also of their parents. The study used data collected with around 3650 children and their parents, and apart from information on the children’s and their parents’ explicit aspirations, there was also information on the children’s estimation of their parents’ aspirations. While only small differences in parental explicit aspirations were found, substantial differences were found with respect to the children’s own aspirations and their estimations of those of their parents. Only children were more likely to estimate high scholastic aspirations on part of their parents, as were first-borns with siblings. First- also tended to express higher scholastic aspirations themselves. Theoretically, strategic parenting and role specialization were used to explain the results.

BackgroundTuberculosis (TB) is a leading cause of morbidity and mortality in Ethiopia. Investigation of the Mycobacterium tuberculosis complex (MTBC) species circulating in the Ethiopian population would contribute to the efforts made to control TB in the country. Therefore, this study was conducted to investigate the MTBC species and spoligo patterns in the Oromia region (central) of Ethiopia.MethodsA cross-sectional study design was used to recruit 450 smear positive pulmonary TB (PTB) cases from the Oromia region between September 2017 and August 2018. Mycobacteria were isolated from sputum samples on the Lowenstein Jensen (LJ) medium. Molecular identification of the isolates was performed by spoligotyping. The results of spoligotyping were transferred into a query box in the SITVIT2 database and Run TB-Lineage in the TB Insight website for the identification of spoligo international type (SIT) number and linages of the isolates, respectively. Statistical Product and Service Solutions (SPSS) 20 was applied for statistical analysis.ResultsThree hundred and fifteen isolates were grouped under 181 different spoligotype patterns. The most dominantly isolated spoligotype pattern was SIT149 and it consisted of 23 isolates. The majority of the isolates were grouped under Euro-American (EA), East-African-Indian (EAI), and Indo-Oceanic (IO) lineages. These lineages consisted of 79.4, 9.8, and 9.8% of the isolates, respectively. One hundred and sixty-five of the isolates were classified under 31 clustered spoligotypes whereas the remaining 150 were singleton types. Furthermore, 91.1% of the total isolates were classified as orphan types. Clustering of spoligotypes was associated (p < 0.001) with EAI lineage.ConclusionSIT149 and EA lineage were predominantly isolated from the Oromia region substantiating the findings of the similar studies conducted in other regions of Ethiopia. The observation of significant number of singleton and orphan spoligotypes warrants for additional genetic typing of the isolates using method(s) with a better discriminatory power than spoligotyping.

The exploration of multiple birth-related genes has always been a significant focus in sheep breeding. This study aimed to find more genes and proteins related to the litter size in sheep. Ovarian specimens of Small Tail Han sheep (multiple births) and Xinji Fine Wool sheep (singleton) were collected during the natural estrus cycle. Transcriptome and proteome of ovarian specimens were analyzed. The transcriptome results showed that "steroid hormone biosynthesis" and "ovarian steroidogenesis" were significantly enriched, in which HSD17B1 played an important role. The proteome data also confirmed that the differentially expressed proteins (DEPs) were enriched in the ovarian steroidogenesis pathway, and the CYP17A1 was the candidate DEP. Furthermore, lncRNA MSTRG.28645 was highly expressed in Small Tailed Han sheep but lowly expressed in Xinji fine wool sheep. In addition, MSTRG.28645, a hub gene in the co-expression network between mRNAs and lncRNAs, was selected as one of the candidate genes for subsequent verification. Expectedly, the overexpression and interference of HSD17B1 and MSTRG.28645 showed a significant effect on hormone secretion in granulosa cells. Therefore, this study confirmed that HSD17B1 and MSTRG.28645 might be potential genes related to the fecundity of sheep. It was concluded that both HSD17B1 and MSTRG.28645 were critical regulators in the secretion of hormones that affect the fecundity of the sheep. [ABSTRACT FROM AUTHOR]

Wheat is a widely cultivated crop and it is one of the major food sources worldwide. Among the various tools used to study diversity of wheat species, the internal transcribed spacer (ITS) assessment emerges to be the more appropriate approach. In the present study, we evaluated 15 genotypes of Iranian wheat cultivars (wild, native, and breed) using ITS gene sequences. Similarity matrices and dendrogram of phylogenic relationship were constructed using Mega ver6 software. We report the major nucleotide changes in the same position between diploid and hexaploid species. dN/dS ratio for diploid, tetraploid, and hexaploid species indicated a pure selection in the examined gene, with no key changes in the genes, and 91% ITS diversity within individual wheat was evident. The results suggest that as evolution moves forward, nucleotide changes are reduced so that only a few changes in nucleotides occur. ITS marker can distinguish different wheat genotypes at the genomic level and thus prove to be the most appropriate assessment tool for analyzing inter and intra-species relationships. [ABSTRACT FROM AUTHOR]

Abstract Background There are still some controversies regarding the risks and benefits of fetal reduction from twins to singletons. We aimed to evaluate if fetal reduction from twins to singleton improves pregnancy outcome. Methods Retrospective analysis of all dichorionic-diamniotic twin pregnancies, who underwent fetal reduction. Pregnancy outcome was compared to ongoing, non-reduced, dichorionic-diamniotic gestations. Primary outcome was preterm birth prior to 37 gestational weeks. Secondary outcomes included: preterm birth prior to 34 gestational weeks, gestational age at delivery, birthweight, small for gestational age, hypertensive disorders, gestational diabetes and stillbirth. Results Ninety-eight reduced pregnancies were compared with 222 ongoing twins. Preterm birth

In the literature there are no unequivocal assessments of the effect of paternal age on the risk of cerebral palsy (CP). The objective of the studies was the analysis of the influence of paternal age on this risk, considering all the important risk factors and division into singleton and twin, as well as term- and preterm-born infants. The inquiry included a group of 278 children with cerebral palsy from selected education-therapeutic institutions in Poland. The control group consisted of the data from medical records of 435 neonates born in God’s Mercy Hospital in Limanowa, Poland. The data were based on a questionnaire designed to obtain information which would make it possible to ascertain the probable etiological factors. Constructed models of logistic regression were used in statistical analysis. The results were presented as the odds ratio (OR) with 95% confidence interval (CI). Though the estimation with a complex model of logistic regression showed no significant effect of paternal age on the occurrence of cerebral palsy, it confirmed it as a stronger predictor compared to maternal age. Disregarding paternal of age while considering maternal age and other risk factors may lead to a bias in the estimations of the risk cerebral palsy.

The exploration of multiple birth-related genes has always been a significant focus in sheep breeding. This study aimed to find more genes and proteins related to the litter size in sheep. Ovarian specimens of Small Tail Han sheep (multiple births) and Xinji Fine Wool sheep (singleton) were collected during the natural estrus cycle. Transcriptome and proteome of ovarian specimens were analyzed. The transcriptome results showed that “steroid hormone biosynthesis” and “ovarian steroidogenesis” were significantly enriched, in which HSD17B1 played an important role. The proteome data also confirmed that the differentially expressed proteins (DEPs) were enriched in the ovarian steroidogenesis pathway, and the CYP17A1 was the candidate DEP. Furthermore, lncRNA MSTRG.28645 was highly expressed in Small Tailed Han sheep but lowly expressed in Xinji fine wool sheep. In addition, MSTRG.28645, a hub gene in the co-expression network between mRNAs and lncRNAs, was selected as one of the candidate genes for subsequent verification. Expectedly, the overexpression and interference of HSD17B1 and MSTRG.28645 showed a significant effect on hormone secretion in granulosa cells. Therefore, this study confirmed that HSD17B1 and MSTRG.28645 might be potential genes related to the fecundity of sheep. It was concluded that both HSD17B1 and MSTRG.28645 were critical regulators in the secretion of hormones that affect the fecundity of the sheep.

Objective: To investigate the influence of labor process time and intervention on postpartum hemorrhage caused by uterine atony in singleton full-term primipara. Methods: Singleton full-term primipara were chosen in the period from January 2017 to December 2020 in our hospital and were grouped according to the first stage time of labor and matched by PSM method included ＜8 h group and ≥ 8 h group each with 771 cases. The general information, duration of labor and uterine atony postpartum hemorrhage were analyzed and the relationship between the time and intervention of labor process and the occurrence of postpartum hemorrhage due to uterine inertia were evaluated. Results: There was no significant difference in age, gestational times and gestational weeks between 2 groups P>0.05 . The second stage time of labor and the first stage + second stage of labor in gestational weeks between 2 groups inertia were evaluated. relations P<0.05 . The postpartum hemorrhage rate of tage + second stage of labor in gestational weeks between 2 groups inertia h group P<0.05 . The second stage of labor and the first stage + second stage of labor in ional weeks between 2 groups inertia were evaluated. relationship between intervention P<0.05 . The first, second and first stage + second stages of labor of f laboroup and < 8 h group with labor intervention were significantly longer than without labor intervention P<0.05 . The postpartum hemorrhage rate of rvention were significantly longer than without laborhigher than without labor intervention P<0.05 . Conclusion: The incidence of postpartum hemorrhage due to uterine atony in singleton term primipara increased with the increased of the first stage time of labor, while the second stage time of labor often increased with the increased of the first stage time of labor. [ABSTRACT FROM AUTHOR]

Abstract Objective This study aimed to identify factors associated with meeting the Obstetric Care Consensus (OCC) guidelines for nulliparous, term, singleton, and vertex (NTSV) cesarean births. Materials and methods This was a retrospective case control study of women with NTSV cesarean births between January 2014 and December 2017 at single tertiary care center. Demographics and clinical characteristics were compared between women with NTSV cesarean births which did or did not meet OCC guidelines. A multivariable logistic regression model was used to evaluate the effect of each variable on the odds of meeting OCC guidelines. Results There were 1,834 women with NTSV cesarean births of which 744 (40.6%) met OCC guidelines for delivery and 1,090 (59.4%) did not. After controlling for confounding factors, the odds of meeting OCC guidelines were increased for in-house providers managing with residents (adjusted odds ratio [aOR] = 2.03, 95% confidence interval [CI]: 1.44–2.87) and without residents (aOR = 1.66, 95% CI: 1.30–2.12), compared with non-in-house providers managing without residents. There was no significant difference in the odds of meeting OCC guidelines for in-house providers managing with or without residents (aOR = 1.23, 95% CI: 0.84–1.79). Conclusion After adjusting for confounding factors, in-house provider coverage, regardless of resident involvement, is associated with increased odds of NTSV cesarean births meeting OCC guidelines. Key Points Frequency of adherence to OCC guidelines for NTSV cesarean births was 40.6%. Neither patient demographics nor comorbidities was associated with the odds of meeting OCC guidelines. In-house providers are associated with increased odds of meeting OCC guidelines.