11 March 2025, Volume 36 Issue 2

    

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  Burden of low birth weight attributable to ambient exposure to fine particulate matters in China

  LU Hong, DENG Jianyu, TONG Mingkun, NI Xueqiu, WANG Ruohan, KANG Ning, XUE Tao

  Chinese Journal of Reproductive Health. 2025, 36(2): 101-108.

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  Objective Low birth weight (LBW) is one of the main risk factors that affect the health of newborns and adults. Fine particulate matter (PM_2.5) is regarded as an essential environment factor that increases the risk of LBW. However, in China, there is a lack of research quantifying the burden of LBW attributable to PM_2.5. This study aimed to accurately estimate the LBW burden attributable to PM_2.5 and analyze its spatial and temporal distribution. Methods This study collected data on the population with low birth weight of 31 provincial-level administrative region in Chinese Mainland from 2002 to 2021 based on the rate of LBW and number of live births derived from “Year book of health in the People′s Republic of China”. According to the administrative boundaries, the exposure data was obtained from the high-resolution estimated PM_2.5 dataset which was created through a combination of satellite, simulation, and monitoring data. The province-level attributable fraction (AF) and attributable number (AN) of LBW then were calculated using the nonlinear exposure-response relationship function from the Global Burden of Disease study. Results LBW attributable to PM_2.5 showed a rising trend from 2002 to 2017, followed by a decline after 2017, reaching a decrease to 17 400 (95% confidence interval:400 to 35 300) by 2021. There were significant regional differences in the distribution of attributable LBW burden, with Hebei, Henan, Guangdong, and Guangxi suffering from a heavier burden in 2021, at 2 400 (95% confidence interval:100 to 5 200), 1 200 (95% confidence interval:0 to 2 700), 1 600 (95% confidence interval:0 to 3 200), and 700 (95% confidence interval:0 to 1 500) respectively, accounting for a total of 34.11% (95% confidence interval:33.55% to 34.78%) of the national disease burden. Conclusion The burden of LBW attributable to PM_2.5 in China had significantly decreased, but was unequally distributed across provinces.
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  Association of serum vitamin A and vitamin E concentrations in first trimester and preeclampsia

  MA Shang, XIA Yuwen, SHI Huifeng, WEI Yuan, WANG Xiaoli

  Chinese Journal of Reproductive Health. 2025, 36(2): 109-114.

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  Objective To explore the association between serum vitamin A and vitamin E concentrations in first trimester of pregnancy and preeclampsia. Methods The study was based on the cohort about the association between serum vitamins A and E during pregnancy and preeclampsia, which was conducted by Development Center for Medical Science & Technology, National Health Commission of the People′s Republic of China. It included the basic characteristics of pregnant women, serum vitamin A and E concentrations at different stages of pregnancy, and status of preeclampsia. The serum vitamin A and vitamin E concentrations were divided into three groups of deficiency, normal range, and excess. We calculated the prevalence of preeclampsia in different groups. Logistic regression models were used to analyze the association between vitamin A and vitamin E concentrations in first trimester and the risk of preeclampsia. Results A total of 61 555 pregnant women were included in this study, and 1 426 (2.3%) were diagnosed with preeclampsia. In first trimester of pregnancy, no significant difference was found in vitamin A levels between pregnant women with preeclampsia and healthy pregnant controls. Pregnant women with preeclampsia had significantly lower levels of vitamin E in first trimester. The risk of preeclampsia was reduced in pregnant women with vitamin A deficiency (OR=0.80, 95%CI: 0.64-0.99), while the risk of preeclampsia was significantly increased in pregnant women with vitamin E deficiency (OR=6.54, 95%CI: 4.98-8.59). Pregnant women with vitamin A in the normal range and vitamin E deficiency in the first trimester had a significantly increased risk of preeclampsia compared to those with both normal levels of vitamin A and E (OR=11.61, 95%CI:8.65-15.58). Conclusion Serum vitamin A and vitamin E concentrations during pregnancy were associated with preeclampsia. Vitamin E deficiency in first trimester is a risk factor for preeclampsia. Monitoring vitamin A and E concentrations in early pregnancy can help identify high-risk individuals for preeclampsia.
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  Prevalence of obesity among preschool children in Chaoyang District, Beijing from 2010 to 2019

  Tang Youchi, Yu Yabin, Li Hongtian, Wang Sizhe, Zhou Yubo

  Chinese Journal of Reproductive Health. 2025, 36(2): 115-120.

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  Objective To investigate the trend and distribution of obesity status in preschool children in Chaoyang District, Beijing, and to provide a scientific basis for children′s development and health management. Methods The data is the physical examination records of 3~6 years old preschool children from 2010 to 2019 managed by kindergartens in Chaoyang District, Beijing from 2010 to 2019. The standard deviation scoring method was used to define obesity, as weight-for-height was more than or equal to the median plus 2 standard deviations. The Cochran-Armitage test was used to analyze the temporal trend of obesity prevalence of preschool children. The χ² test was used to compare the differences in the obesity prevalence by characteristics of preschool children and kindergartens. Results The prevalence of obesity among preschool children in Chaoyang District, Beijing, showed a decreasing trend from 2010 to 2019, with obesity prevalence of 4.5%, 4.2%, 4.3%, 4.7%, 4.6%, 4.3%, 4.1%, 3.8%, 3.4% and 3.4%, respectively(P<0.001). The obesity prevalence showed an increasing trend with age, with the prevalence of 3.0%, 3.5%, 4.7%, and 5.9% for children aged 3 to < 4, 4 to <5, 5 to <6, and 6 to <7 years old, respectively(P<0.001). The obesity prevalence was higher in children of local household registration(4.3%) than those of floating household registration(3.7%)(P<0.001). Stratified analyses by characteristics of kindergartens showed that the obesity prevalence in preschool children was higher in urban kindergartens than in rural kindergartens(4.3% vs. 3.8%, P<0.05), higher in kindergartens with grade 3(3.9%), grade 2(4.7%) and grade 1(4.4%) than that without grade(3.5%)(P<0.05), higher in kindergartens that regularly conducted and passed health care evaluations(4.3%) than those that did not regularly conduct health care evaluation assessments(2.8%)(P<0.05), and higher in public kindergartens than private kindergartens(4.8% vs. 3.5%, P<0.05). Conclusion The obesity prevalence of preschool children decreased from 2010 to 2019 in Chaoyang District, Beijing. Results from stratified analyses indicated that health care education should be strengthened in children with local resident and older age, and in kindergartens in rural and township region, with low grade, without regular evaluation, or private kindergartens to improve their health care management in children.
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  Impact of twin pregnancy on the long-term risk of hypertension in women

  SONG Jingsi, ZHONG Junhui, Li Nan, ZHANG Yali, LI Zhiwen

  Chinese Journal of Reproductive Health. 2025, 36(2): 121-126.

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  Objective To investigate the effect of twin pregnancy on the long term risk of hypertension in women. Methods Data were derived from an ongoing twin survey study which aims to recruit 1 000 women and their children who had twin pregnancies during 1990~2010, along with a matched control group of approximately 1 000 women with singleton pregnancy and their children. Women were matched based on the same township and with pregnancy dates within less than a year. Questionnaires data were collected from 1 686 mother from four counties/districts in Hebei Province(Mancheng, Xianghe, Leting, and Fengrun) from Jun 2021 to September 2023. Exclusion criteria included lack of confirmed hypertension diagnosis, diagnosis of hypertension before pregnancy, during pregnancy, or within two years postpartum, and missing critical information such as date of birth, height, weight, lifestyle, and dietary habits. Finally, a total of 1 550 women were included in the analysis. There were 769 women with twin pregnancies(twin group) and 781 women with singleton pregnancies(singleton group). Basic characteristics of these women were described. Kaplan-Meier curve was used to analyze the cumulative prevalence of hypertension, and Cox regression was used to explore the influence of twin pregnancy on hypertension in women. Results The incidence of hypertension in the twin group was 8.8%(68/769), which was significantly higher than the singleton group(5.8%,45/781). Univariate Cox analysis revealed that twin pregnancy was a risk factor for hypertension(HR=1.57,95% CI:1.07-2.28). After adjusting for age, body mass index, education level, frequency of tea consumption, smoking, and alcohol consumption, twin pregnancy remained an independent risk factor for hypertension(adjusted HR=1.55,95% CI:1.06-2.27). Conclusion Twin pregnancy is an independent risk factor for hypertension in women. Risk management of long-term hypertension in women with twin pregnancy should be strengthened.
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  Cesarean section and related factors among pregnant women from 13 monitoring hospitals in Jilin Provinces, 2017-2020

  JIANG Tingting, YI Liyan, WAN Lixin, HE Huan, HAN Dan

  Chinese Journal of Reproductive Health. 2025, 36(2): 127-132.

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  Objective To investigate the cesarean section rate among 182 179 pregnant women in Province Jilin, analyze the related factors influencing the mode of delivery chosen by pregnant women, and provide effective measures to reduce the cesarean section rate. Methods A cross-sectional survey method was employed, utilizing the National Maternal and Child Health Monitoring System to collect data on pregnant women who delivered above at 28 weeks (≥28 gestational weeks) from 13 monitoring hospital across the province between January 1, 2017, and December 31, 2020. A multivariate logistic regression analysis model was applied to explore the influencing factors of cesarean sections among pregnant women. Results Over the four-year period in Province Jilin, 95 954 cesarean sections were recorded, yielding a cesarean section rate of 52.7%. The multivariate unconditional logistic regression model analysis indicated that the following factors were associated with an increased rate of cesarean sections:maternal age above 30 years (≥30 years) multiparous women, with of comorbidities or complications, placenta previa, abruption placenta, hypertensive disorders of pregnancy, diabetes, male fetal gender, delivery of twins or more, low birth weight, and macrosomia. Pregnant women with an educational level of high school/technical secondary school and anemia were associated with a reduced rate of cesarean sections. Conclusion The cesarean section rate among pregnant women in Province Jilin is at a relatively high level and shows a rising trend, with numerous factors influencing the rate. It is recommended to strengthen health monitoring and focus on the management of high-risk groups, particularly on the education of primiparous women, in order to reduce the cesarean section rate.
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  Analysis of maternal death due to cardiac disease in pregnancy in Sichuan Province, 2016-2022

  DENG Jiaxin, HE Dan, PENG Mingming, CHEN Yanbin, GAO Yan

  Chinese Journal of Reproductive Health. 2025, 36(2): 133-138.

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  Objective To explore the current situation and causes of maternal death due to cardiac disease in pregnancy, promptly identify and understand the existing problems in various aspects, develop targeted interventions, and effectively reduce maternal mortality rate. Methods A retrospective analysis was conducted on the clinical data of 60 pregnancy-related deaths due to cardiac disease during the provincial review period in Sichuan Province from 2016 to 2022. Results In 2016-2022, the number of pregnancy-related deaths due to cardiac disease accounted for 11.2% of the total number of reviews, and the specific rate of heart disease deaths was 1.2 per 100 000 in Sichuan Province. Among the 60 cases of pregnancy-related deaths, other heart diseases (58.3%) were the most common type. 75.0% of those with junior high school education or below, half of those with less than 5 prenatal examinations. Avoidable deaths accounted for 51 cases (85.0%), mainly attributed to individual and family knowledge, skills, attitudes and resources (25.0%) and the knowledge and skills of healthcare institutions (51.0%). Conclusion The proportion of indirect obstetric causes has increased, and cardiac disease became the primary factor in maternal death. The reasons include inadequate early identification of medical institutions, the need for improved treatment capacity, insufficient awareness of prenatal care during pregnancy and the critical issue of health education. It is necessary to standardize periconceptional health care services during pregnancy and childbirth, strictly manage high-risk pregnant, enhance the skills training for grassroots personnel, and strengthen the intensity of science popularization and education to reduce the occurrence of maternal deaths due to pregnancy-related cardiac disease.