fetus

胎儿
  • 文章类型: Journal Article
    长链和极长链多不饱和脂肪酸(LC-PUFA)优先由母亲转运至胎儿。未能提供LC-PUFA与死产密切相关,胎儿生长受限,和受损的神经发育结果。然而,怀孕期间的饮食补充不能简单地逆转这些结果,这表明膳食脂肪酸摄入量与母体供应的分子机制之间的相互作用尚不完全清楚。在这里,我们采用了一种综合方法,将非靶向和靶向脂质组学与小鼠妊娠中母体和胎儿组织的转录谱分析相结合。野生型小鼠与脂质代谢受损的遗传模型的比较使我们能够描述向发育中的胎儿提供LC-PUFA所需的母体肝脏适应。妊娠晚期特有的,肝X受体信号传导途径的选择性激活显著增加循环磷脂内的LC-PUFA的母体供应。至关重要的是,母亲对该途径的遗传消融减少了胎儿的LC-PUFA积累,特别是二十二碳六烯酸(DHA),大脑发育的关键营养素。
    The long and very long chain polyunsaturated fatty acids (LC-PUFAs) are preferentially transported by the mother to the fetus. Failure to supply LC-PUFAs is strongly linked with stillbirth, fetal growth restriction, and impaired neurodevelopmental outcomes. However, dietary supplementation during pregnancy is unable to simply reverse these outcomes, suggesting imperfectly understood interactions between dietary fatty acid intake and the molecular mechanisms of maternal supply. Here we employ a comprehensive approach combining untargeted and targeted lipidomics with transcriptional profiling of maternal and fetal tissues in mouse pregnancy. Comparison of wild-type mice with genetic models of impaired lipid metabolism allows us to describe maternal hepatic adaptations required to provide LC-PUFAs to the developing fetus. A late pregnancy-specific, selective activation of the Liver X Receptor signalling pathway dramatically increases maternal supply of LC-PUFAs within circulating phospholipids. Crucially, genetic ablation of this pathway in the mother reduces LC-PUFA accumulation by the fetus, specifically of docosahexaenoic acid (DHA), a critical nutrient for brain development.
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  • 文章类型: Journal Article
    视网膜的发育受到严格的时间和空间控制。为了深入了解这个过程的分子基础,我们生成了人类正在发育的视网膜的单核双组图集,该图集具有来自14个人类胚胎和受孕后8至23周的胎儿的约22万个细胞核,并具有匹配的黄斑和外周组织.这个图集捕获了视网膜中所有主要的细胞类别,以及很大比例的祖细胞和细胞类型特异性前体。细胞轨迹分析揭示了从早期祖细胞的连续发展到细胞类型规范的后期阶段的分层发展的转变。已知和未记录的候选转录因子,以及驱动各种细胞命运转变的基因调控网络,被识别。黄斑和外周视网膜之间的比较表明了一种基本一致但截然不同的发育模式。该地图集为开发过程中的转录和染色质可及性景观提供了无与伦比的分辨率,为深入了解视网膜发育和相关疾病提供宝贵的资源。
    The development of the retina is under tight temporal and spatial control. To gain insights into the molecular basis of this process, we generate a single-nuclei dual-omic atlas of the human developing retina with approximately 220,000 nuclei from 14 human embryos and fetuses aged between 8 and 23-weeks post-conception with matched macular and peripheral tissues. This atlas captures all major cell classes in the retina, along with a large proportion of progenitors and cell-type-specific precursors. Cell trajectory analysis reveals a transition from continuous progression in early progenitors to a hierarchical development during the later stages of cell type specification. Both known and unrecorded candidate transcription factors, along with gene regulatory networks that drive the transitions of various cell fates, are identified. Comparisons between the macular and peripheral retinae indicate a largely consistent yet distinct developmental pattern. This atlas offers unparalleled resolution into the transcriptional and chromatin accessibility landscapes during development, providing an invaluable resource for deeper insights into retinal development and associated diseases.
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  • 文章类型: Journal Article
    背景:Türkiye是在绵羊育种方面排名世界的国家。哈姆达尼杂交绵羊品种是适应我国艰苦条件的绵羊品种之一。此外,这句话可以被纠正为“特别是在蒂尔基耶的东南部,杂交育种是育种者的首选,以提高绵羊的产量特性。
    目的:在我们的研究中,目的是通过三维建模方法对中期和中期的Hamdani杂交绵羊胎儿进行盆栽分析。
    方法:为此,共有40个中期妊娠(10名女性,10名男性)和孕晚期(10名女性,使用10只雄性)胎儿。胎儿的骨盆用CT成像并创建3D模型。从模型中进行了16次骨盆测量。对获得的结果进行统计学评价。
    结果:研究发现,在妊娠中期,男性和女性胎儿在垂直直径(VD)和闭孔宽度(FOW)测量参数方面存在统计学上的显着差异。在妊娠晚期,髋臼(AC)性别间差异有统计学意义(p<0.01),坐骨内侧结节(MIT),和坐骨弓(IA)(p<0.05)参数。作为相关性分析的结果,确定骨盆长度(PL)测量参数在两个时期都与不同参数呈不同程度的正相关,而IA参数在妊娠的最后两个时期与其他参数没有显着相关性。
    结论:结论:获得的数据将有助于人类和动物胎儿的骨盆测量评估,解剖学教育,动物考古学和分类学研究。
    BACKGROUND: Türkiye is a country in the world ranking in terms of sheep breeding. Hamdani crossbred sheep breed is one of the sheep breeds that can adapt to the difficult conditions in our country. In addition, the sentence may be corrected as \'Especially in the southeastern part of the Türkiye, crossbreeding is preferred by breeders to increase the yield characteristics of sheep\'.
    OBJECTIVE: In our study, it was aimed to perform a pelvimetric analysis of Hamdani crossbred sheep fetuses in the second and third trimesters by three-dimensional modelling method.
    METHODS: For this purpose, a total of 40 second-trimester (10 females, 10 males) and third-trimester (10 females, 10 males) fetuses were used. The pelvises of the fetuses were imaged with CT and 3D models were created. Sixteen pelvimetric measurements were performed from the models. The results obtained were evaluated statistically.
    RESULTS: The study found statistically significant differences between male and female fetuses in terms of vertical diameter (VD) and foramen obturatum width (FOW) measurement parameters in the second trimester. In the third trimester, there were statistically significant differences between genders in acetabulum (AC) (p < 0.01), medial ischial tuberosities (MIT), and ischiatic arch (IA) (p < 0.05) parameters. As a result of the correlation analysis, it was determined that the pelvis length (PL) measurement parameter was positively correlated with different parameters in varying degrees in both periods, while the IA parameter did not show significant correlations with the other parameter in the last two periods of pregnancy.
    CONCLUSIONS: In conclusion, the data obtained will be useful in pelvimetric evaluations of human and animal fetuses, anatomy education, zooarchaeology and taxonomy studies.
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  • 文章类型: Journal Article
    背景:下丘脑-垂体-肾上腺(HPA)和性腺(HPG)轴是连接脊椎动物神经和内分泌系统的两条主要途径。诸如产前应激和母体暴露于外源性类固醇的因素已显示在胎儿发育期间影响这些途径。另一个研究较少的因素是多胎妊娠中激素在胎儿之间的转移。这种形式的转移已被证明会影响形态,解剖学,生理学,和后代在携带垃圾的哺乳动物中的行为,这种影响称为宫内位置(IUP)效应。在这项研究中,我们试图描述IUP如何影响HPA和HPG脑受体,肽,和子宫内的酶(以下简称成分)以及这些影响在男性和女性之间可能有什么不同。
    方法:我们使用了非常规的自由放养营养学家(Myocastorcoypus)模型,具有很大的自然变异。我们收集了营养胎儿的脑组织,并量化了三个大脑区域中关键HPA和HPG成分的表达:前额叶皮质,下丘脑,和纹状体。
    结果:我们在盐皮质激素受体(MR)中发现了性别与IUP之间的相互作用,促性腺激素释放激素受体(GNRHR),雄激素受体(AR),和雌激素受体α(ESR1)。IUP在促性腺激素释放激素(GnRH)及其受体GNRHR中均有显著意义,但以不同的方式。在下丘脑,与同性邻居相邻的胎儿的GnRH表达高于与异性相邻的胎儿。相反,在大脑皮层,GNRHR表现出相反的模式,与异性相邻的胎儿的表达水平高于与同性相邻的胎儿。不管IUP,在大多数表现出显著性别差异的成分中,女性胎儿的mRNA表达水平高于男性胎儿。我们还发现HPA和HPG成分在妊娠早期高度相关,性别和发育阶段之间存在相互作用。在怀孕的早期阶段,女性成分表达水平比男性更相关,但在怀孕的最后三个月,男性成分比女性成分更相关。
    结论:这项研究表明,在胎儿发育过程中,有不同的调节HPA和HPG轴的机制。内分泌轴成分的mRNA表达水平较高可能是帮助女性应对长期妊娠期雄激素暴露的机制。此外,这些发现表明,在胎儿发育阶段,男性和女性内分泌轴的协调要求不同。
    BACKGROUND: The hypothalamic-pituitary-adrenal (HPA) and -gonadal (HPG) axes are two major pathways that connect the neural and endocrine systems in vertebrates. Factors such as prenatal stress and maternal exposure to exogenous steroids have been shown to affect these pathways during fetal development. Another less studied factor is the transfer of hormones across fetuses in multifetal pregnancies. This form of transfer has been shown to influence the morphology, anatomy, physiology, and behavior of the offspring in litter-bearing mammals, an influence termed the intrauterine position (IUP) effect. In this study, we sought to delineate how the IUP effects HPA and HPG brain receptors, peptides, and enzymes (hereafter components) in utero and how these influences may differ between males and females.
    METHODS: We utilized the unconventional model of culled free-ranging nutria (Myocastor coypus), with its large natural variation. We collected brain tissues from nutria fetuses and quantified the expression of key HPA and HPG components in three brain regions: prefrontal cortex, hypothalamus, and striatum.
    RESULTS: We found an interaction between sex and IUP in the mineralocorticoid receptor (MR), gonadotropin-releasing hormone receptor (GNRHR), androgen receptor (AR), and estrogen receptor alpha (ESR1). IUP was significant in both gonadotropin-releasing hormone (GnRH) and its receptor GNRHR, but in different ways. In the hypothalamus, fetuses adjacent to same-sex neighbors had higher expression of GnRH than fetuses neighboring the opposite sex. Conversely, in the cortex, GNRHR exhibited the inverse pattern, and fetuses that were neighboring the opposite sex had higher expression levels than those neighboring the same sex. Regardless of IUP, in most components that showed significant sex differences, female fetuses had higher mRNA expression levels than male fetuses. We also found that HPA and HPG components were highly related in the early stages of gestation, and that there was an interaction between sex and developmental stage. In the early stages of pregnancy, female component expression levels were more correlated than males\', but in the last trimester of pregnancy, male components were more related to each other than female\'s.
    CONCLUSIONS: This study suggests that there are sexually different mechanisms to regulate the HPA and HPG axes during fetal development. Higher mRNA expression levels of endocrine axes components may be a mechanism to help females cope with prolonged androgen exposure over a long gestational period. Additionally, these findings suggest different coordination requirements of male and female endocrine axes during stages of fetal development.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    目的:call体发育不全(ACC)是一种异常,可在怀孕期间在胎儿中发生。然而,目前没有针对胎儿ACC的治疗。因此,我们对胎儿ACC的产科结局进行了回顾性分析,以探讨胎儿ACC表型与染色体拷贝数异常之间的关系.
    结果:从患有胎儿ACC的孕妇中提取羊水或脐带血进行核型分析和染色体微阵列分析(CMA)。在使用ACC的48个胎儿中,22(45.8%,22/48)隔离了ACC,和26(54.2%,26/48)有非孤立的ACC。通过核型分析发现4例染色体异常。除4例致病性拷贝数变异(CNVs)检测核型外,CMA显示2例致病性CNV,具有17q12微重复和16p12.2微缺失。随访26例非孤立性ACC患者的产科结局,17人选择终止妊娠。此外,9例非孤立性ACC患者中有7例在产后随访中没有明显异常,而只有一例CMA正常的病例在6个月时表现出异常表型。在22例孤立的ACC患者中,六人选择终止妊娠。对16例孤立的ACC病例进行的产后随访显示,只有一例患有良性CNV,表现出智力残疾。
    结论:胎儿ACC的孕妇应进行产前CMA,特别是非孤立的ACC。ACC患者应进行长时间的产后随访,如有必要,应提供适当的干预措施。
    OBJECTIVE: Agenesis of the corpus callosum (ACC) is an anomaly that can occur in fetuses during pregnancy. However, there is currently no treatment for fetal ACC. Therefore, we conducted a retrospective analysis of obstetric outcomes of fetal ACC to explore the relationship between fetal ACC phenotypes and chromosomal copy number abnormalities.
    RESULTS: Amniotic fluid or umbilical cord blood were extracted from pregnant women with fetal ACC for karyotype analysis and chromosomal microarray analysis (CMA). Among the 48 fetuses with ACC, 22 (45.8%, 22/48) had isolated ACC, and 26 (54.2%, 26/48) had non-isolated ACC. Chromosomal abnormalities were detected via karyotype analysis in four cases. In addition to the four cases of pathogenic copy number variations (CNVs) detected using karyotype analysis, CMA revealed two cases of pathogenic CNVs with 17q12 microduplication and 16p12.2 microdeletion. The obstetric outcomes of 26 patients with non-isolated ACC were followed up, and 17 chose to terminate the pregnancy. In addition, seven of the nine cases with non-isolated ACC showed no obvious abnormality during postnatal follow-up, whereas only one case with normal CMA showed an abnormal phenotype at six months. Of the 22 patients with isolated ACC, six chose to terminate the pregnancy. Postnatal follow-up of 16 isolated ACC cases revealed only one with benign CNV, presenting with intellectual disability.
    CONCLUSIONS: Pregnant women with fetal ACC should be offered prenatal CMA, particularly non-isolated ACC. Patients with ACC should undergo prolonged postnatal follow-up, and appropriate intervention should be provided if necessary.
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  • 文章类型: Journal Article
    背景:哺乳动物中的造血是一个复杂且高度调节的过程,其中造血干细胞(HSC)产生所有类型的分化血细胞。先前的研究表明,毛状和分裂增强子(HES)抑制因子是Notch信号传导下游成年HSC发育的重要调节因子。
    方法:在本研究中,我们研究了HES家族成员HES1的作用,在胎儿造血中,使用表型流式细胞术使用胚胎造血特异性Hes1条件敲除小鼠模型,组织病理学分析,和功能性体外集落形成单位(CFU)测定和体内骨髓移植(BMT)测定。
    结果:我们发现胚胎早期阶段Hes1的缺失导致胚胎和胎儿肝脏变小,减少造血干祖细胞(HSPC)池,导致多谱系分化缺陷。功能上,缺乏Hes1的胎儿造血细胞在移植受体中表现出体外祖细胞活性降低和体内再增殖能力受损。进一步分析表明,Hes1fl/flFlt3Cre胚胎中的胎儿造血缺陷是由于增殖减少和细胞凋亡升高所致,与去抑制的HES1目标相关,P27和PTEN在Hes1-KO胎儿HSPCs中的表达。最后,p27或PTEN的药理学抑制可改善胎儿HSPCs的体外和体内功能.
    结论:一起,我们的发现揭示了HES1在调节胎儿造血中以前未被重视的作用,并为胎儿和成人HSC维持之间的差异提供新的见解。
    BACKGROUND: Hematopoiesis in mammal is a complex and highly regulated process in which hematopoietic stem cells (HSCs) give rise to all types of differentiated blood cells. Previous studies have shown that hairy and enhancer of split (HES) repressors are essential regulators of adult HSC development downstream of Notch signaling.
    METHODS: In this study, we investigated the role of HES1, a member of HES family, in fetal hematopoiesis using an embryonic hematopoietic specific Hes1 conditional knockout mouse model by using phenotypic flow cytometry, histopathology analysis, and functional in vitro colony forming unit (CFU) assay and in vivo bone marrow transplant (BMT) assay.
    RESULTS: We found that loss of Hes1 in early embryonic stage leads to smaller embryos and fetal livers, decreases hematopoietic stem progenitor cell (HSPC) pool, results in defective multi-lineage differentiation. Functionally, fetal hematopoietic cells deficient for Hes1 exhibit reduced in vitro progenitor activity and compromised in vivo repopulation capacity in the transplanted recipients. Further analysis shows that fetal hematopoiesis defects in Hes1fl/flFlt3Cre embryos are resulted from decreased proliferation and elevated apoptosis, associated with de-repressed HES1 targets, p27 and PTEN in Hes1-KO fetal HSPCs. Finally, pharmacological inhibition of p27 or PTEN improves fetal HSPCs function both in vitro and in vivo.
    CONCLUSIONS: Together, our findings reveal a previously unappreciated role for HES1 in regulating fetal hematopoiesis, and provide new insight into the differences between fetal and adult HSC maintenance.
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  • 文章类型: Journal Article
    这项研究调查了胚胎第13天(E13)和第15天(E15)的胎儿小鼠皮肤再生过程中的三维(3D)细胞相互作用和隧道纳米管(TNTs)。我们旨在了解参与皮肤再生的细胞类型之间的空间关系,并评估TNTs的潜在作用。在E13和E15胚胎中进行全厚度皮肤切口。收集伤口部位,嵌入环氧树脂中,处理用于三维重建(厚度为1μm的切片),并进行整体免疫染色。我们与胎儿巨噬细胞和成纤维细胞进行了体外共培养实验,以观察TNT的形成。为了评估TNTs对皮肤再生的影响,将抑制剂(细胞松弛素B)给予羊水。结果显示,E13表皮角质形成细胞与真皮成纤维细胞和巨噬细胞相互作用,促进皮肤再生。在E13细胞伤口部位观察到TNT结构,在巨噬细胞中,在巨噬细胞和成纤维细胞之间,通过体外共培养实验证实。体外和子宫细胞松弛素B的施用阻碍了E13伤口部位的这些形成和低效的皮肤质地再生。这强调了E13小鼠胚胎皮肤再生过程中表皮和真皮细胞之间3D细胞相互作用的必要性。TNT结构的流行表明它们参与实现完整的皮肤纹理恢复。
    This study investigated the three-dimensional (3D) cellular interactions and tunneling nanotubes (TNTs) during fetal mouse skin regeneration on embryonic days 13 (E13) and 15 (E15). We aimed to understand spatial relationships among cell types involved in skin regeneration and assess the potential role of TNTs. Full-thickness skin incisions were performed in E13 and E15 embryos. Wound sites were collected, embedded in epoxy resin, processed for 3D reconstruction (1 μm thickness sections), and subjected to whole-mount immunostaining. We conducted in vitro co-culture experiments with fetal macrophages and fibroblasts to observe TNT formation. To assess the effect of TNTs on skin regeneration, an inhibiting agent (cytochalasin B) was administered to amniotic fluid. Results revealed that E13 epidermal keratinocytes interacted with dermal fibroblasts and macrophages, facilitating skin regrowth. TNT structures were observed at the E13-cell wound sites, among macrophages, and between macrophages and fibroblasts, confirmed through in vitro co-culture experiments. In vitro and utero cytochalasin B administration hindered those formation and inefficient skin texture regeneration at E13 wound sites. This emphasizes the necessity of 3D cellular interactions between epidermal and dermal cells during skin regeneration in mouse embryos at E13. The prevalence of TNT structures indicated their involvement in achieving complete skin texture restoration.
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  • 文章类型: Journal Article
    产前给予羊水干细胞(AFSC-EV)的细胞外囊泡逆转了先天性膈疝(CDH)模型中肺发育不全的特征。然而,目前尚不清楚AFSC-EV治疗会影响哪些肺细胞区室和生物学途径。在这里,我们对接受载体或AFSC-EV治疗的大鼠胎儿CDH肺进行了单核RNA测序(snRNA-seq).我们确定羊膜内注射的AFSC-EV到达CDH大鼠的胎儿肺,它们促进肺分支形态发生和上皮细胞分化。此外,snRNA-seq显示大鼠胎儿CDH肺具有巨噬细胞富集的多谱系炎症特征,AFSC-EV治疗可逆转。通过免疫荧光证实CDH胎鼠肺中的巨噬细胞富集,流式细胞术,和用GW2580进行抑制研究。此外,我们验证了人胎儿CDH肺尸检样本中的巨噬细胞富集。一起,这项研究提高了对肺发育不全发病机制的认识,并进一步证明了基于EV的治疗对CDH胎儿的价值.
    Antenatal administration of extracellular vesicles from amniotic fluid stem cells (AFSC-EVs) reverses features of pulmonary hypoplasia in models of congenital diaphragmatic hernia (CDH). However, it remains unknown which lung cellular compartments and biological pathways are affected by AFSC-EV therapy. Herein, we conducted single-nucleus RNA sequencing (snRNA-seq) on rat fetal CDH lungs treated with vehicle or AFSC-EVs. We identified that intra-amniotically injected AFSC-EVs reach the fetal lung in rats with CDH, where they promote lung branching morphogenesis and epithelial cell differentiation. Moreover, snRNA-seq revealed that rat fetal CDH lungs have a multilineage inflammatory signature with macrophage enrichment, which is reversed by AFSC-EV treatment. Macrophage enrichment in CDH fetal rat lungs was confirmed by immunofluorescence, flow cytometry, and inhibition studies with GW2580. Moreover, we validated macrophage enrichment in human fetal CDH lung autopsy samples. Together, this study advances knowledge on the pathogenesis of pulmonary hypoplasia and further evidence on the value of an EV-based therapy for CDH fetuses.
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  • 文章类型: Journal Article
    怀孕前妇女感染乙型肝炎病毒(HBV)是否会影响后代先天性畸形的风险仍存在争议。我们通过使用大量的中国女性全国样本,通过考虑总体上的先天性畸形以及器官系统的风险来评估它们之间的关联。
    我们对参加全国免费孕前健康检查项目的女性进行了一项记录联系队列研究,在2010年1月1日至2019年12月31日期间,可以从国家基于人口的出生缺陷监测网络获得有关其后代先天性畸形的数据。总共获得了498,968条链接记录,其中127,371被排除,因为怀孕前HBV状态未知,记录涉及多胎妊娠,或怀孕后进行孕前检查。根据孕前状况,母亲被分配到两个类别的HBsAg-或HBsAg+和,在某些分析中,到三类HBsAg-,HBsAg+/HBeAg-或HBsAg+/HBeAg+。血清学状态与先天性畸形风险的潜在关联,单独或总体考虑,使用多水平逻辑回归进行了探索。还探讨了可能影响此类关联的因素。
    在分析的371597名女性中,21,482(5.78%)怀孕前HBsAg+,和8333(2.24%)的胎儿或儿童被诊断为先天性畸形,由7744HBsAg-女性和589HBsAg+女性组成。HBsAg+状态与总体先天性畸形(OR1.14,95%CI1.03-1.25)和心血管畸形(OR1.18,95%CI1.03-1.35)的风险增加相关。HBsAg+/HBeAg-状态与心血管畸形(OR1.19,95%CI1.01-1.39)以及生殖畸形(OR1.51,95%CI1.02-2.23)的风险显着升高。妊娠前HBsAg+状态与先天性畸形风险之间的关联由丙氨酸转氨酶活性修饰(P交互作用<0.05)。
    孕前HBV感染可能与胎儿畸形有关。这种关联需要进一步调查,以确认它是否是因果关系,并评估HBsAg+计划怀孕的女性的抗病毒治疗是否可能降低胎儿畸形的风险。
    中华人民共和国国家卫生健康委员会,中国;四川省科学技术厅,中国;和中华人民共和国科学技术部。
    UNASSIGNED: Whether hepatitis B virus (HBV) infection of women prior to pregnancy can influence risk of congenital malformations in offspring remains controversial. We assessed the association between them by considering congenital malformations in the aggregate as well as risk of organs systems using a large national sample of Chinese women.
    UNASSIGNED: We performed a record-linkage cohort study of women who participated in National Free Preconception Health Examination Project, between January 1, 2010, and December 31, 2019 for whom data on congenital malformations in their offspring were available from the National Population-Based Birth Defects Surveillance Network. A total of 498,968 linked records were obtained, of which 127,371 were excluded because HBV status before pregnancy was unknown, the records involved multiple pregnancies, or pre-pregnancy examinations were conducted after conception. Based on pre-pregnancy status, mothers were assigned to two categories of HBsAg- or HBsAg+ and, in certain analyses, to three categories of HBsAg-, HBsAg+/HBeAg- or HBsAg+/HBeAg+. Potential associations of serological status with risk of congenital malformations, considered separately or in aggregate, were explored using multilevel logistic regression. Factors that might influence such associations were also explored.
    UNASSIGNED: Among the 371,597 women analyzed, 21,482 (5.78%) were HBsAg+ before pregnancy, and 8333 (2.24%) had a fetus or child diagnosed with congenital malformations, composed of 7744 HBsAg- women and 589 HBsAg+ women. HBsAg+ status was associated with increased risk of congenital malformations in the aggregate (OR 1.14, 95% CI 1.03-1.25) and of cardiovascular malformations specifically (OR 1.18, 95% CI 1.03-1.35). HBsAg+/HBeAg- status was associated with significantly higher risk of cardiovascular malformations (OR 1.19, 95% CI 1.01-1.39) as well as reproductive malformations (OR 1.51, 95% CI 1.02-2.23). Associations between HBsAg+ status before pregnancy and risk of congenital malformations was modified by alanine aminotransferase activity (P interaction < 0.05).
    UNASSIGNED: Prepregnancy HBV infection might be associated with fetal malformations. This association needs further investigation to confirm whether it is a causal association, and assess whether antiviral therapy of women with HBsAg+ planning to conceive might reduce the risk of fetal malformations.
    UNASSIGNED: The National Health Commission of the People\'s Republic of China, China; Science and Technology Department of Sichuan Province, China; and the Ministry of Science and Technology of the People\'s Republic of China.
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