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      Study Design and Baseline Profiles of Participants in the Tianjin Birth Cohort (TJBC) in China

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          Abstract

          Background

          To investigate the causal link between early-life exposures and long-term health consequences, we established the Tianjin Birth Cohort (TJBC), a large-scale prospective cohort in northern China.

          Methods

          TJBC aims to enroll 10,000 families with follow-ups from pregnancy until children’s six year-old. Pregnant women and their spouses were recruited through a three-tier antenatal healthcare system at early pregnancy, with follow-ups at mid-pregnancy, late pregnancy, delivery, 42 days after delivery, 6 months after delivery, and each year until 6 years old. Antenatal/neonatal examination, biological samples and questionnaires were collected.

          Results

          From August 2017 to January 2019, a total of 3,924 pregnant women have already been enrolled, and 1,697 women have given birth. We observed the prevalence of gestational diabetes mellitus as 18.1%, anemia as 20.4%, and thyroid hypofunction as 2.0%. In singleton live births, 5.6% were preterm birth (PTB), 3.7% were low birth weight, and 7.3% were macrosomia. Based on current data, we also identified maternal/paternal factors which increased the risk of PTB, including paternal age (OR 1.07; 95% CI, 1.01–1.14 for each year increase), vaginal bleeding during pregnancy (OR 2.82; 95% CI, 1.54–5.17) and maternal early-pregnancy BMI (OR 1.08; 95% CI, 1.01–1.15 for each kg/m 2 increase).

          Conclusion

          TJBC has the strength of collecting comprehensive maternal, paternal, and childhood information. With a diverse range of biological samples, we are also engaging with emerging new technologies for multi-omics research. The study would provide new insight into the causal link between macro/micro-environmental exposures of early life and short/long-term health consequences.

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          Most cited references27

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          Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis

          Summary Background Preterm birth is the leading cause of death in children younger than 5 years worldwide. Although preterm survival rates have increased in high-income countries, preterm newborns still die because of a lack of adequate newborn care in many low-income and middle-income countries. We estimated global, regional, and national rates of preterm birth in 2014, with trends over time for some selected countries. Methods We systematically searched for data on preterm birth for 194 WHO Member States from 1990 to 2014 in databases of national civil registration and vital statistics (CRVS). We also searched for population-representative surveys and research studies for countries with no or limited CRVS data. For 38 countries with high-quality data for preterm births in 2014, data are reported directly. For countries with at least three data points between 1990 and 2014, we used a linear mixed regression model to estimate preterm birth rates. We also calculated regional and global estimates of preterm birth for 2014. Findings We identified 1241 data points across 107 countries. The estimated global preterm birth rate for 2014 was 10·6% (uncertainty interval 9·0–12·0), equating to an estimated 14·84 million (12·65 million–16·73 million) live preterm births in 2014. 12· 0 million (81·1%) of these preterm births occurred in Asia and sub-Saharan Africa. Regional preterm birth rates for 2014 ranged from 13·4% (6·3–30·9) in North Africa to 8·7% (6·3–13·3) in Europe. India, China, Nigeria, Bangladesh, and Indonesia accounted for 57·9 million (41×4%) of 139·9 million livebirths and 6·6 million (44×6%) of preterm births globally in 2014. Of the 38 countries with high-quality data, preterm birth rates have increased since 2000 in 26 countries and decreased in 12 countries. Globally, we estimated that the preterm birth rate was 9×8% (8×3–10×9) in 2000, and 10×6% (9×0–12×0) in 2014. Interpretation Preterm birth remains a crucial issue in child mortality and improving quality of maternal and newborn care. To better understand the epidemiology of preterm birth, the quality and volume of data needs to be improved, including standardisation of definitions, measurement, and reporting. Funding WHO and the March of Dimes.
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            Host remodeling of the gut microbiome and metabolic changes during pregnancy.

            Many of the immune and metabolic changes occurring during normal pregnancy also describe metabolic syndrome. Gut microbiota can cause symptoms of metabolic syndrome in nonpregnant hosts. Here, to explore their role in pregnancy, we characterized fecal bacteria of 91 pregnant women of varying prepregnancy BMIs and gestational diabetes status and their infants. Similarities between infant-mother microbiotas increased with children's age, and the infant microbiota was unaffected by mother's health status. Gut microbiota changed dramatically from first (T1) to third (T3) trimesters, with vast expansion of diversity between mothers, an overall increase in Proteobacteria and Actinobacteria, and reduced richness. T3 stool showed strongest signs of inflammation and energy loss; however, microbiome gene repertoires were constant between trimesters. When transferred to germ-free mice, T3 microbiota induced greater adiposity and insulin insensitivity compared to T1. Our findings indicate that host-microbial interactions that impact host metabolism can occur and may be beneficial in pregnancy. Copyright © 2012 Elsevier Inc. All rights reserved.
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              Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales.

              Although the rise in ischaemic heart disease in England and Wales has been associated with increasing prosperity, mortality rates are highest in the least affluent areas. On division of the country into two hundred and twelve local authority areas a strong geographical relation was found between ischaemic heart disease mortality rates in 1968-78 and infant mortality in 1921-25. Of the twenty-four other common causes of death only bronchitis, stomach cancer, and rheumatic heart disease were similarly related to infant mortality. These diseases are associated with poor living conditions and mortality from them is declining. Ischaemic heart disease is strongly correlated with both neonatal and postneonatal mortality. It is suggested that poor nutrition in early life increases susceptibility to the effects of an affluent diet.
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                Author and article information

                Journal
                J Epidemiol
                J Epidemiol
                JE
                Journal of Epidemiology
                Japan Epidemiological Association
                0917-5040
                1349-9092
                5 January 2022
                3 October 2020
                2022
                : 32
                : 1
                : 44-52
                Affiliations
                [1 ]Tianjin Women’s and Children’s Health Center, Tianjin, China
                [2 ]BGI-Shenzhen, Shenzhen, China
                [3 ]China National GeneBank, Shenzhen, China
                Author notes
                Address for correspondence. Puyi Qian, BGI-Shenzhen/China National GeneBank, Jinsha Road, Dapeng District, Shenzhen 518000, China (e-mail: qianpy@ 123456cngb.org ); Lingyan Feng, Tianjin Women’s and Children’s Health Center, Guizhou Road No. 96, Heping District, Tianjin 300070, China (e-mail: haiyangfly_2000@ 123456163.com ); Fang Chen, BGI-Shenzhen, Building No. 11, Beishan Industrial Zone, Yantian District, Shenzhen 518083, China (e-mail: fangchen@ 123456genomics.cn ); Gongshu Liu, Tianjin Women’s and Children’s Health Center, Guizhou Road No. 96, Heping District, Tianjin 300070, China (e-mail: liugongshu727@ 123456163.com ).
                [#]

                Co-first authors contributed equally to this work.

                [*]

                Co-corresponding contributed equally to this work.

                Author information
                http://orcid.org/0000-0002-3146-5818
                http://orcid.org/0000-0001-7131-7230
                Article
                JE20200238
                10.2188/jea.JE20200238
                8666315
                33012776
                8811b3c5-7419-4987-87b1-9729ed3b51d6
                © 2020 Shuo Wang et al.

                This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 8 June 2020
                : 14 September 2020
                Funding
                Funded by: The National Key Research and Development Program of China
                Award ID: 2016YFC0900602
                Categories
                Study Profile
                Maternal and Child Health

                design,birth cohort,child,early-onset chronic disease,biobank

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