Background:China’s two-child policy has led to a trend of aging in pregnancy which was associated with adverse outcomes.This study aimed to identify the clinically cutoff maternal age for adverse obstetric outcomes i...Background:China’s two-child policy has led to a trend of aging in pregnancy which was associated with adverse outcomes.This study aimed to identify the clinically cutoff maternal age for adverse obstetric outcomes in China.Methods:This secondary analysis of a multicenter retrospective cohort study included data of childbearing women from 39 hospitals collected in urban China during 2011 to 2012.Logistic regression was used to assess the adjusted odds ratios(aOR)of adverse outcomes in different age groups in comparison to women aged 20 to 24 years.The adjustments included the location of the hospital,educational level,and residence status.Clinically cutoff age was defined as the age above which the aOR continuously become both statistically(P<0.05)and clinically(aOR>2)significant.Results:Overall,108,059 women were recruited.In primiparae,clinically cutoff maternal ages for gestational diabetes(aOR:2.136,95%confidence interval[CI]:1.856-2.458,P<0.001),placenta previa(aOR:2.400,95%CI:1.863-3.090,P<0.001),cesarean section(aOR:2.511,95%CI:2.341-2.694,P<0.001),hypertensive disorder(aOR:2.122,95%CI:1.753-2.569,P<0.001),post-partum hemorrhage(aOR:2.129,95%CI:1.334-3.397,P<0.001),and low birth weight(aOR:2.174,95%CI:1.615-2.927,P<0.001)were 27,31,33,37,41,and 41 years,respectively.In multiparae,clinically cutoff ages for gestational diabetes(aOR:2.977,95%CI:1.808-4.904,P<0.001),hypertensive disorder(aOR:2.555,95%CI:1.836-3.554,P<0.001),cesarean section(aOR:2.224,95%CI:1.952-2.534,P<0.001),post-partum hemorrhage(aOR:2.140,95%CI:1.472-3.110,P<0.001),placenta previa(aOR:2.272,95%CI:1.375-3.756,P<0.001),macrosomia(aOR:2.215,95%CI:1.552-3.161,P<0.001),and neonatal asphyxia(aOR:2.132,95%CI:1.461-3.110,P<0.001)were 29,31,33,35,35,41,and 41 years,respectively.Conclusions:Early cutoff ages for gestational diabetes and cesarean section highlight a reasonable childbearing age in urban China.The various optimized cutoff ages for different adverse pregnancy outcomes should be carefully considered in childbearing women.展开更多
Objective:To examine the association between sleep characteristics and night shift work and the risk of polycystic ovary syndrome(PCOS)in Chinese women and to investigate their relationship with infertility in PCOS.Me...Objective:To examine the association between sleep characteristics and night shift work and the risk of polycystic ovary syndrome(PCOS)in Chinese women and to investigate their relationship with infertility in PCOS.Methods:From March 21,2021 to April 31,2021,3927 Chinese women with or without PCOS were recruited online.All participants completed WeChat-based electronic questionnaires.Sleep characteristics were measured using the Pittsburgh sleep quality index.Results:A total of 2871 women were included in the final analysis.Sleep duration(odds ratio[OR],0.857;95%confidence interval[CI],0.763-0.963),sleep midpoint(OR,1.142;95%CI,1.049-1.244),sleep disturbance(OR,1.320;95%CI,0.957-1.146),daytime dysfunction(OR,1.136;95%CI,1.030-1.253),and night shift work(OR,1.628;95%CI,1.264-2.097)were associated with a higher risk of PCOS.After adjusting for confounders,including age,body mass index,smoking status,and coffee and tea drinking status,sleep disturbance(OR,1.314;95%CI,1.111-1.555),daytime dysfunction(OR,1.143;95%CI,1.034-1.264),and night shift work(OR,1.800;95%CI,1.388-2.333)remained associated.In addition,sleep disturbance(OR,1.887;95%CI,1.400-2.542)and subjective sleep quality(OR,1.299;95%CI,1.037-1.627)were associated with infertility in women with PCOS,and sleep disturbance(OR,1.750;95%CI,1.281-2.390)remained significant after adjusting for confounders.Conclusions:Sleep disturbance,daytime dysfunction,and night shift work are significantly associated with PCOS.Screening for sleep disturbances and providing appropriate treatment could be potential strategies for managing PCOS and its long-term complications.展开更多
基金This work was supported by grants from the Shanghai Key Program of Clinical Science and Technology Innovation(No.17411950500 ,No.18511105602)Shanghai Medical Center of Key Programs for Female Reproductive Diseases(No.2017ZZ01016).
文摘Background:China’s two-child policy has led to a trend of aging in pregnancy which was associated with adverse outcomes.This study aimed to identify the clinically cutoff maternal age for adverse obstetric outcomes in China.Methods:This secondary analysis of a multicenter retrospective cohort study included data of childbearing women from 39 hospitals collected in urban China during 2011 to 2012.Logistic regression was used to assess the adjusted odds ratios(aOR)of adverse outcomes in different age groups in comparison to women aged 20 to 24 years.The adjustments included the location of the hospital,educational level,and residence status.Clinically cutoff age was defined as the age above which the aOR continuously become both statistically(P<0.05)and clinically(aOR>2)significant.Results:Overall,108,059 women were recruited.In primiparae,clinically cutoff maternal ages for gestational diabetes(aOR:2.136,95%confidence interval[CI]:1.856-2.458,P<0.001),placenta previa(aOR:2.400,95%CI:1.863-3.090,P<0.001),cesarean section(aOR:2.511,95%CI:2.341-2.694,P<0.001),hypertensive disorder(aOR:2.122,95%CI:1.753-2.569,P<0.001),post-partum hemorrhage(aOR:2.129,95%CI:1.334-3.397,P<0.001),and low birth weight(aOR:2.174,95%CI:1.615-2.927,P<0.001)were 27,31,33,37,41,and 41 years,respectively.In multiparae,clinically cutoff ages for gestational diabetes(aOR:2.977,95%CI:1.808-4.904,P<0.001),hypertensive disorder(aOR:2.555,95%CI:1.836-3.554,P<0.001),cesarean section(aOR:2.224,95%CI:1.952-2.534,P<0.001),post-partum hemorrhage(aOR:2.140,95%CI:1.472-3.110,P<0.001),placenta previa(aOR:2.272,95%CI:1.375-3.756,P<0.001),macrosomia(aOR:2.215,95%CI:1.552-3.161,P<0.001),and neonatal asphyxia(aOR:2.132,95%CI:1.461-3.110,P<0.001)were 29,31,33,35,35,41,and 41 years,respectively.Conclusions:Early cutoff ages for gestational diabetes and cesarean section highlight a reasonable childbearing age in urban China.The various optimized cutoff ages for different adverse pregnancy outcomes should be carefully considered in childbearing women.
文摘Objective:To examine the association between sleep characteristics and night shift work and the risk of polycystic ovary syndrome(PCOS)in Chinese women and to investigate their relationship with infertility in PCOS.Methods:From March 21,2021 to April 31,2021,3927 Chinese women with or without PCOS were recruited online.All participants completed WeChat-based electronic questionnaires.Sleep characteristics were measured using the Pittsburgh sleep quality index.Results:A total of 2871 women were included in the final analysis.Sleep duration(odds ratio[OR],0.857;95%confidence interval[CI],0.763-0.963),sleep midpoint(OR,1.142;95%CI,1.049-1.244),sleep disturbance(OR,1.320;95%CI,0.957-1.146),daytime dysfunction(OR,1.136;95%CI,1.030-1.253),and night shift work(OR,1.628;95%CI,1.264-2.097)were associated with a higher risk of PCOS.After adjusting for confounders,including age,body mass index,smoking status,and coffee and tea drinking status,sleep disturbance(OR,1.314;95%CI,1.111-1.555),daytime dysfunction(OR,1.143;95%CI,1.034-1.264),and night shift work(OR,1.800;95%CI,1.388-2.333)remained associated.In addition,sleep disturbance(OR,1.887;95%CI,1.400-2.542)and subjective sleep quality(OR,1.299;95%CI,1.037-1.627)were associated with infertility in women with PCOS,and sleep disturbance(OR,1.750;95%CI,1.281-2.390)remained significant after adjusting for confounders.Conclusions:Sleep disturbance,daytime dysfunction,and night shift work are significantly associated with PCOS.Screening for sleep disturbances and providing appropriate treatment could be potential strategies for managing PCOS and its long-term complications.
