06-04 "Voice of Mother and Baby", we interpreted 10 documents, focusing on: respiratory syncytial virus , vaccine, food allergy , pregnancy exercise, cesarean section, pregnancy diet, pregnancy outcome, obesity, neonatal bacterial flora
Lancet: The most complete data estimate, children respiratory syncytial virus infection disease burden
Lancet——[79.321]
① A total of 481 studies were included, including some unpublished data; ② The study estimated that in 2019, among children aged 0-5, there were 33 million incidents related to respiratory syncytial virus (RSV) in the world, 3.6 million RSV-related infection hospitalizations, and 26,300 RSV-related hospitalization deaths; ③ Among infants aged 0-6 months, there were an estimated 6.6 million RSV-related acute respiratory infections, 1.4 million RSV-related hospitalizations, and 13,300 RSV-related deaths; ④ 2% of children under the age of 5 can be attributed to RSV infection; ⑤ More than 97% of deaths caused by RSV infection occur in low/middle-income countries.
[Editor's Comment]
After this study was systematically reviewed and integrated relevant data, it comprehensively reported the incidence, hospitalization rate and death of respiratory syncytial virus (RSV) infection events in children, which accounted for the majority in low- and middle-income countries. This study provides an important foundation for further carrying out the prevention and control of RSV. (@Epi Wang)
【Original information】
Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysistml2
2022-05-19, doi: 10.1016/S0140-6736(22)00478-0
NEJM: Successful trial of respiratory inclusion virus vaccine during pregnancy
New England Journal of Medicine—[91.245]
① Evaluate the efficacy, immunogenicity and safety of the bivalent respiratory syncytial virus (RSV) F protein vaccine in pregnant women; ② 406 pregnant women were included, of which 80.5% were vaccinated with RSVpreF vaccine, and most of the immune responses after vaccination were mild to moderate; ③ The incidence of local reactions in pregnant women who received the RSVpreF vaccine containing aluminum hydroxide was higher than that in the group without aluminum hydroxide vaccine; ④ The incidence of maternal and infant adverse events in the vaccine group and placebo group was similar; ⑤ The RSVpreF vaccine triggered neutralizing antibody response through effective transplacental transfer, and the transfer rate of non-aluminum preparations was higher than that of aluminum preparations.
[Editor's Comment]
The results of a vaccine clinical trial published in "New England Journal of Medicine" prove that a newly developed respiratory inclusion virus vaccine based on the F gene has achieved clinical trial success. This study provides scientific data for further strengthening vaccination management during pregnancy. (@Epi Wang)
[Original information]
Prefusion F Protein–Based Respiratory Syncytial Virus Immunization in Pregnancy
2022-04-28, doi: 10.1056/NEJMoa2106062
Cohort study reveals the natural history of peanuts/egg allergies in children
Journal of Allergy and Clinical Immunology——[10.793]
① 5276 children included in the HealthNuts cohort, and their food allergies at the age of 1-6 were followed up; ② The rate of newly-occurred peanut allergies was higher than that at the age of 1-6; ② The rate of newly-occurred peanut allergies was higher than that at the age of 1 (0.7% vs 0.09%), while the "recovery rate" of egg allergies was higher than that at the age of 6 (89% vs 29%); ③ Overall, the prevalence of peanut allergies was 3.1% at the age of 6, and the prevalence of egg allergies was 1.2%; ④ The risk factors of persistent peanut allergies included skin prick test at the age of 1≥8mm, early onset severe eczema, etc.; ⑤ The risk factors of persistent egg allergies include skin prick test at the age of 1≥4mm, multiple nut allergies, roasted egg allergies, early onset severe eczema , etc.
[Editor's comment]
Children's food allergies have always troubled many parents. This cohort study is based on observations from the natural population cohort and found that most of the egg allergies that occur in infancy will naturally "recover", but new egg allergies will also occur during this period. Children with early onset eczema during infancy are at a higher risk of future persistent food allergies.(@Epi Wang)
[Original information]
The natural history of peanut and egg allergy in children up to age 6 years in the HealthNuts population-based longitudinal study
2022-05-10, doi: 10.1016/j.jaci.2022.04.008
The benefits of pregnancy exercise, epigenetic show magical powers
Diabetes——[9.461]
① A mother's high-fat diet can induce WDR82 carbonylation and histone H3K4 methyltransferase inactivation, thereby inducing glucose metabolism disorders in the offspring of mice; ② If the mother's mice are allowed to exercise during pregnancy, the entire signal will be restored, which can increase the level of the glucose metabolism gene promoter H3K4me3 in the offspring of the offspring of the offspring; ③ Maternal exercise increases HKMT activity and reduces the protein carbonylation phenomenon induced by ROS in the offspring of the offspring of the ; ④ Placenta-derived SOD3 mediates the protective effect of glucose metabolism in the offspring of the mother's exercise; ⑤ Exercise during pregnancy can regulate the epigenetic system in the fetal liver, thereby passing the benefits of exercise to the offspring.
[Editor's comment]
The damage to the metabolic function of offspring is currently recognized, but it is not clear whether exercise intervention during pregnancy can slow this damage and what mechanism is passed. Through animal experiments, this study found that mothers' pregnancy exercise can regulate the health damage caused by high-fat diet to a certain extent, and pass on the benefits to offspring. (@Epi Wang)
[Original information]
Maternal Exercise-Induced SOD3 Reverses the Deleterious Effects of Maternal High Fat Diet on Offspring Metabolism Through Stabilization of H3K4me3 and Protection Against WDR82 Carbonylation
2022-06-01, doi: 10.2337/db21-0706
BMJ: Preventive use of antibiotics before cesarean section will not increase the risk of asthma in offspring
British Medical Journal—[39.89]
① More than 510,000 pregnant and maternal data collected in British databases from 2006 to 2018 were included, and their children's health data were followed up until 5 years old;② Among them, the rate of cesarean section was around 25.4%, of which 98% of them used antibiotics in preventive use of antibiotics before cesarean section was not found compared with the use of umbilical cord clamping, no increased risk of asthma, eczema, and hospitalization due to asthma/eczema were found;④ However, preoperative prophylactic use of antibiotics can reduce the risk of maternal infection events; ⑤ The above studies found it to be more robust in different databases and various sensitivity analyses.
[Editor's Comment]
In view of the enthusiasm of intestinal flora research, many scholars believe that preventive use of antibiotics before cesarean section may enter the fetus through the placental barrier, thereby affecting the development of the fetus' intestinal flora and increasing the subsequent risk of asthma and eczema. However, the risk results of this big data show that preventive antibiotic use is not statistically related to the risk of asthma and eczema in children within 5 years of birth. At the same time, preventive use of antibiotics can effectively reduce the risk of infection in mothers. Therefore, in obstetric practice, the preventive use of antibiotics may outweigh the disadvantages. (@Epi Wang)
[Original information]
Long term impact of prophylactic antibiotic use before incision versus after cord clamping on children born by caesarean section: longitudinal study of UK electronic health records
2022-05-17, doi: 10.1136/bmj-2021-069704
Chongqing cohort: There is a correlation between dietary pattern during pregnancy and maternal and child outcome
Frontiers in Nutrition—[6.576]
① 1437 participants were included in the Chongqing maternal and infant cohort. Dietary patterns were investigated at 11-14 weeks of pregnancy, and the pregnancy outcome and the infant's development scale score were followed up; ② Principal component analysis obtained two dietary patterns, namely PSO type (in pasta, sweet drink, heavy oil, heavy condiments) and FPV type (rich in fish, poultry and vegetable patterns); ③ The higher the PSO dimension score, the lower the infant development scale score, and the placenta weight was about lower, and the skin fold thickness was greater at 6 weeks of age; ④ The higher the FPV dimension score, the greater the weight gain of pregnant women at 11-34 weeks, but no statistical correlation between their scores and the maternal and infant outcome and infant development scale was observed.
[Editor's comment]
There are few prospective cohort studies on dietary patterns and infant growth and development of Chinese people. Therefore, this study used the Chongqing cohort population to conduct analysis and summarized two dietary patterns using principal component analysis. This study provides important data support for guiding healthy diets during pregnancy. (@Epi Wang)
[Original information]
An Investigation of the Relationship Between Dietary Patterns in Early Pregnancy and Maternal/Infant Health Outcomes in a Chinese Cohort
2022-04-22, doi: 10.3389/fnut.2022.775557
Pregnancy serological indicators predict adverse pregnancy outcomes? Very difficult!
American Journal of Obstetrics and Gynecology—[8.661]
① Data of 10,038 primary mothers were included, including 800 premature births, 568 preeclampsia, 5406 less than gestational age, and 49 stillbirth;② The levels of vascular endothelial growth factor , placental growth factor, soluble FMS-like tyrosine kinase, inactivate A, alpha-fetoprotein and other placental proteins in the serum of mothers from 6 to 13 weeks and 16 to 21 weeks were detected respectively;③ Although some indicators have changed in pregnant women with adverse pregnancy outcomes, the changes are small and cannot be independently predicted by adverse pregnancy outcomes;④ Even after combining maternal baseline information and serological indicator information, it is impossible to construct a feasible prediction model for adverse pregnancy outcomes .
[Editor's Comment]
Early identification of the risk of adverse pregnancy outcomes is of great significance to implement clinical intervention as soon as possible and reduce disease risk. However, there is currently no accurate predictive model of adverse pregnancy outcomes. Based on this, this study tested the levels of proteins of multiple placental-related in continuous serum during pregnancy. Although there may be statistical differences among women who saw adverse pregnancy outcomes through nested case control design, these differences are small and are not enough to construct an effective evaluation prediction model. Therefore, if you want to predict adverse pregnancy outcomes, the obstacles will be long and difficult. (@Epi Wang)
[Original information]
Placental protein levels in maternal serum are associated with adverse pregnancy outcomes in nulliparous patients
2022-04-26, doi: 10.1016/j.ajog.2022.03.064
Children's obesity may not affect the symptoms of inflammatory bowel inflammation in children
American Journal of Gastroenterology——[10.864]
① 4,972 children with newly diagnosed Crohn's disease (CD) and ulcerative colitis (UC) from 2006 to 2018 were followed up 12-18 months after diagnosis, and symptom remission was evaluated based on different scales; ② If the PGA table was used, there was no difference in disease activity in CD children who were overweight/obese at 1 year compared with normal weight children, while the sPCDAI scale was used to evaluate the disease activity in obese children; ③ For children with UC, there was no difference in disease activity after 1 year whether they were evaluated by PGA scale or PUCAI scale; ④ There was no evidence that childhood obesity was related to the severity of inflammatory enteritis.
[Editor's comment]
Since childhood obesity may be related to chronic inflammation in the body, many scholars suspect that there may be some correlation between inflammatory enteritis and obesity in children. Through cohort data, there is no definite evidence for the differences in symptoms of obese children after diagnosing inflammatory enteritis.(@Epi Wang)
[Original information]
Overweight and obese status is not associated with disease activity for children and adolescents with newly diagnosed IBD
2022-04-26, doi: 10.14309/ajg.0000000000000001803
Neonatal microbiome perspective (view)
Microbiome——[14.65]
① The infant's microbiome is related to long-term life and health, so it may be an important intervening window period; ② The prenatal environment may affect the microbiome colonization of the newborn, while cesarean section may affect the "transmission" between the maternal and infant flora. Whether it should be a scientific question for the "colonization" of the mother's flora for infants during cesarean section is a scientific question; ③ One of the key questions to be answered is how maternal-born microorganisms affect the long-term growth, development and disease resistance of the infant; ④ In addition, methods of intervening in infant flora, including vaginal flora transmission, fecal bacteria transplantation, probiotics, antibiotic management, etc. are worth further proof.
[Editor's Comment]
's opinion article published in "Microbiome" summarizes the current understanding of the role of the neonatal microbiome, influencing factors and cutting-edge intervention methods, and provides a theoretical basis for further carrying out related research. (@Epi Wang)
[Original information]
Should we modulate the neonatal microbiome and what should be the goal?
2022-05-10, doi: 10.1186/s40168-022-01281-4
Another discussion on the influencing factors of neonatal microbiome structure (review)
Genome Medicine——[11.117]
① The delivery method first affects the microbiome of the newborn. The vaginal flora seeding of infants with cesarean section will make the vaginal-related flora more abundant in the oral, skin, and intestinal flora, but its health effects are worth further discussion; ② When the mother is exposed to the pet environment, herbicides, environmental pollutants, as well as the mother's dietary habits and mental stress, it may be related to the microbiome structure of the offspring neonates; ③ The birth of a sterile animal model has brought powerful tools to study flora, but the abnormal development of the animal model it brings is a challenge to overcome; ④ In addition, whether there are bacteria in the uterus is still a controversial topic.
[Editor's Comment]
This study gives very specific examples to illustrate the impact of mothers on the bacterial structure of offspring babies in prenatal/perinatal periods. It discusses the opportunities and challenges faced in infant bacterial research in depth, and is worthy of reference by experts in relevant fields. (@Epi Wang)
[Original information]
Maternal and early life exposures and their potential to influence development of the microbiome
2022-01-11, doi: 10.1186/s13073-021-01005-7
Thanks to the creators of this issue of the daily report: Epi Wang, Yin Xiaotian
Click to read the daily report in the past 10 days:
05-29 | Children and adolescents should prevent the new crown, vaccines should come first!
05-13 | NEJM's important thing: prevent cardiovascular diseases, start with the baby!
04-29 | I always want to eat during pregnancy, and the brain nerves are at work
04-22 | 6 articles focus on vaginal flora, are there also "traitors" in Lactobacillus?
