SGA High Risk Factors During Pregnancy And Early Postnatal Metabonomics Study

Part 1 Maternal risk factors for infants with small for gestational age by severityObjectiveBy analyzing the correlation between the metabolites of tandem mass spectrometry and the occurrence of SGA,to screen the indices of tandem mass spectrometry closely related to the outcomes of SGAMethodsThe study population was 903 volunteers from Shanghai Yousheng cohort recruited in Xinhua Hospital from September 2013 to December 2016.Two children with chromosomal abnormality and severe congenital malformation were excluded(one with trisomy 21 syndrome and one with congenital achondroplasia respectively),54 children with birth weight,gestational age or gender deficiency were excluded,and 847 children were finally enrolled.Subjects with SGA were classified into 3 subgroups based on their birth weight percentile by sex and gestational age:5th-10th percentile,3th-5th percentile and<3th percentile,defined as mild,moderate and severe SGA.Using multivariate logistic regression,we explored the association between maternal risk factors of clinical characteristics and the severity of SGAResults·No difference of maternal age,education,parity and preterm birth was found between infants with SGA and without SGA.The independent risk factors of SGA were maternal pre-pregnant body mass index,pregnancy associated hypertension(PAH)and infertility.Compared to mothers whose BMI?18.5 kg/cm2 or without PAH,those mothers with these conditions had 3.6-fold(95%confidence interval(CI):1.1-11.6)and4.0-fold(95%Cl:1.0-15.4)high risk to delivery moderate SGA infants respectively.Mothers with infertility had 6.4-fold(95%CI:1.2-34.2)high risk of severe SGA.Mild SGA was not associated with the above risk factors ConclusionMaternal pre-pregnant malnutrition,PAH and infertility were high risk factors for moderate and severe SGA.Different severity SGA was related to various risk factors·Part 2 Screening of indices of tandem mass spectrometry closely related to children with SGAObjectiveBy analyzing the correlation between the metabolites of tandem mass spectrometry and the physical development indicators of SGA children from postnatal to 2 years old,a prediction model was established to evaluate the postnatal physical development of SGA children.MethodsSingle newborn babies delivered in Xinhua Hospital from January 2013 to December 2016 were selected as subjects.The outcomes were birth weight,birth weight percentages of gestational age(SGA and LGA)and low birth weight(<2500 g).96 amino acid and carnitine indices in tandem mass spectrometry screening were exposed.LASSO regression model was used.The indices of tandem mass spectrometry closely related to the above outcomes were screened out.Using logistic regression analysis,we validated the above screening indicators and the related risk levels of SC A at 10th percentile,LGA at 90th percentile and low birth weight(<2500g)in all the single newborns sent to Xinhua Hospital from January 2017 to April 2017 in tandem mass spectrometry databaseResultFive tandem mass spectrometric indexes,C3/CO,C18:2,c10:1,C16,Phe/Tyr,which are closely related to birth weight and birth weight specific age percentile,were screened out by lasso regression model.Further logistic regression analysis showed that C3/CO,C16,C18:2,c10:1,Phe/Tyr were decreased,and C18:2,c10:1,Phe/Tyr were increased in the three-day-old SGA infants in the experimental group.The derivation group also reached the above conclusions,and completed within seven days of age The results of tandem mass spectrometry analysis of newborns are basically consistent with the aboveConclusionC3/CO,C16 decreased,C18:2,c10:1,Phe/Tyr increased in early SGA.