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Maternal and Neonatal Outcomes of Twin Pregnant Women With Anemia
- Nacheng Lin, Ping Shen, Huilian Hu, Wenying Song, Yali Hu, Yimin Dai, Yi-Hua Zhou
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- Journal:
- Twin Research and Human Genetics / Volume 26 / Issue 4-5 / August 2023
- Published online by Cambridge University Press:
- 31 August 2023, pp. 313-318
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The aim of this study was to investigate the prevalence of anemia in twin pregnancies and the influence of anemia on maternal and neonatal outcomes. This retrospective study included twin pregnant women who delivered in a tertiary hospital in China from January 2018 to December 2018. Patients were divided by WHO criteria (hemoglobin <11.0 g/dL): the anemic and nonanemic groups. Patients with anemia were further classified as recovered or unrecovered subgroup after oral iron therapy. Maternal and neonatal outcomes in women carrying twins were compared using Student’s t test and the chi-squared test or the Fisher exact test. Univariable and multivariable logistic regression models were used to determine the association of maternal and neonatal characteristics with anemia. Linear regression analysis was used to estimate mean birth weight and gestational week. The prevalence of anemia was 42.6% (182/427) in twin pregnancies. The anemic group had higher rates of low 1-minute Apgar score (4.4% vs. 1.8%, p = .028), perinatal death (1.9% vs. 0.2%, p = .012) and neonatal intensive care unit (NICU) admission (27.2% vs. 20.2%, p = .017; adjusted OR, 1.478; 95% CI [1.07, 2.044]). The recovered subgroup had lower NICU admission rate (13.5% vs. 30.3%, p = .006; OR, 0.388; 95% CI [0.186, 0.809]), higher gestational week and birth weight (β, 0.954 week; 95% CI [0.114, 1.794] and β, 171.01 g; 95% CI [9.894, 332.126] respectively). The prevalence of anemia in twin gestation is high. Anemia is associated with adverse neonatal outcomes, and correction of anemia significantly improved the pregnancy outcomes.
Persistent eutrophication and hypoxia in the coastal ocean
- Minhan Dai, Yangyang Zhao, Fei Chai, Mingru Chen, Nengwang Chen, Yimin Chen, Danyang Cheng, Jianping Gan, Dabo Guan, Yuanyuan Hong, Jialu Huang, Yanting Lee, Kenneth Mei Yee Leung, Phaik Eem Lim, Senjie Lin, Xin Lin, Xin Liu, Zhiqiang Liu, Ya-Wei Luo, Feifei Meng, Chalermrat Sangmanee, Yuan Shen, Khanittha Uthaipan, Wan Izatul Asma Wan Talaat, Xianhui Sean Wan, Cong Wang, Dazhi Wang, Guizhi Wang, Shanlin Wang, Yanmin Wang, Yuntao Wang, Zhe Wang, Zhixuan Wang, Yanping Xu, Jin-Yu Terence Yang, Yan Yang, Moriaki Yasuhara, Dan Yu, Jianmin Yu, Liuqian Yu, Zengkai Zhang, Zhouling Zhang
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- Journal:
- Cambridge Prisms: Coastal Futures / Volume 1 / 2023
- Published online by Cambridge University Press:
- 23 February 2023, e19
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Coastal eutrophication and hypoxia remain a persistent environmental crisis despite the great efforts to reduce nutrient loading and mitigate associated environmental damages. Symptoms of this crisis have appeared to spread rapidly, reaching developing countries in Asia with emergences in Southern America and Africa. The pace of changes and the underlying drivers remain not so clear. To address the gap, we review the up-to-date status and mechanisms of eutrophication and hypoxia in global coastal oceans, upon which we examine the trajectories of changes over the 40 years or longer in six model coastal systems with varying socio-economic development statuses and different levels and histories of eutrophication. Although these coastal systems share common features of eutrophication, site-specific characteristics are also substantial, depending on the regional environmental setting and level of social-economic development along with policy implementation and management. Nevertheless, ecosystem recovery generally needs greater reduction in pressures compared to that initiated degradation and becomes less feasible to achieve past norms with a longer time anthropogenic pressures on the ecosystems. While the qualitative causality between drivers and consequences is well established, quantitative attribution of these drivers to eutrophication and hypoxia remains difficult especially when we consider the social economic drivers because the changes in coastal ecosystems are subject to multiple influences and the cause–effect relationship is often non-linear. Such relationships are further complicated by climate changes that have been accelerating over the past few decades. The knowledge gaps that limit our quantitative and mechanistic understanding of the human-coastal ocean nexus are identified, which is essential for science-based policy making. Recognizing lessons from past management practices, we advocate for a better, more efficient indexing system of coastal eutrophication and an advanced regional earth system modeling framework with optimal modules of human dimensions to facilitate the development and evaluation of effective policy and restoration actions.