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The prevalence of GDM is very high worldwide. The specific pathogenesis of GDM is currently not very clear. Recent research suggests that changes in the intestinal flora during pregnancy play a key role in it. Therefore, this study is aimed at exploring the characteristics of the intestinal flora of patients with gestational diabetes in the third trimester of pregnancy and at finding the intestinal flora with significant differences in healthy pregnant women to provide a basis for future clinical attempts of using intestinal microecological agents to treat gestational diabetes mellitus (GDM). We sequenced the V3-V4 regions of the 16S ribosomal ribonucleic acid (rRNA) gene from stool samples of 52 singleton pregnant women at >28 weeks of gestation. Our results showed that there were significant differences between the NOR group vs. GDM group and the G group vs. LG group among Bacteroides, Firmicutes, and Firmicutes/Bacteroides. At the species level, there were significant differences in the abundance of eight species in the NOR and GDM groups. Among them, the relative abundance of Clostridium_spiroforme, Eubacterium_dolichum, and Ruminococcus_gnavus was positively correlated with FBG, and Pyramidobacter_piscolens was negatively correlated with FBG, whereas there were significant differences in the abundance of five species in the G and LG groups. Functional analysis showed that there were differences in the biosynthesis and metabolism of polysaccharides, digestive system, classification, and degradation of the intestinal microbes between the NOR and GDM groups and between the G and LG groups. These results indicated that the gut microbes between GDM patients in the third trimester of pregnancy and healthy controls had essential characteristic changes and might be involved in the regulation of patients’ blood glucose levels.

Reference intervals are very important for clinical laboratory diagnosis and physiological evaluation. 1 The accuracy and applicability of such reference intervals directly affect the efficient diagnosis and treatment of the disease. Hematology is commonly used to assess health and disease states associated with blood disorders, infectious diseases, and the immune system. 2 However, suitable age-and sexspecific reference intervals of hematologic analytes of children are often lacking or incomplete. Children are not small adults, and consensus guidelines for adults may not apply to children. 3 Hematological reference intervals are affected by many factors such as the location of the population, economic background, lifestyle habits, and dietary structure. While it is inappropriate to randomly use the reference intervals established in other countries, there are no standard pediatric reference intervals for China. Therefore, it is necessary to establish a hematological reference range for Chinese children. The purpose of this study was to establish the age-and Abstract Introduction: Reference intervals for pediatric laboratory tests need to be interpreted in the context of age-and sex-dependent dynamics. However, few reference intervals for healthy ethnic Han Chinese children have previously attempted to establish using large sample sizes. As such, there are no national hematological standards in China for pediatric reference intervals. Methods:We used a direct method to enroll a total of 2164 healthy 1-to 7-year-old children from Henan province. Hematological reference intervals were established by analyzing venous blood sample data on 17 hematologic analytes. The reference values for different ages and sexes were estimated using both parametric methods (mean ± 2 SD) and nonparametric methods (2.5-97.5th percentiles). Results:We provided reference intervals for 17 hematologic analytes including red blood count, hemoglobin concentration, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width, white blood count and differential count as well as platelet count and related parameters. Conclusion:We established age-and sex-specific reference intervals that can provide more evidence-based guidance for the diagnosis and treatment for pediatric diseases. Our findings provide the basis for the next step in establishing national blood testing standards. K E Y W O R D Schildren, hematologic analytes, reference interval, venous blood

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