IMPORTANCE Appropriate infant feeding practices have the potential for long-term health effects. However, research findings on improving early infant feeding practices are limited. The wide use of mobile phone short message service (SMS) provides new opportunities for health promotion and services. OBJECTIVE To assess the effect of an SMS intervention on infant feeding practices. DESIGN AND SETTING Quasiexperimental design with follow-up measures scheduled at 4, 6, and 12 months at 4 community health centers in Shanghai, China. Two community health centers represented the intervention group, and 2 other community health centers represented the control group. PARTICIPANTS In total, 582 expectant mothers were recruited during the first trimester. Expectant mothers were eligible to participate if they owned a mobile phone, were first-time mothers, conceived a singleton fetus, were older than 20 years and less than 13 weeks' gestation, had completed at least a compulsory junior high school education, and had no illness that limited breastfeeding after childbirth. INTERVENTION Mothers in the intervention group received weekly SMS messages about infant feeding from the third trimester to 12 months' post partum. MAIN OUTCOMES AND MEASURES The primary outcome was the duration of exclusive breastfeeding (EBF). Survival analysis was used to compare the duration of EBF between the intervention group and the control group. RESULTS Compared with the control group, the intervention group had a significantly longer median duration of EBF at 6 months (11.41 [95% CI, 10.25-12.57] vs 8.87 [95% CI, 7.84-9.89] weeks). The hazard ratio for stopping EBF in the intervention group was 0.80 (95% CI, 0.66-0.97). The intervention resulted in a significantly higher rate of EBF at 6 months (adjusted odds ratio, 2.67 [95% CI, 1.45-4.91]) and a significantly lower rate of the introduction of solid foods before 4 months (adjusted odds ratio, 0.27 [95% CI, 0.08-0.94]). CONCLUSIONS AND RELEVANCE An SMS intervention may be effective in promoting EBF, delaying the introduction of solid foods, increasing awareness of the World Health Organization breastfeeding guidelines, and improving knowledge of appropriate infant feeding practices for new mothers.

BackgroundExcessive gestational weight gain (GWG) poses negative impact on mothers and their children. It is important to understand the modifiable lifestyle factors associated with excessive GWG during pregnancy to guide future public health practice.AimTo investigate the association between physical activity during pregnancy and GWG of Chinese urban pregnant women.MethodsA pregnant women cohort was established between 2005 and 2007 in Changzhou, China. Physical activity levels of pregnant women were assessed using pedometer in the 2nd and 3rd trimester, respectively. According to step counts, pregnant women were categorized into 4 different physical activity groups: Sedentary, Low Active, Somewhat Active and Active. The pregnant women were followed for eligibility and data collection from the 2nd trimester to delivery. Multiple linear regression and multiple binary logistic model were applied to determine the association between physical activity and GWG.ResultsPhysical activity levels and GWG of 862 pregnant women were assessed, among them 473 (54.9%) experienced excessive GWG. The adjusted odds ratio (OR) was 0.59 (95%CI: 0.36 ~ 0.95) for excessive GWG in the Active group during the 2nd trimester and 0.66 (95%CI: 0.43 ~ 1.00) in the Somewhat Active group during the 3rd trimester, compared with the Sedentary group respectively. In the last two trimesters, the Active group had 1.45 kg less GWG, than the Sedentary group. The ORs of excessive GWG decreased with the increased level of physical activity (P < 0.05).ConclusionThis study suggests that pregnant women being physically active have less weight gain during pregnancy.

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Primary biliary cholangitis (PBC) is an autoimmune liver disease with a strong hereditary component. Here, we report a genome-wide association study that included 1,122 PBC cases and 4,036 controls of Han Chinese descent, with subsequent replication in a separate cohort of 907 PBC cases and 2,127 controls. Our results show genome-wide association of 14 PBC risk loci including previously identified 6p21 (HLA-DRA and DPB1), 17q12 (ORMDL3), 3q13.33 (CD80), 2q32.3 (STAT1/STAT4), 3q25.33 (IL12A), 4q24 (NF-κB) and 22q13.1 (RPL3/SYNGR1). We also identified variants in IL21, IL21R, CD28/CTLA4/ICOS, CD58, ARID3A and IL16 as novel PBC risk loci. These new findings and histochemical studies showing enhanced expression of IL21 and IL21R in PBC livers (particularly in the hepatic portal tracks) support a disease mechanism in which the deregulation of the IL21 signalling pathway, in addition to CD4 T-cell activation and T-cell co-stimulation are critical components in the development of PBC.