There is no information concerning the prevalence of thalassemia among pregnant women in Hubei Province currently. This study is aimed to explore the prevalence of aand b-thalassemia genotypes among pregnant women in Hubei Province, and to explore the clinically applicable screening approach, as well as to investigate the pregnancy outcomes of aand b-thalassemia carriers.Pregnant participants were recruited from 4 hospitals for the screening of aand b-thalassemia mutations in Hubei Province. Polymerase Chain Reaction and flow cytometry methods were used to examine aand b-thalassemia mutations. The hematological parameters and pregnancy outcomes of aand b-thalassemia carriers were obtained from the hospital information system. The chisquare tests were used to evaluate the difference in hematological parameters between pregnant thalassemia carriers and the control group.Among 11,875 participants, 414 (3.49%) were confirmed with a-thalassemia carriers, 228 (1.92%) were confirmed with b-thalassemia carriers, and 3 (0.03%) were confirmed with both aand b-thalassemia carriers. The frequency of -a 3.7 accounted for 2.05% and it was the most frequent genotype of a-thalassemia; the proportion of IVS-II-654 was 0.85% and it was the most frequent genotype of b-thalassemia in Hubei Province. Furthermore, the proportion of patients with low mean corpuscular volume (MCV) or mean cell hemoglobin (MCH) values was accounted for 36.64% and 93.97% among a-thalassemia and b-thalassemia carriers, respectively. And participants with normal MCV and MCH values were accounted for 95.07% among non-thalassemia participants. High prevalence of pregnancy-induced diabetes (16.97%), preterm birth (9.96%), pregnancy-induced hypertension (8.12%), and low birth weight (5.90%) were observed among pregnant thalassemia carriers.MCV and MCH values were suggested to apply on the preliminary screening of pregnant b-thalassemia; however, it's unpractical on that of a-thalassemia. Furthermore, thalassemia carriers might have a high risk of negative pregnancy outcomes. These findings could be useful for the preliminary screening of thalassemia and perinatal care for the pregnant thalassemia carriers.Abbreviations: MCH = mean cell hemoglobin, MCV = mean corpuscular volume, TI = thalassemia intermedia.

This study aims to investigate the efficacy of insulin in treating severe hypertriglyceridaemia (HTG) during the third trimester of pregnancy. Women with severe HTG (TG ≥ 11.30 mmol/L) in the third trimester of pregnancy who received clinical examination and delivered in Hubei Maternal and Child Health Hospital from 01 January 2017 to 30 September 2021 were recruited. Patients with TG ≥ 11.30 mmol/L at 30–32 weeks of gestation were treated with a low-fat diet and insulin as the insulin treatment group. For the control group, patients with TGs of 5.65–11.30 mmol/L at 30–32 weeks of gestation who developed severe HTG (TG ≥ 11.30 mmol/L) before delivery were treated with a low-fat diet only. General maternal information, delivery, perinatal treatment and laboratory examination information were collected from electronic medical records and compared. We found that in the insulin treatment group, there were higher values of progestational body mass index (BMI) (Z = −2.281, P = 0.023), higher incidence of diabetes (χ2 = 20.618, P < 0.001) and higher incidence of fatty liver (χ2 = 4.333, P = 0.037) than in the control group but also a higher pregnancy weight gain compliance rate (χ2 = 4.061, P = 0.044). Laboratory examination before delivery revealed that compared with the control group, insulin treatment significantly decreased prenatal TG (Z = −10.392, P < 0.001), cholesterol (Z = −8.494, P < 0.001), low-density lipoprotein (Z = −3.918, P < 0.001), apolipoprotein A1 (t = 2.410, P = 0.019), cystatin (Z = −4.195, P < 0.001), incidence of hypocalcaemia (P = 0.036), and absolute number of lymphocytes (Z = −3.426, P = 0.001). Delivery outcomes were also improved in the insulin treatment group compared with the control group, including lower neonatal weight (Z = −2.200, P = 0.028), incidence of macrosomia (χ2 = 4.092, P = 0.043), gestational age (Z = −3.427, P = 0.001), and rate of intensive care unit (ICU) conversion (P = 0.014). In conclusion, insulin therapy for HTG in the third trimester of pregnancy could increase the pregnancy weight gain compliance rate, decrease blood lipid levels and the incidence of severe complications such as HTG acute pancreatitis (HTG-AP), and improve pregnancy outcomes.

Purpose: To evaluate the clinical implication of metabolic score for insulin resistance (METS-IR) during early midpregnancy on subsequent risk of gestational diabetes mellitus (GDM) in Chinese women.Methods: A total of 1747 pregnant women without pre-existing diabetes from the Tongji Maternal and Child Health Cohort (TMCHC) were included in this analysis. Blood glucose and lipid profiles (triglyceride [TG], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C]) were measured during 15-19 weeks and 75-g 2-h oral glucose tolerance test was conducted during 24-28 weeks to diagnose GDM. METS-IR was calculated by a modified formula which originally as follows: Ln(2×FPG[mg/dl]+TG[mg/dl])×BMI[kg/m2] /Ln(HDL-C[mg/dl]).Results: The median (interquartile range) of age was 28 (26-30) years, and 19.7% of them were underweight and 11.7% were overweight/obese before pregnancy. The overall incidence of GDM was 9.4% and median (interquartile range) of METS-IR was 27.36 (24.57-31.07). The median METS-IR was significantly increased with the increasing pre-pregnancy BMI categories (22.92 vs 27.72 vs 35.55, P＜0.001). Based on quartiles of METS-IR in women with normal pre-pregnancy BMI, participants were classified into 4 groups. Compared with women in the lowest quartile of METS-IR (＜25.52) , the adjusted RRs (95% CIs) of GDM were 2.15 (1.23-3.74), 1.34 (0.72-2.49), and 3.63 (2.22-5.95) for women in quartile 2 (25.52-27.71), quartile 3 (27.72-30.39) and quartile 4 (≥30.40) after adjusting potential confounds. In addition, a significant increase risk of GDM (adjusted RR [95% CI]: 2.55 [1.83-3.55]) was found in women within the highest quartile of METS-IR (≥30.40) compared to the other 3 lower quartiles (＜30.40).Conclusions: Women with METS-IR (≥30.40) during early midpregnancy were more likely to develop GDM, thus the index might be a reliable early indicator for identifying women at high risk of GDM.