Gestational diabetes mellitus (GDM) is prevalent worldwide, leading to a high risk of significant morbidity for both the mother and offspring with complications. Increasing evidences suggest that gut microbiota plays a role in the pathogenesis of GDM. Lifestyle modification is the cornerstones of GDM treatment. However, a number of patients whose blood glucose is not controlled by lifestyle modification still require exogenous insulin to control blood glucose. No observational study is available about the relationship between the gut microbiota in GDM patients and lifestyle modifications. Thus, we investigated the differences in gut microbiota between GDM patients with successful glycemic control (GDM1) and failure of glycemic control (GDM2) by lifestyle modifications. We sequenced the V3-V4 regions of 16S ribosomal ribonucleic acid (rRNA) gene from stool samples of 52 singleton pregnant women with 24–28 weeks of gestation. Our results showed that Blautia, Eubacterium_hallii_group, and Faecalibacterium in the gut microbiota showed significant differences among the normoglycemic mother, GDM1, and GDM2 groups, respectively. The combined diagnostic performance of Blautia, Eubacterium_hallii_group, and Faecalibacterium in differentiating GDM2 from GDM was considered as the most reasonable identification indicator. Gut bacteria may participate in the pathological development of GDM2 through the peroxisome proliferator-activated receptor (PPAR) signaling pathway. These results indicated that Blautia, Eubacterium_hallii_group, and Faecalibacterium had important characteristic changes in the gut microbiota of women with GDM2.

Background：To evaluate the value of the proportion of large platelets (PLCR) and platelet crit (PCT) in predicting necrotizing enterocolitis (NEC) in low birth weight (LBW) neonates. Methods：A total of 155 LBW (< 2500 g) neonates with NEC admitted to the neonatal intensive care unit (NICU) of the hospital from January 1, 2017 to November 30, 2019 were included in the case group. According to the 1:3 case-control study design, a total of 465 LBW neonates without NEC (3 for each LBW neonate with NEC) in the NICU born ≤ 24 h before or after the birth of the cases were included in the control group. Results：During the study period, a total of 6946 LBW neonates were born, and 155 had NEC, including 98 who also had sepsis. Neonatal sepsis was the most important risk factor and confounding factor for NEC in LBW neonates. Further stratified analysis of the sepsis showed that in LBW neonates without sepsis, anemia, high PLCR, and high PCT increases the risk of NEC, and the receiver operating characteristic curve area of PLCR was 0.739, the sensitivity was 0.770, the specificity was 0.610, and the cutoff value was 33.55. Conclusions: The data showed that 2/100 LBW neonates were prone to NEC, and stratified analysis of confounding factors of sepsis identified the risk factors of NEC in LBW neonates. This study first reported the significant value of PLCR in the early prediction of NEC occurrence in LBW neonates without sepsis.

To evaluate the value of the proportion of large platelets (PLCR) and platelet crit (PCT) in predicting necrotizing enterocolitis (NEC) in low birth weight (LBW) neonates.A total of 155 LBW (< 2500 g) neonates with NEC admitted to the neonatal intensive care unit (NICU) of the hospital from January 1, 2017 to November 30, 2019 were included in the case group. According to the 1:3 case-control study design, a total of 465 LBW neonates without NEC (3 for each LBW neonate with NEC) in the NICU born ≤ 24 h before or after the birth of the cases were included in the control group.During the study period, a total of 6946 LBW neonates were born, and 155 had NEC, including 98 who also had sepsis. Neonatal sepsis was the most important risk factor and confounding factor for NEC in LBW neonates. Further stratified analysis of the sepsis showed that in LBW neonates without sepsis, anemia, high PLCR, and high PCT increases the risk of NEC, and the receiver operating characteristic curve area of PLCR was 0.739, the sensitivity was 0.770, the specificity was 0.610, and the cutoff value was 33.55.Conclusion: The data showed that 2/100 LBW neonates were prone to NEC, and stratified analysis of confounding factors of sepsis identified the risk factors of NEC in LBW neonates. This study first reported the significant value of PLCR in the early prediction of NEC occurrence in LBW neonates without sepsis.