Objective: To characterize the metabolic variation in neonatal hair samples associated with intrauterine growth discordance in dichorionic-diamniotic (DCDA) twins and to evaluate the effects of specific metabolic alterations on later neurobehavioural outcomes in infancy. Design: Cohort-based case-control study Setting: Peking University Third Hospital Population: DCDA twins with birth weight discordance(DCDA-D) and birthweight concordance (DCDA-C) within a twin cohort recruited between September 2017 and December 2018 in Beijing, China. Methods: A specific hair metabolic profile of 14 pairs of DCDA-D twins was revealed using gas chromatography-mass spectrometry by comparing that of 28 pairs of DCDA-C twins. Pearson’s correlation was used to assess the relationship between the neonatal hair metabolome and neurocognitive outcomes, assessed using the Ages and the Infant’s Stages Questionnaires, third edition (ASQ-3) at 2 or 3 years of age. Main outcome measure: neonatal hair metabolome and long-term neurodevelopment. Results: A total of seventeen hair metabolites were significantly different within DCDA-D twin pairs compared to DCDA-C twins. Particularly, reduced levels of cysteine, threonine, and leucine were identified in both the larger and smaller DCDA-D twins compared with DCDA-C twins. The deregulated metabolic pathways including cysteine, methionine, aminoacyl-tRNA, nicotinate, and nicotinamide metabolism biosynthesis pathways in DCDA-D groups were positively correlated with infant neurocognitive development at 2 or 3 years of age, especially in problem-solving domains. Conclusion: Neonatal hair metabolic variations in utero of growth discordance in DCDA twins may be associated with poor neurocognitive development. Metabolome profiles of hair may be novel predictors of infant neurodevelopment longitudinally.

We performed fetoscopic laser photocoagulation at 25+1 weeks gestation successfully. But ultrasound showed apparent separation of the chorioangioma from the placenta at 32+2 weeks gestation. An urgent cesarean section was performed with the delivery of a healthy female infant. To date, there have been no reports of similar cases.

Objective Investigate the effect of an antenatal lifestyle education seminar on reducing preterm birth, and whether education timing modifies outcomes among women with different characteristics. Design Retrospective cohort study Setting A metropolitan hospital in Beijing, China Population A total of 3008 singleton livebirths Methods Extracted data from deidentified electronic medical records were analyzed. Odds ratios (ORs) for preterm birth according to antenatal education attendance using stepwise binary logistic regression stratified by different maternal characteristics was conducted. Outcome measure Preterm birth (gestational age <37+0 weeks) Results Overall prevalence of preterm birth was 8.7%, but higher for women who did not attend the antenatal seminar (11.5%). Risk of preterm birth for first trimester attendees decreased by 53% ([OR] 0.47, 95% CI 0.35-0.64), and 41% for later attendees ([OR] 0.59, 95% CI 0.41-0.86). Estimates persisted after adjusting pre-existing and gestational covariates. In subgroup analysis, young or nulliparous women who attended later than first trimester were at decreased risk. For women aged ≥35 years, multiparous, who had a previous caesarean section/myomectomy, the risk of preterm birth was reduced among first trimester attendees, but no longer significant after adjusting for pre-existing and gestational covariates (p > 0.05). Timing of the seminar was not significant for women received assisted reproductive technologies. Conclusions Offering an antenatal lifestyle education seminar was associated with lower preterm birth risk and was modified by education timing and women’s characteristics. Results can inform the development of tailored preterm birth prevention strategies. Keywords Antenatal education, lifestyle factors, preterm birth, intervention timing, health promotion.