Cadmium exposure during pregnancy is a non-negligible public health problem which may increase the risk of shortened telomere length in newborns and cardiovascular metabolic health damage in children, and has attracted attention from many researchers in recent years. This article reviewed recent studies both domestically and internationally on the associations among cadmium exposure during pregnancy, shortened telomere length in newborns, and cardiovascular metabolic abnormalities in children, and briefly outlined possible mechanisms of shortened telomere length in newborns by cadmium exposure during pregnancy. Current research results showed that cadmium exposure during pregnancy is related to shortened telomere length in newborns and cardiovascular metabolic abnormalities in children, and shortened telomere length in newborns is also related to cardiovascular metabolic abnormalities in children. It suggested that telomere length in newborns may be a biomarker reflecting cardiovascular metabolic abnormalities in children caused by cadmium exposure during pregnancy. In addition, the current potential mechanisms of cadmium exposure during pregnancy accelerating neonatal telomere length shortening include inflammatory reaction, mitochondrial dysfunction, antioxidant consumption/antioxidant enzyme inactivation, and DNA methylation, and these biological mechanisms are associated with cardiovascular metabolic abnormalities through certain factors, such as obesity, elevated blood pressure, impaired fasting blood glucose, and dyslipidemia in children, suggesting that cardiovascular metabolic abnormalities in children may be programmed in early life, but there are still few relevant studies. In the future, research should be conducted on the association among cadmium exposure during pregnancy, telomere length, and offspring cardiovascular metabolism, as well as possible mediating efficacy and related biological mechanisms of telomere length, aiming to provide early-life biological information for the prevention of cardiovascular and metabolic diseases.

The timing of the adiposity rebound (AR) gradually shifted to earlier ages throughout the world; early AR has a great effect on children's health, especially is possible associated with the development of metabolic disease for life, while the special mechanism isn't very clear. Metabolic diseases(MD) are common in adults, and the establishment of MD is the result of pathological chronic processes that can start in early life stages. If the metabolic risk factors and its predictive factors can be found in early childhood, it can bring forward the prevention and control of adult diseases. This paper is a review of the prevalence of early AR around the world, the factors that influence the timing of the AR, the significance of early detection and prevention of MD, the associations between timing of AR and metabolic risk in children and explored the possible mechanism. It aims to raise public awareness about the harm of early AR and provide new perspective to prevent and control of the metabolic syndrome.

Objective To analyze the correlation between elective cesarean delivery and duration of breastfeeding in Ma'anshan city from 2013 to 2014. Methods From May 2013 to September 2014, a total of 3 474 pregnant women with the first prenatal checkup were recruited from Ma'anshan maternal and child health care hospital. Finally, 3 109 pregnant women were included after exclusion of those with terminated pregnancies, adverse birth outcomes, twin or multiple pregnancies, breech traction, breech midwifery and loss of delivery information. Demographic data of pregnant women, mode of delivery and breast feeding of children were collected through questionnaires and hospital records. Logistic regression model was used to analyze the relationship between elective cesarean delivery and duration of breastfeeding in children, with the mode of delivery as independent variable and the duration of breastfeeding as dependent variable. Results The age of 3 109 subjects was (26.6±3.6) years old, the rate of vaginal delivery was 51.1% (1 589), and the rate of elective cesarean delivery was 46.4% (1 443), among which the rate of non?indicative elective cesarean delivery was 26.4% (820), the rate of indicative elective cesarean delivery was 20.0% (623), and the rate of emergency cesarean delivery was 2.5% (77). The proportion of breastfeeding lasting until 4, 12 and 18 months was 45.0% (1 348/2 998), 23.7% (702/2 962) and 5.2% (154/2 944), respectively. After adjusting the confounding factors, compared with vaginal delivery, the OR (95%CI ) values of breastfeeding for 4 months in indicative elective cesarean delivery and non?indicative elective cesarean delivery women were 0.870(0.714-1.059), 0.795(0.665-0.949), and the OR (95%CI) values of breastfeeding for 12 months were 0.772(0.611-0.975), 0.755(0.610-0.934), respectively. Conclusion Elective cesarean delivery may result in shorter duration of breastfeeding in children.

Objective To analyze the correlation between elective cesarean delivery and duration of breastfeeding in Ma'anshan city from 2013 to 2014. Methods From May 2013 to September 2014, a total of 3 474 pregnant women with the first prenatal checkup were recruited from Ma'anshan maternal and child health care hospital. Finally, 3 109 pregnant women were included after exclusion of those with terminated pregnancies, adverse birth outcomes, twin or multiple pregnancies, breech traction, breech midwifery and loss of delivery information. Demographic data of pregnant women, mode of delivery and breast feeding of children were collected through questionnaires and hospital records. Logistic regression model was used to analyze the relationship between elective cesarean delivery and duration of breastfeeding in children, with the mode of delivery as independent variable and the duration of breastfeeding as dependent variable. Results The age of 3 109 subjects was (26.6±3.6) years old, the rate of vaginal delivery was 51.1% (1 589), and the rate of elective cesarean delivery was 46.4% (1 443), among which the rate of non?indicative elective cesarean delivery was 26.4% (820), the rate of indicative elective cesarean delivery was 20.0% (623), and the rate of emergency cesarean delivery was 2.5% (77). The proportion of breastfeeding lasting until 4, 12 and 18 months was 45.0% (1 348/2 998), 23.7% (702/2 962) and 5.2% (154/2 944), respectively. After adjusting the confounding factors, compared with vaginal delivery, the OR (95%CI ) values of breastfeeding for 4 months in indicative elective cesarean delivery and non?indicative elective cesarean delivery women were 0.870(0.714-1.059), 0.795(0.665-0.949), and the OR (95%CI) values of breastfeeding for 12 months were 0.772(0.611-0.975), 0.755(0.610-0.934), respectively. Conclusion Elective cesarean delivery may result in shorter duration of breastfeeding in children.

Objective To describe the epidemiological characteristics on the supplement of folic acid in progestation and early pregnancy,and to probe the protective effects of supplement of folic acid in early pregnancy against pregnant depression,in Ma’anshan city,Anhui province. Methods In this cohort study,5 150 subjects who had their first antenatal examination at Ma’anshan Maternal and Child Care Centers were recruited under informed consent,from October 2008 to October 2010. All the information were collected through questionnaires in the first,second and third trimesters respectively. A“Center for Epidemiological Studies Depression Scale(CES-D)”was used to assess the mood of depression in the second questionnaire. Single factor analysis and the unconditional multivariate logistic regression were applied to analyze the association of supplement folic acid in peri-conceptional period and pregnancy depression. Results In the study,the prevalence of those who had never taken the supplement folic acid but only the supplement folic acid in progestation and supplement in the first-trimester,or supplement in the peri-conceptional period were 27.3%,0.5%,27.4%and 17.9%,respectively. The incidence of pregnancy depression was 4.8%(247/5 150). Data from logistic regression analysis showed that,supplement of folic acid only in the first-trimester or in the peri-conceptional period were negatively associated with pregnancy depression even after adjustment for potential confounders. The adjusted odds ratio were 0.63(95%CI:0.44-0.90) and 0.61(95%CI:0.39-0.95)respectively. Conclusion Supplement of folic acid in peri-conceptional period could be a preventive factor for pregnancy depression.

Objective: To investigate the effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction. Methods: From May 2013 to September 2014, a total of 3 474 pregnant women who took their first antenatal care and willing to undergo their prenatal care and delivery in Ma 'anshan Maternity and Child Care Centers were recruited in the cohort study. Excluding subjects without weight data before delivery (n=54), pregnancy termination (n=162), twins live births (n=39), without fetal birth weight data (n=7), 3 212 maternal-singleton pairs were enrolled for the final data analysis. Demographic information of pregnant woman, pregnancy history, disease history, height and weight were collected. In the 24^th-28^th, 32^nd-36^th gestational week and childbirth, three follow-up visits were undertaken to collect data of pregnancy weight, pregnancy vomiting, gestational hypertension, gestational diabetes mellitus, newborn gender and birth weight. χ² test was used to compare the detection rate of fetal growth restriction in different groups. Multivariate unconditional logistic regression model and spreadsheet were used to analyze the independent and interaction effect of pre-pregnancy weight and the increase of gestational weight on fetal growth restriction. Results: The incidence of fetal growth restriction was 9.7%(311/3 212). The incidence of fetal growth restriction in pre-pregnancy underweight group was 14.9% (90/603), higher than that in normal pre-pregnancy weight group (8.7% (194/2 226)) (χ²=24.37, P<0.001). The incidence of fetal growth restriction in inadequate increase of gestational weight group was 17.9% (50/279), higher than the appropriate increase of weight group (11.8% (110/932)) (χ²=36.89, P<0.001). Multivariate unconditional logistic regression analysis showed that compared with normal pre-pregnancy weight group, pre-pregnancy underweightwas a risk factor for fetal growth restriction, with RR (95%CI) at 1.76 (1.34-2.32); Compared with the appropriate increase of gestational weight group, inadequate weight increase during pregnancy was a risk factor for fetal growth restriction, with the RR (95%CI) at 1.70 (1.17-2.48). No additive model interaction [relative excess risk of interaction, attributable proportions of interaction, the synergy index and their 95%CI were 0.75 (-2.14-3.63), 0.21 (-0.43-0.86) and 1.43 (0.45-4.53), respectively] or multiplication model interaction (RR (95%CI): 1.00 (0.44-2.29)) existed between pre-pregnancy underweight and inadequate increase of gestational weight on fetal growth restriction. Conclusion Pre-pregnancy underweight and inadequate increase of gestational weight would increase the risk of fetal growth restriction without interaction.

Objective:To describe the epidemiological characteristics of mobile phone use in early pregnancy, and to explore the relationship between pregnancy mobile use and infant sleep-wake behavior.Methods:During February 2015 to August 2016, 2 212 subjects who had their first antenatal examination at Maanshan Maternity and Child Health Hospital were recruited in this cohort study and followed until postpartum for 6 months. Information of phone use was collected through questionnaire in the third trimester. There were 1 779 pregnant reported hours of mobile phone use in the questionnaire. A total of 1 951 parent reported the night-wake times. Data on night-wake behavior in infants was collected during the 6 months study. Questionnaires were completed by parents when taking the physical examination. More than 3 times per night was defined as the night-wake frequency. Unconditional multivariate logistic regression was applied to analyze the association of pregnancy time of mobile phone use and the infant night-wake frequencies.Results:In this cohort study, the average age of 2 212 pregnant women was (26.95±3.82) years, with 1 983 of them were followed up to the time of delivery. The incidence of night-wake frequency was 28.3 % (553/1 951) among these 6-month-old infants. After adjusted for feeding factors in the first trimester, frequencies of using the phone as "3 to 4 hour per day" and "5 hour and above per day" were both positively associated with the frequencies of night-wake behavior in infants. The adjusted OR (95 %CI) were 1.49 (1.07-2.07) and 1.79 (1.31-2.46), respectively. Conclusions:The mobile phone use during pregnancy was associated with night-wake of infants. Mobile phone should be rationally used during pregnancy.

Objective To explore the correlation between pregnancy-related anxiety and serum 25 (OH)D level during early pregnancy. Methods A radioimmunoassay was used to determine the serum 25 (OH)D levels of 2 122 early pregnant women in Maanshan Maternal and Child Health Care Hospital, from June 2015 to 2016. Data were collected using a questionnaire. Results The mean serum 25(OH)D level was(29.71±32.27)nmol/L.About 15.2% of the subjects had adequate,22.6% had insufficient,45.1% had deficient,and 17.1% had severely deficient serum 25(OH)D levels.The type of housing and testing seasons were significantly associated with the serum 25(OH)D level.Single factor logistic regression analysis results show that pregnancy-related anxiety incidence in the group deficient in 25(OH)D was higher than that in the adequate group, which has a statistically significant difference (P<0.05). After adjusting for the maternal age,BMI,and educational level,multivariate logistic regression analysis results showed that the difference was statistically significant. Conclusion The serum 25(OH)D level in early pregnant women was inadequate. Furthermore, lack of serum 25(OH)D in early pregnancy and pregnancy-related anxiety were negatively correlated.

Objective: To investigate the longitudinal association between peer bullying victimization and internalizing symptoms, and to examine whether parental warmth buffers against this effect,so as to provide a reference for improving the mental health of the special group of children. Methods: Students in grade 4 and grade 5 from three primary schools in Ma’anshan, Anhui Province were selected in Oct. 2017 with informed consent. Height, weight and pubertal development were objectively assessed. Internalizing symptoms and peer bullying victimization were evaluated at baseline and 1-year follow-up by using the MacArthur Health and Behavior Questionnaire-Child. Children were classified into three groups as non-bullying, non-consistent and consistent bullying victimization group. Multiple linear regression model was used to analyze whether the association between peer bullying victimization and internalizing symptoms varied across different parental warmth groups. Results: Compared with non-bullying victimization group, consistent-and non-consistent bullying victimization had higher internalizing symptoms at baseline and 1-year follow-up(P<0.01). Students reported consistent, non-consistent bullying victimization under moderate parental warmth had lower internalizing symptoms at baseline and 1-year follow-up than those reported under low parental warmth group(P<0.01). Multiple liner regression showed that consistent bullying victimization [β=0.66(95%CI=0.33-0.99), 0.37(95%CI=0.15-0.59), 0.58(95%CI=0.31-0.84), P<0.05] and non-consistent bullying victimization[β=0.33(95%CI=0.18-0.47), 0.28(95%CI=0.13-0.41), 0.29(95%CI=0.08-0.51),P<0.05] were associated with higher 1-year follow-up internalizing symptoms in non-consistent, moderate-and low parental warmth group, while such association was not observed in consistent parental warmth group. Abstract The experience of peer bullying victimization increases the risk of internalizing symptoms and this finding suggests that parental warmth help to buffer children from the internalizing symptoms associated with bullying victimization.