Objective To investigate the optimal gestational weight gain (GWG) in twin pregnancies and to analyze the impact of GWG on pregnant outcomes.Methods A retrospective cohort study of twin pregnancies was conducted on women who gave birth in International Peace Maternity and Child Health Hospital,Shanghai Jiaotong University School of Medicine from January 1,2012 to the June 30,2015.An optimal range of GWG was calculated based on the amount of weight gain in 711 subjects who gave birth to normal twins and with uncomplicated pregnancy.Another 504 twin pregnant women without gestational complications were recruited for further analysis of the relationship between GWG and gestational outcomes.T-test,analysis of variance and Chi-square test were used for statistical analysis.Results (1) The optimal range of GWG for full-term twin-pregnancy was 15.3-21.4 kg.In those with low body mass index (BMI,＜18.5),normal BMI (≥ 18.5-＜25.0) and overweight/obesity (≥ 25.0),the GWG [M(P25-P75)] were 18.5 (15.8-22.2),18.3 (15.3-21.3) and 18.1 (14.9-21.5) kg,respectively.There was no significant difference in GWG among those groups (F=0.121,P=0.886).(2) According to the optimal GWG mentioned above,we divided the 504 cases into three groups,including lower GWG group (less than the optimal GWG,n=137),normal GWG group (in the GWG range,n=238) and higher GWG group (more than the optimal GWG,n=129).The neonatal birth weights in the three groups were (2 626.1 ±225.8),(2 680.14-237.9) and (2 751.9±257.1) g (F=9.189,P＜0.01),respectively,indicating that neonatal birth weight was increased by increasing GWG.The proportion of both twins with birth weights of more than 2 500 g was slightly increased,but there was no significant difference among the three groups [51.1 ％ (70/137),60.5％ (144/238) and 64.3％ (83/129),respectively,x2=5.279,P=0.071].The incidence of gestational diabetes mellitus (GDM) was reduced along with increased GWG [31.4％ (43/137),14.7％ (35/238) and 9.3％ (12/129),respectively,x2=25.144,P＜0.01],while the incidence of hypertensive disorders in pregnancy (HDP,including gestational hypertension and preeclampsia) in the three groups showed no significant difference.There were 90 cases (17.8％) of GDM in the 504 cases with a pre-pregnancy BMI of 22.5±2.8,which was higher than that of the non-GDM cases (21.21±2.9),(t=3.735,P＜0.01).Among the 504 cases,there were 67 cases (13.3％) of HDP (including gestational hypertension and preeclampsia) with a pre-pregnancy BMI of 22.4±2.8,which was higher than that of the non-HDP patients (21.3 ± 2.9,t=2.767,P=0.006).Conclusions The pre-pregnancy BMI has little influence on GWG in twin pregnancies.Increasing GWG to the recommended optimal range or above,and within a certain range,could promote an increase in neonatal birth weight without adding the risks of gestational complications,such as gestational diabetes mellitus,gestational hypertension and preeclampsia.

Objective To investigate human papillomavirus(HPV)infection in Jiading District of Shang-hai,and to explore the relationship between different HPV subtypes and cervical lesions.Methods A retro-spective analysis was conducted for HPV subtype results and pathological results during the same period of time from 19 030 patients who visited Maternity and Children Health Care Hospital of Jiading District from March 13th,2023 to March 31,2024,and underwent the HPV subtype detection.The relationship between HPV infection and age and cervical lesions were analyzed.Results Out of 19 030 samples,3 506 were HPV positive,and the infection rate was 18.42%.There were 2 185 cases of single infection and 1 321 cases of mul-tiple infection.The HPV infection rate in each age group were as below:the infection rates were 30.34%in≤20-year-old group,18.46%in 20-30 year-old group,16.46%in>30-40 year-old group,14.83%in>40-50 year-old group,21.29%in>50-60 year-old group and 32.74%in>60 year-old group,and there was a statistically significant difference in HPV infection rates among different age groups(P<0.001).The top 5 subtypes were type 52(21.50%),53(10.84%),58(10.02%),33(8.33%)and 59(6.85%).The proportions of the who progressed to higher-level cervical lesions in individuals with HPV subtypes of the top 5 infection rates,as well as those with HPV16 and 18 positive,were significantly higher than that in HPV negative indi-viduals,among which the individuals with HPV16,18,58,and 33 were more likely to progress to severe cervi-cal lesions[atypical squamous cells:cannot exclude high-grade squamous intraepithelial lesion(ASC-H)+low-grade squamous intraepithelial lesion(LSIL)+high-grade squamous intraepithelial lesion(HSIL)+squamous cell carcinoma(SCC)](P<0.05).Compared to HPV 52 positive individuals with the highest infection rate,HPV 16,18,58,and 33 positive individuals were more likely to progress to higher-level cervical lesions(P<0.05).Conclusion HPV infection rates in≤20 year-old group and>60 year-old group are relatively high in Jiading District of Shanghai.The risk of progression to cervical lesions varies among different HPV subtypes.In addition to HPV 16 and 18,HPV 58 and HPV 33 are also closely related to higher levels of cervical lesions and should be given sufficient attention.