1.Effect and Mechanisms of Luteolin on Gout
Jinlai CHENG ; Xiaoyu ZHANG ; Yuyan XU ; Huajing WANG ; Yuqing TAN ; Feng SUI ; Miyi YANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):140-149
ObjectiveTo integrate network pharmacology prediction with multi-level experimental verification methods, and to explore in depth the therapeutic efficacy and potential mechanism of luteolin in treating gout. MethodsDatabases were used to obtain potential pharmacodynamic targets of luteolin. Protein-protein interaction (PPI) network construction and network pharmacology analysis techniques were used to screen key core targets of luteolin in gout treatment. Further biological function enrichment analysis and signaling pathway analysis were performed on these targets. Molecular docking simulation was used to calculate the binding energy between luteolin and potential core targets, clarifying the strength of their interactions. In the in vivo experiment for hyperuricemia, 48 mice were randomly divided into a blank group, a model group, an allopurinol group (5 mg·kg-1), and low-dose (10 mg·kg-1), medium-dose (30 mg·kg-1), and high-dose (90 mg·kg-1) luteolin groups. For the first three days, the blank and model groups were gavaged with an equal volume of normal saline, while the allopurinol group and luteolin groups were gavaged with corresponding drugs. From day 4 onwards, modeling was performed by intraperitoneal injection at 12:00 daily (normal saline for the blank group, and oxonic acid potassium-hypoxanthine mixture for other groups, with 300 mg·kg-1 for each group). Gavage intervention was administered at 18:00 daily (normal saline for the blank/model groups, and corresponding drugs for the treatment groups) until day 7. After sampling, levels of serum uric acid (UA), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were measured. Levels of xanthine oxidase (XO) in the liver and kidney, ATP-binding cassette transporter G2 (ABCG2) and malondialdehyde (MDA) in the kidney, and superoxide dismutase (SOD) in the liver were determined. Renal HE staining was also performed. In the pharmacodynamic study of gouty arthritis, 36 rats were randomly divided into a blank group, a model group, a colchicine group (0.315 mg·kg-1), and low-dose (7 mg·kg-1), medium-dose (21 mg·kg-1), and high-dose (63 mg·kg-1) luteolin groups. The model was established by vertically injecting 100 µL of 25 g·L-1 monosodium urate suspension into the posterior lateral aspect of the right ankle joint (the blank group was injected with an equal volume of normal saline), with repeated injections every two days for reinforcement. From day 2 after modeling, daily gavage administration was performed (normal saline for the blank/model groups, and corresponding drugs for the treatment groups) for a total of 16 days. During the experiment, ankle swelling and pain threshold were measured regularly. After sampling, levels of serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) were determined. Ankle joints were subjected to HE, Masson, and safranin O-fast green staining, and HE staining was also performed on ankle synovial tissue and various organs. Western blot was used to determine the expression levels of key proteins in gout-related signaling pathways. ResultsNetwork pharmacology analysis predicted that luteolin may regulate over 20 core targets, such as XO, ABCG2, nuclear factor erythroid 2-related factor 2 (Nrf2), and SOD, through acting on signaling pathways including NF-κB, phosphoinositide 3-kinase/protein kinase B (PI3K/Akt), and ABC transporters, thereby affecting uric acid metabolism and inflammatory responses. In the hyperuricemia model, compared with the blank group, the model group showed significantly increased serum UA level, liver and kidney XO activity, renal ABCG2 expression, and liver SOD activity (P<0.01). Compared with the model group, the high-dose luteolin group significantly reduced serum UA level (P<0.01), inhibited liver and kidney XO activity (P<0.01), and significantly increased renal ABCG2 expression and liver SOD activity (P<0.01), effectively alleviating renal oxidative stress damage and improving renal histopathological status. In the gouty arthritis model, compared with the blank group, the model group showed significant ankle swelling, decreased pain threshold, and significantly increased levels of IL-6, IL-1β, and TNF-α in serum and synovial tissue (P<0.01). The high-dose luteolin group significantly reduced ankle swelling, prolonged hot plate pain threshold, effectively decreased the levels of the above inflammatory factors in serum and synovial tissue (P<0.01), and significantly improved ankle pathological damage, showing good analgesic and anti-inflammatory effects. Western blot results further confirmed that luteolin significantly upregulated Nrf2 protein expression and downregulated XO and nucleotide-binding oligomerization domain (NOD)-like receptor protein 3 (NLRP3) expression in animals. ConclusionLuteolin can improve symptoms of hyperuricemia and gouty arthritis, and its potential mechanism may be related to inhibiting XO activity, increasing ABCG2 and SOD levels, and regulating Nrf2-mediated oxidative stress-related pathways.
2.Setd2 overexpression rescues bivalent gene expression during SCNT-mediated ZGA.
Xiaolei ZHANG ; Ruimin XU ; Yuyan ZHAO ; Yijia YANG ; Qi SHI ; Hong WANG ; Xiaoyu LIU ; Shaorong GAO ; Chong LI
Protein & Cell 2025;16(6):439-457
Successful cloning through somatic cell nuclear transfer (SCNT) faces significant challenges due to epigenetic obstacles. Recent studies have highlighted the roles of H3K4me3 and H3K27me3 as potential contributors to these obstacles. However, the underlying mechanisms remain largely unclear. In this study, we generated genome-wide maps of H3K4me3 and H3K27me3 in mouse pre-implantation NT embryos. Our analysis revealed that aberrantly over-represented broad H3K4me3 domain and H3K27me3 signal lead to increased bivalent marks at gene promoters in NT embryos compared with naturally fertilized (NF) embryos at the 2-cell stage, which may link to relatively low levels of H3K36me3 in NT 2-cell embryos. Notably, the overexpression of Setd2, a H3K36me3 methyltransferase, successfully restored multiple epigenetic marks, including H3K36me3, H3K4me3, and H3K27me3. In addition, it reinstated the expression levels of ZGA-related genes by reestablishing H3K36me3 at gene body regions, which excluded H3K27me3 from bivalent promoters, ultimately improving cloning efficiency. These findings highlight the excessive bivalent state at gene promoters as a potent barrier and emphasize the removal of these barriers as a promising approach for achieving higher cloning efficiency.
Animals
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Mice
;
Histone-Lysine N-Methyltransferase/biosynthesis*
;
Histones/genetics*
;
Nuclear Transfer Techniques
;
Female
;
Gene Expression Regulation, Developmental
;
Promoter Regions, Genetic
;
Epigenesis, Genetic
;
Embryo, Mammalian/metabolism*
3.Constructing adverse outcome pathway for per- and polyfluoroalkyl substances and retinoblastoma based on PI3K-AKT/MAPK signaling pathway
Yuyan GUI ; Tingji WANG ; Minghao WANG ; Yaqi XU ; Yunhui ZHANG
Journal of Environmental and Occupational Medicine 2024;41(12):1361-1368
Background Exposure to per- and polyfluoroalkyl substances (PFAS) is associated with various cancers, and recent studies suggest it may also increase the risk of retinoblastoma (RB) in newborns. However, the pathogenic mechanisms remain unclear. Objective By constructing an adverse outcome pathway (AOP) framework based on public databases to elucidate the potential mechanisms linking PFAS and RB. Methods Chemical-gene interactions and disease-gene interactions from the Comparative Toxicogenomics Database were retracted to identify key toxicological disruption pathways using Kyoto Encyclopedia of Genes and Genomes (KEGG) and a priori knowledge. The Pathview package in R was employed to predict molecular initiating events, key events, and their associated phenotypes, for further understanding the relevant gene-molecule interaction toxicity pathway network. Molecular docking techniques were utilized to validate the affinity of PFAS for these molecular initiating events. An AOP framework focused on toxicological pathways was developed using classical AOP methodologies. Results The PI3K-AKT/MAPK signaling pathway was identified as a potential toxicological pathway involved in PFAS-related RB development, based on KEGG and a priori knowledge. The activation of receptor tyrosine kinases (RTKs) served as the molecular initiating event, leading to the activation of key oncogenes such as RAS and AKT, as well as nuclear factor kappa-light chainenhancer of activated B cells (NF-κB), along with the inhibition of the tumor suppressor gene P53. In this study, 14 types of PFAS demonstrated good binding affinity with most RTKs, with chlorinated polyfluorinated ether sulfonates (Cl-PFESAs) showing particularly favorable predicted binding. Oncogenes, including the c-kit-encoded tyrosine kinase receptor for stem cell factor, epidermal growth factor receptor, and neurotrophic tyrosine kinase receptor 1, were identified as the receptors with the best predicted binding affinity. Conclusion The PI3K-AKT/MAPK signaling pathway may serve as a potential toxicological mechanism linking PFAS to an increased risk of RB.
4.Effects of early rehabilitation based on quantitative evaluation on knee function and quality of life of patients undergoing total knee arthroplasty by kinematic alignment technology
Leyun ZHANG ; Yuyan LIU ; Juan XU
Journal of Navy Medicine 2024;45(2):141-145
Objective To explore the effects of early rehabilitation based on quantitative evaluation on knee function and quality of life of patients undergoing total knee arthroplasty(TKA).Methods A total of 82 patients undergoing TKA from February 2020 to November 2022 in No.904 Hospital of Joint Logistics Support Force of PLA were selected as study subjects.They were divided into control and observation groups according to their admission time,with 41 cases in each group.One patient in the control group was excluded due to loss of follow-up.Kinematic alignment was adopted in all the patients.Routine rehabilitation training was carried out in the control group,and early rehabilitation based on quantitative evaluation was applied in the observation group.The knee function and quality of life of the two groups were observed and compared on the next day and 3 months after operation.Results There were significant differences in the inter-group,time,and interaction of active flexion angle of knee joint between the two groups(P<0.05).The active flexion angle of knee joint at 1,2 and 3 months after operation was larger than that on the next day after operation in both groups.There was no statistically significant difference in the active flexion angle of knee joint between the two groups on the next day and 1 month after operation(P>0.05).The active flexion angle of knee joint in the observation group was significantly larger than that in the control group at 2 months and 3 months after operation(P<0.05).There was no statistically significant difference in the scores of each dimension or the total score of the short-form arthritis impact measurement scales 2(AIMS2-SF)on the next day after operation between the two groups(P>0.05).The scores of each dimension and total scores of AIMS2-SF at 3 months after operation were significantly lower than those on the next day after operation in both groups(P<0.05).And theses scores in the observation group were significantly lower than those in the control group at 3 months after operation(P<0.05).Conclusion Early rehabilitation based on quantitative evaluation is helpful to improve the knee function of patients undergoing TKA by kinematic alignment technology and has a positive impact on the improvement of the quality of life.
5.Dexmedetomidine can not reduce the incidence of acute and chronic kidney disease after laparoscopic radical nephrectomy: a propensity score matching-based analysis.
Yuwei SU ; Wen SUN ; Di WANG ; Yuyan DONG ; Ying DING ; Longhe XU ; Yongzhe LIU
Journal of Southern Medical University 2023;43(4):654-659
OBJECTIVE:
To investigate the effect of dexmedetomidine (DEX) on renal function after laparoscopic radical nephrectomy.
METHODS:
We reviewed the clinical data of 282 patients with renal cell carcinoma (RCC), who underwent laparoscopic radical nephrectomy (LRN) in the Department of Urology, Third Medical Center of PLA General Hospital from November, 2020 and June, 2022.According to whether DEX was used during the operation, the patients were divided into DEX group and control group, and after propensity score matching, 99 patients were finally enrolled in each group.The incidence of acute kidney injuries were compared between the two groups.Serum creatinine (sCr) data within 3 months to 1 year after the operation were available in 51 patients, including 26 in DEX group and 25 in the control group, and the incidence of chronic kidney disease (CKD) was compared between the two groups.
RESULTS:
After propensity score matching and adjustment for significant covariates, there were no significant differences in postoperative levels of sCr, cystatin C (CysC), β2-microglobulin (β2-MG), hemoglobin (Hb), or C-reactive protein (CRP), extubation time, incidence of AKI, or length of hospital stay between the two groups (P>0.05).The intraoperative urine volume was significantly higher in DEX group than in the control group (P < 0.05).A significant correlation between AKI and CKD was noted in the patients (P < 0.05).The incidence of CKD did not differ significantly between the two groups (P>0.05).
CONCLUSION
DEX can not reduce the incidence of AKI or CKD after LRN.
Humans
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Dexmedetomidine
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Incidence
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Propensity Score
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Renal Insufficiency, Chronic/epidemiology*
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Kidney Neoplasms/surgery*
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Nephrectomy/adverse effects*
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Laparoscopy/adverse effects*
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Acute Kidney Injury/prevention & control*
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Retrospective Studies
6.Study on the Mechanism of Liuling Jiedu Pills Inhibiting Acute Pharyngitis Induced by Staphylococcus Aureus in Rats
Yuyan GAO ; Jinfu LU ; Gaohong LYU ; Hengbin WANG ; Niancui LUO ; Fangyu YANG ; Huiqin XU ; Bin YU ; Liuqing DI ; Ping DU
Traditional Chinese Drug Research & Clinical Pharmacology 2023;34(12):1736-1742
Objective To investigate the effect and mechanism of Liuling Jiedu Pills on acute pharyngitis caused by Staphylococcus aureus in rats.Methods The rat model of acute pharyngitis was replicated using the method of injecting 1×109 CFU·mL-1 of Staphylococcus aureus solution into the pharynx of rats.SD rats were randomly divided into a blank group,a model group,a Lanqin Oral Solution group(5 mL·kg-1),and a low-,medium-,and high-dose group of Liuling Jiedu Pills(4.375,8.750,and 17.500 mg·kg-1),with 10 rats in each group.Rats in each group were administered the drug by gavage once a day for 7 days.The general conditions of the rats were observed and recorded every day during the modeling and drug administration periods,and the local inflammation in the pharynx was scored;histopathological changes in the pharynx of the rats were observed by hematoxylin-eosin(HE)staining;serum interleukin 1β(IL-1β),interleukin 6(IL-6),tumor necrosis factor α(TNF-α),and tumor necrosis factor-α(TNF-α)were detected by ELISA.Immunohistochemistry and Western Blot were used to detect the protein expression levels of IL-1β,IL-6 and TNF-α in rat pharyngeal tissue.Results Compared with the blank group,rats in the model group had significantly increased pharyngeal erythema,significantly higher inflammation scores(P<0.01),significantly lower body mass on days 5-7 after modeling(P<0.05,P<0.01),significantly higher pathological scores(P<0.01),significantly higher levels of the serum inflammatory factors IL-1β,IL-6,and TNF-α(P<0.01),and significantly higher pharyngeal tissues showed significantly higher levels of IL-1β,IL-6,and TNF-α proteins(P<0.01).Compared with the model group,the pharyngeal erythema was significantly reduced in the Lanqin Oral Solution group and the low-,medium-and high-dose groups of Liuling Jiedu Pills,and the inflammation scores were significantly reduced(P<0.01),and the serum levels of IL-1β,IL-6,and TNF-α were significantly reduced(P<0.01);the body mass of the rats in the Lanqin Oral Solution group,and in the medium-and high-dose groups of Liuling Jiedu Pills,were significantly increased on the seventh day of the modeling(P<0.01);the histopathological scores and the levels of IL-1β,IL-6 and TNF-α proteins in pharyngeal tissue were significantly decreased(P<0.05,P<0.01).Conclusion Liuling Jiedu Pills can significantly improve the symptoms and inflammatory pathological changes of pharyngeal tissues in rats with acute pharyngitis,and its mechanism may be related to the down-regulation of the expression levels of inflammatory factors such as IL-1β,IL-6,and TNF-α.
7.Activation of intestinal mucosal TLR4/NF-κB pathway is associated with renal damage in mice with pseudo-sterile IgA nephropathy.
Yuyan TANG ; Weiqian SUN ; Haidong HE ; Ping HU ; Meiping JIN ; Ping LIU ; Lusheng HUANG ; Xudong XU
Chinese Journal of Cellular and Molecular Immunology 2023;39(10):865-871
Objective To investigate the effect of intestinal mucosal Toll-like receptor 4/nuclear factor κB (TLR4/NF-κB) signaling pathway on renal damage in pseudo-sterile IgA nephropathy (IgAN) mice. Methods C57BL/6 mice were randomly divided into experimental group (pseudosterile mouse model group), control group (IgAN mouse model group), pseudosterile mouse blank group, and normal mouse blank group. Pseudosterile mice were established by intragastric administration of quadruple antibiotics once a day for 14 days. The pseudosterile IgAN mouse model was set up by combination of oral bovine serum albumin (BSA) administration and staphylococcal enterotoxin B (SEB) injection. The pathological changes of renal tissue were observed by immunofluorescence staining and PAS staining, and the intestinal mucosa barrier damage indicators lipopolysaccharide(LPS), soluble intercellular adhesion molecule 1(sICAM-1) and D-lactate(D-LAC) were analyzed by ELISA. Biochemical analysis was used to test 24 hour urine protein, serum creatinine and blood urea nitrogen. The mRNA and protein levels of Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88) and nuclear factor κB (NF-κB) were detected by reverse transcription PCR and Western blot analysis. Results The kidney damage of pseudosterile IgAN mice was more severe than that of IgAN mice, and the expressions of intestinal mucosal barrier damage markers (LPS, sICAM-1 and D-LAC) were significantly increased in pseudosterile IgAN mice. In addition, the expressions of TLR4, MyD88, and NF-κB level were all up-regulated in the intestinal tissues of IgAN pseudosterile mice. Conclusion Intestinal flora disturbance leads to intestinal mucosal barrier damage and induces activation of TLR4 signaling pathway to mediate renal injury in IgAN.
Animals
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Mice
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Mice, Inbred C57BL
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Glomerulonephritis, IGA
;
NF-kappa B
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Toll-Like Receptor 4/genetics*
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Lipopolysaccharides
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Myeloid Differentiation Factor 88/genetics*
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Kidney
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Intestinal Mucosa
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Infertility
;
Disease Models, Animal
8.Expression of HER2 in 429 cases of urothelial carcinoma and clinicopathological analysis
Mengni ZHANG ; Jing GONG ; Xueqin CHEN ; Ling NIE ; Miao XU ; Yuyan WEI ; Qiao ZHOU ; Ni CHEN
Chinese Journal of Pathology 2023;52(3):243-249
Objective:To investigate the expression of HER2 and its relationship with clinicopathological features in patients with urothelial carcinoma.Methods:Urothelial carcinoma specimens collected from January 2019 to June 2022 were used. The expression of HER2, cytokeratin 20 and cytokeratin 5/6 was examined using immunohistochemistry. The HER2 expression was assessed according to the clinical pathological expert consensus on HER2 testing in urothelial carcinoma in China. Cases with HER2 2+/3+ were classified as HER2 positive. The relationship between HER2 expression and clinicopathological and molecular features was analyzed.Results:Four hundred and twenty-nine urothelial carcinoma specimens were analyzed, including 166 cases of raclical resection and 263 cases of local tumor resection. The median patient-age was 69 years (range: 31-93 years). The male: female ratio was 2.9∶1.0. The positive rate of HER2 was 45.7%(196/429). The positive rate of HER2 in patients with local tumor resection was higher than that in patients with radical resection [51.7%(136/263) vs.36.1%(60/166), P<0.05]. In the upper urinary tract (renal pelvis/ureter) urothelial carcinomas, the positive rate of HER2 was 35.2% (37/105). In bladder urothelial carcinoma, the positive rate of HER2 was 49.1%(157/320), and higher than that in upper urinary tract urothelial carcinoma ( P<0.05). In high grade urothelial carcinoma, the positive rate of HER2 was 52.8%(168/318) and higher than that in low grade urothelial carcinomas (25.2%, 28/111, P<0.01). In 166 radical resection specimens, the positive rate of HER2 was not differentially distributed by tumor pT stage [Ta (26.1%, 6/23), T1 (41.7%, 20/48), T2 (40.0%, 10/25), T3 (28.1%, 16/57), T4 (8/13) ( P>0.05)]. In urothelial carcinomas with muscle invasion, the HER2 positive rate was 35.8%(34/95), while the rate in non-muscle-invasion urothelial carcinoma was 36.6%(26/71, P>0.05). CK20 and CK5/6 were used to refine the urothelial carcinoma molecular subtypes. The positive rate of HER2 was highest in CK20 +/CK5/6 -group (124/194, 63.9%), followed by CK20 +/CK5/6 +group (18/40, 45.0%), CK20 -/CK5/6 -group (14/41, 34.1%) and CK20 -/CK5/6 +group (25/131, 19.1%, P<0.01). The positive rate of HER2 in micropapillary urothelial carcinoma was highest (14/15), followed by urothelial carcinoma with glandular differentiation (11/14), conventional urothelial carcinoma (161/360, 44.7%) and urothelial carcinoma with squamous differentiation (6/35, 17.1%, P<0.01). In the cases with lymph node metastasis, the positive rate of HER2 was 45.5% (10/22) and higher than the cases without lymph node metastasis (31.0%, 13/42). But there was no statistically significant association between HER2 expression and lymph node metastasis ( P>0.05). Conclusions:Expression of HER2 in urothelial carcinoma is closely correlated with tumor location, grade, histologic subtypes, molecular subtypes and surgical approach, but not with pT stage, muscle invasiveness or lymph node metastasis.
9.LIN28 coordinately promotes nucleolar/ribosomal functions and represses the 2C-like transcriptional program in pluripotent stem cells.
Zhen SUN ; Hua YU ; Jing ZHAO ; Tianyu TAN ; Hongru PAN ; Yuqing ZHU ; Lang CHEN ; Cheng ZHANG ; Li ZHANG ; Anhua LEI ; Yuyan XU ; Xianju BI ; Xin HUANG ; Bo GAO ; Longfei WANG ; Cristina CORREIA ; Ming CHEN ; Qiming SUN ; Yu FENG ; Li SHEN ; Hao WU ; Jianlong WANG ; Xiaohua SHEN ; George Q DALEY ; Hu LI ; Jin ZHANG
Protein & Cell 2022;13(7):490-512
LIN28 is an RNA binding protein with important roles in early embryo development, stem cell differentiation/reprogramming, tumorigenesis and metabolism. Previous studies have focused mainly on its role in the cytosol where it interacts with Let-7 microRNA precursors or mRNAs, and few have addressed LIN28's role within the nucleus. Here, we show that LIN28 displays dynamic temporal and spatial expression during murine embryo development. Maternal LIN28 expression drops upon exit from the 2-cell stage, and zygotic LIN28 protein is induced at the forming nucleolus during 4-cell to blastocyst stage development, to become dominantly expressed in the cytosol after implantation. In cultured pluripotent stem cells (PSCs), loss of LIN28 led to nucleolar stress and activation of a 2-cell/4-cell-like transcriptional program characterized by the expression of endogenous retrovirus genes. Mechanistically, LIN28 binds to small nucleolar RNAs and rRNA to maintain nucleolar integrity, and its loss leads to nucleolar phase separation defects, ribosomal stress and activation of P53 which in turn binds to and activates 2C transcription factor Dux. LIN28 also resides in a complex containing the nucleolar factor Nucleolin (NCL) and the transcriptional repressor TRIM28, and LIN28 loss leads to reduced occupancy of the NCL/TRIM28 complex on the Dux and rDNA loci, and thus de-repressed Dux and reduced rRNA expression. Lin28 knockout cells with nucleolar stress are more likely to assume a slowly cycling, translationally inert and anabolically inactive state, which is a part of previously unappreciated 2C-like transcriptional program. These findings elucidate novel roles for nucleolar LIN28 in PSCs, and a new mechanism linking 2C program and nucleolar functions in PSCs and early embryo development.
Animals
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Cell Differentiation
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Embryo, Mammalian/metabolism*
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Embryonic Development
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Mice
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Pluripotent Stem Cells/metabolism*
;
RNA, Messenger/genetics*
;
RNA, Ribosomal
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RNA-Binding Proteins/metabolism*
;
Transcription Factors/metabolism*
;
Zygote/metabolism*
10.Effects of interpregnancy interval on pregnancy outcomes of subsequent pregnancy: a multicenter retrospective study
Juan JUAN ; Huixia YANG ; Yumei WEI ; Geng SONG ; Rina SU ; Xu CHEN ; Qiuhong YANG ; Jianying YAN ; Mei XIAO ; Ying LI ; Shihong CUI ; Yali HU ; Xianlan ZHAO ; Shangrong FAN ; Ling FENG ; Meihua ZHANG ; Yuyan MA ; Zishan YOU ; Haixia MENG ; Haiwei LIU ; Ying ZHU ; Chunfeng WU ; Yan CAI ; Kejia HU ; Hongjuan DING
Chinese Journal of Obstetrics and Gynecology 2021;56(3):161-170
Objective:To explore the effects of interpregnancy interval (IPI) on pregnancy outcomes of subsequent pregnancy.Methods:A multicenter retrospective study was conducted in 21 hospitals in China. Information of age, height, pre-pregnancy weight, IPI, history of diseases, complications of pregnancy, gestational age of delivery, delivery mode, and pregnancy outcomes of the participants were collected by consulting medical records of pregnant women who had two consecutive deliveries in the same hospital during 2011 to 2018. The participants were divided into 4 groups according to IPI:<18 months, 18-23 months, 24-59 months and ≥60 months. According to the WHO′s recommendation, with the IPI of 24-59 months group as a reference, to the effects of IPI on pregnancy outcomes of subsequent pregnancy were analyzed. Stratified analysis was further carried out based on age, history of gestational diabetes mellitus (GDM), macrosomia, and premature delivery, to explore the differences in the effects of IPI on pregnancy outcomes among women with different characteristics.Results:A total of 8 026 women were included in this study. There were 423, 623, 5 512 and 1 468 participants in <18 months group, 18-23 months group, 24-59 months group and ≥60 months group, respectively. (1) The age, pre-pregnancy body mass index (BMI), history of cesarean section, GDM, gestational hypertension and cesarean section delivery rate of <18 months group, 18-23 months group, 24-59 months group and ≥60 months group were gradually increased, and the differences were statistically significant ( P<0.05). (2) After adjusting for potential confounding factors, compared with women in the IPI of 24-59 months group, the risk of premature delivery, premature rupture of membranes, and oligohydramnios were increased by 42% ( OR=1.42, 95% CI: 1.07-1.88, P=0.015), 46% ( OR=1.46, 95% CI: 1.13-1.88, P=0.004), and 64% ( OR=1.64, 95% CI: 1.13-2.38, P=0.009) respectively for women in the IPI≥60 months group. No effects of IPI on other pregnancy outcomes were found in this study ( P>0.05). (3) After stratified by age and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of oligohydramnios for women with advanced age ( OR=2.87, 95% CI: 1.41-5.83, P=0.004); and <18 months could increase the risk of premature rupture of membranes for women under the age of 35 ( OR=1.59, 95% CI: 1.04-2.43, P=0.032). Both the risk of premature rupture of membranes ( OR=1.58, 95% CI: 1.18-2.13, P=0.002) and premature delivery ( OR=1.52, 95% CI: 1.07-2.17, P=0.020) were significantly increased in the IPI≥60 months group. After stratified by history of GDM and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would lead to an increased risk of postpartum hemorrhage for women with a history of GDM ( OR=5.34, 95% CI: 1.45-19.70, P=0.012) and an increased risk of premature rupture of membranes for women without a history of GDM ( OR=1.44, 95% CI: 1.10-1.90, P=0.009). After stratified by history of macrosomia and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months could increase the proportion of cesarean section for women with a history of macrosomia ( OR=4.11, 95% CI: 1.18-14.27, P=0.026) and the risk of premature rupture of membranes for women without a history of macrosomia ( OR=1.46, 95% CI: 1.12-1.89, P=0.005). After stratified by history of premature delivery and adjusted for confounding factors, compared with women in the IPI of 24-59 months group, IPI≥60 months would significantly increase the risk of premature rupture of membranes for women without a history of premature delivery ( OR=1.47, 95% CI: 1.13-1.92, P=0.004). Conclusions:Both IPI≥60 months and <18 months would increase the risk of adverse pregnancy outcomes in the subsequent pregnancy. Healthcare education and consultation should be conducted for women of reproductive age to maintain an appropriate IPI when they plan to pregnant again, to reduce the risk of adverse pregnancy outcomes in the subsequent pregnancy.

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