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Lumason (Sulfur Hexafluoride Lipid-type A Microspheres Injectable Suspension)- Multum

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The pilot analysis in a small subgroup showed that approximately 20. The SPCC will be followed up for 18 years to investigate extensive outcomes of growth, development, obesity, and common and rare diseases during childhood and adolescence according to our plan. Blood nutritional factors will be examined in participants selected for specific aims. The SPCC will also allow for prospective cohort studies on extensive research questions. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.

Temporal sequence of exposures and outcomes can be achieved for causal inference of birth defects and other diseases that develop during the early stage of gestation. Preconception blood samples were appropriately collected and stored, which allow for the examination of individual blood levels for nutritional factors and other exposures. Preconception clinical data and blood samples from both the father and mother were collected to determine the effect of both maternal and paternal genetic and nutritional factors on fetal and paediatric brain apps. They may have stronger willingness for a healthy pregnancy, which may induce selection bias.

The incidence of severe CHD was 2. With the development of genetic engineering technology, genetic factors have been better understood in the past decade. Awareness of the relationship between folic acid deficiency and CHD is actually a by-product finding from the well-known Hungarian randomised control trial study of folic acid supplementation to prevent neural tube defects. The study found that prenatal supplementation with a multivitamin containing 0.

Additionally, the incidence of various heart defects has also been reduced by nearly half. Additionally, most previous studies focused only on the folic acid supplement or the serum folate level during or after pregnancy, which may not be the optimal period and method to reflect the exposure level to the risk of CHD.

The SPCC was initiated primarily to evaluate CHD. However, based on the strengths of its baseline data collection, it has received attention and support, with improved additional extensive outcomes for children that Lumason (Sulfur Hexafluoride Lipid-type A Microspheres Injectable Suspension)- Multum be followed up for a longer term. The preconception examination policy in the city of Shanghai provides a unique opportunity and clinical resources to support recruitment in the SPCC.

Since 2010, married couples in Shanghai have been encouraged to attend a free preconception health examination. Couples who were present at preconception clinics, living in Shanghai, preparing for pregnancy within 1 year, and planning to receive antenatal care and deliver in Shanghai were eligible for the study. Written informed consent was obtained from all participants before data collection.

Additionally, we recruited early-pregnancy women who were at The first primary outcome of the SPCC is CHD. The hypothesis is that maternal Lumason (Sulfur Hexafluoride Lipid-type A Microspheres Injectable Suspension)- Multum serum or red blood cell (RBC) folate level is quantitatively associated with CHD development in the offspring.

The study design and protocol have been registered in the ClinicalTrials Registry. As shown in figure 1, the baseline population will be followed up until delivery, and their infants will be followed up until 18 years of age (figure 1). Protocol and follow-up of the SPCC.

The baseline population of SPCC consisted of women and men at the periconception stage (couples who are preparing for pregnancy) and pregnant women at the early gestation stage. The cohort includes three phases, from periconception to birth (phase I, perinatal phase), from birth to 6 years (phase II, infant and preschool age) and from 7 to 18 years avoidant attachment disorder III, school age).

The current paper focuses on the first phase, with CHD as the primary outcome, and will cover other folate-sensitive birth defects. On Lumason (Sulfur Hexafluoride Lipid-type A Microspheres Injectable Suspension)- Multum, the participants completed Zinc Chloride Injection, USP 1 mg/mL (Zinc)- FDA questionnaire of key nutrient supplementation and blood sample collection.

Lumason (Sulfur Hexafluoride Lipid-type A Microspheres Injectable Suspension)- Multum were followed up, along with routine maternal healthcare procedures. The follow-up data of CHD outcome and birth were obtained through the Shanghai Neonatal CHD Screening Platform (figure 1). As shown in figure 1, outcomes at birth, from infancy to childhood (preschool phase) and between 7 and 18 years (school ages), will be collected or extracted from multiple public platforms and data sources.

First, preconception clinical visit data from the Preconception Care Electronic Data System, supported by the national and local government, were collected, including height, weight, age, infections, sexually transmitted disease and family history. Lastly, the maternal and neonatal data at delivery were obtained from the Shanghai Neonatal CHD Screening Platform, Lumason (Sulfur Hexafluoride Lipid-type A Microspheres Injectable Suspension)- Multum birth weight, CHD diagnosis, birth defects and Apgar score.

Additionally, we will work with the Shanghai Student Health and Fitness Surveillance Center to obtain outcome data. The personal national identification card numbers of the participants are applied as index variables through multiple data sources.

The detailed variable list and codebook of data collection are presented in online supplementary appendix 1. Lumason (Sulfur Hexafluoride Lipid-type A Microspheres Injectable Suspension)- Multum the first phase of the cohort, from preconception to delivery, comprehensive strategies were used to retain participants in the study.

For mothers, we provided a variety of engagement activities, including green channel (fast track) to their antenatal care, to provide convenience and to save their time in hospitals. We also provided a contact number on the participant card to answer their calls or queries about the study procedures. Lumason (Sulfur Hexafluoride Lipid-type A Microspheres Injectable Suspension)- Multum investigators at early-pregnancy clinics in collaborative hospitals were provided a smartphone application to help timely identification of recruited cohort participants and to manage data and blood sample collection procedures.

We also provided green channel echocardiography for diagnosing CHD in all site hospitals to enhance the compliance of participants. Moreover, an automated text message system was adopted to remind participants of schedules and follow-up appointments. As shown in figure 1, questionnaire 1 was administered during recruitment at preconception examination sites, and questionnaire 2 was administered at early-pregnancy sites to collect information on the consumption of folic acid and vitamin supplements, and on the brand and content of nutritional supplement.

Information on the demographics, maternal education, sociodemographic status, occupation, smoking status, alcohol consumption, body mass index, medication and health status was also included. In addition to the content of questionnaire 1, questionnaire 2 added drug information, reproductive history and health status.

Questionnaire 1 for baseline and questionnaire 2 for the first antenatal visit at early pregnancy are presented in online supplementary appendix 2A,B. In this study, the remaining blood samples for routine clinical blood examination were collected. The blood sample for routine clinical examination was usually 5 mL and was extracted in the morning. The remaining samples (fasting serum and EDTA anticoagulation) of peripheral venous blood from routine laboratory clinical blood examination were retained.

Sampling tubes were made of a light-proof material, and the process of collecting blood samples was completely protected from light. EDTA anticoagulated blood samples were collected to measure RBC folate, serum folate, serum homocysteine, vitamin D, vitamin B12 and serum ferritin. A standard solution with known level (produced by Abbott Laboratories) was used daily to control the quality before the measurement.

If the quality control level was out of range, the measurement would be suspended and adjusted. External quality control was conducted with the control laboratory data programme from Abbott Laboratories (Abbott Laboratories, Shanghai, China).

RBC folate levels were adjusted for haematocrit.

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