Paediatric and perinatal epidemiology最新文献

{"title":"Exploring the Relationship Between Respiratory Syncytial Virus and Asthma Using Calendar Time at Birth as a Source of Quasi-Random Variation.","authors":"Michelle C Dimitris, Daniel R Feikin, Erin Sparrow, Susan E Schultz, Jeffrey C Kwong, Sarah A Buchan, David A Savitz, Steven M Brunwasser, Deshayne B Fell","doi":"10.1111/ppe.70168","DOIUrl":"10.1111/ppe.70168","url":null,"abstract":"<p><strong>Background: </strong>Observational studies suggest an association between severe respiratory syncytial virus (RSV) and asthma, but it is unclear if this relationship is causal or confounded.</p><p><strong>Objectives: </strong>We investigated this relationship using calendar time at birth as a source of quasi-random variation with respect to individual-level risk factors for severe RSV infection. We similarly examined influenza (another respiratory virus) and rotavirus (a negative control exposure).</p><p><strong>Methods: </strong>We analysed province-wide linked administrative data for 1,437,731 infants born in Ontario, Canada, from 2002-2013 (which facilitated 5 years of follow-up for asthma). We ascertained whether each infant experienced an RSV, influenza, and/or rotavirus hospitalisation (and the weekly incidences of RSV, influenza, and rotavirus hospitalisation among infants), and whether each child had asthma at 5 years of age. We used regression models to investigate the relationships between: (i) infant ages during the weeks with the highest incidences of RSV, influenza, and rotavirus hospitalisation and paediatric asthma; (ii) weekly incidences of RSV, influenza, and rotavirus hospitalisation and probability of paediatric asthma.</p><p><strong>Results: </strong>We observed the highest odds of asthma among infants aged 13-16 weeks during the RSV peak, 11-13 weeks during the influenza peak, and 16-19 weeks during the rotavirus peak. The relationship between weekly incidence of RSV hospitalisation and probability of paediatric asthma was small in magnitude; we estimated a 3.15 (95% confidence interval -0.07, 6.36) percentage-point change in probability of paediatric asthma per 1 percentage-point change in weekly incidence of RSV hospitalisation among infants (offset by 13 weeks, which was the infant age at RSV peak that conferred maximum crude odds of paediatric asthma). Additionally, an unexpected relationship between rotavirus seasonal variation and asthma emerged.</p><p><strong>Conclusions: </strong>We found evidence supporting a limited causal role that did not fully explain the relationship between RSV and asthma. Other mechanisms, including seasonal factors, may contribute to previously reported associations.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"811-823"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small Relative Risks, Large Uncertainty: What Confounding Leaves Unresolved for Clinical Actionability.","authors":"Boujenah Jérémy","doi":"10.1111/ppe.70198","DOIUrl":"10.1111/ppe.70198","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"840-841"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Shortened Gestation Cause (or Just Predict) Neurodevelopmental Disorders?","authors":"David A Savitz","doi":"10.1111/ppe.70199","DOIUrl":"10.1111/ppe.70199","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"803-804"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational Age as a Risk Factor for Neurodevelopmental Disabilities: Exploring Causal Pathways.","authors":"Marianna Cortese, Dag Moster, Rolv Terje Lie, Allen J Wilcox","doi":"10.1111/ppe.70177","DOIUrl":"10.1111/ppe.70177","url":null,"abstract":"<p><strong>Background: </strong>Early and late delivery are associated with increased risk of neurodevelopmental disabilities. Some experts emphasise direct causal effect, while others propose confounding by underlying pathologies.</p><p><strong>Objectives: </strong>We present detailed relative-risk estimates for five major neurodevelopmental disabilities by strata of gestational age. Confounding is explored through sibling-matched analyses and the relative risks of birth defects with gestational age.</p><p><strong>Methods: </strong>Using data from Norway's Medical Birth Registry and other national health registries for 2.9 million births in 1967-2019, we conducted a prospective cohort analysis assessing gestational-age-specific relative risks for cerebral palsy (CP), intellectual impairment, epilepsy, autism spectrum disorder (ASD), and attention deficit/hyperactivity disorder (ADHD). We used an analysis of sibship-matched pairs to assess the role of unmeasured confounding by conditions that persist across successive pregnancies. We also compared these gestational-age-specific risk patterns with the corresponding risks of five birth defects present before delivery.</p><p><strong>Results: </strong>Multivariable-adjusted relative risks (RRs) of all five neurodevelopmental disabilities were increased with early pre-term delivery. Compared with births at 40 weeks, infants born at 23-27 weeks had RRs ranging from 2-fold for ADHD (RR 2.2, 95% confidence interval [CI] 2.0, 2.5) to 50-fold for CP (95% CI 44, 58). Relative risks for post-term delivery (≥ 43 weeks) were smaller, ranging from 1.15 to 1.45. In sibship analyses, relative risks with pre-term delivery were attenuated, suggesting the influence of unmeasured confounding. The relative risks of birth defects with preterm and post-term delivery were similar to neurodevelopmental disabilities, showing that confounding alone can produce relative risks of the magnitude seen with neurodevelopmental disabilities.</p><p><strong>Conclusions: </strong>The effect of gestational age at birth on neurodevelopment is likely less-and perhaps much less-than suggested by the observed associations. Prevention of neurodevelopmental disabilities depends not just on interventions during and after delivery, but on identifying and intervening on prenatal causes of these disabilities.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"794-802"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response-Conditioning on Live Birth May Explain the Paradoxical Association Between Larger Mid-Gestation Head Size and Neurodevelopmental Disorders.","authors":"Mads Langager Larsen, Gorm Greisen, Lone Krebs, Christina Engel Hoei-Hansen, Olav Bjørn Petersen","doi":"10.1111/ppe.70187","DOIUrl":"https://doi.org/10.1111/ppe.70187","url":null,"abstract":"","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":"40 7","pages":"838-839"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-pregnancy Cardiovascular Health and Adverse Pregnancy Outcomes After Frozen Embryo Transfer: A Retrospective Cohort Study.","authors":"Fengyi Ren, Wen Zhang, Mengyao Qin, Xin Liu, Zixuan Zhang, Fei Zhao, Lei Sheng, Ling Geng, Xinxia Chen","doi":"10.1111/ppe.70189","DOIUrl":"https://doi.org/10.1111/ppe.70189","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular health before pregnancy may influence maternal and pregnancy outcomes; however, evidence among women undergoing frozen embryo transfer (FET) remains limited.</p><p><strong>Objective: </strong>This retrospective cohort study aims to investigate the association between pre-pregnancy biomedical cardiovascular health (CVH), defined by the American Heart Association, and adverse pregnancy outcomes (APOs) after FET.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted from January 2019 to August 2023 and included 1521 women undergoing FET in their first in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) cycle. The main APOs included hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), preterm birth (PTB), offspring being large for gestational age (LGA) and small for gestational age (SGA). Modified Poisson regression models with restricted cubic splines were used to investigate the relationship between biomedical CVH and APOs, and adjusted population-attributable fraction (PAF) and partial population-attributable fraction(partial PAFs) models were used to quantify the theoretical reduction in APOs with CVH improvement.</p><p><strong>Results: </strong>Compared with the high CVH group, the low-to-moderate CVH group was associated with higher risks of HDP (relative risk [RR] 2.61, 95% confidence interval [CI] 1.83, 3.73), GDM (RR 1.82, 95% CI 1.40, 2.38), PTB (RR 2.03, 95% CI 1.47, 2.81), and LGA (RR 1.28, 95% CI 1.08, 1.52). CVH was linearly associated with the log risk of HDP and PTB. In contrast, CVH showed nonlinear associations with the log risk of GDM and LGA. PAF estimates suggest that 11.0%-36.1% of these APOs could be associated with low-to-moderate CVH (CVH score < 80). Specifically, for individual CVH components, elevated blood pressure was the leading risk factor for HDP, whereas overweight and obesity (BMI) were the strongest risk factors for GDM, PTB, and offspring LGA.</p><p><strong>Conclusions: </strong>Biomedical CVH is negatively associated with APOs in pregnancies after FET. Women undergoing FET might benefit from preventive strategies to improve CVH, especially BMI and blood pressure.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising Perinatal Mortality in Greece, 2014-2024: Are Changes in Stillbirth Registration Practices the Only Explanation?","authors":"Eirini Nikaina, Georgia Kourlaba, Kyriaki Velali, Panagiota Markopoulou, Dimitra Metallinou, Tania Siahanidou","doi":"10.1111/ppe.70195","DOIUrl":"https://doi.org/10.1111/ppe.70195","url":null,"abstract":"<p><strong>Background: </strong>Perinatal mortality appears to have increased recently in Greece; however, it is unclear whether this increase can be solely attributed to the 2018 change in the defined gestational age threshold for stillbirth registration.</p><p><strong>Objectives: </strong>To examine temporal trends in perinatal mortality rates in Greece during the period 2014-2024 and evaluate the potential impact of changes in stillbirth registration practices.</p><p><strong>Methods: </strong>Nationwide data from the Hellenic Statistical Authority (2014-2024; Ν = 926,154 total births) were analysed to estimate trends in perinatal mortality. Changes in stillbirth recording after 2018, following the adoption of a 22-week gestational viability threshold, were taken into account. Poisson Regression, Interrupted Time Series (ITS) and Joinpoint Regression analyses were used.</p><p><strong>Results: </strong>Perinatal mortality was 5.6 in 2014 versus 8.2 in 2024 per 1000 total births. Poisson regression showed an overall increase in perinatal mortality rates (4.4% annually, 95% confidence interval [CI] 3.5 to 5.3), driven by rising stillbirth rates (6.8% annually, 95% CI 5.5 to 8.1), while early neonatal mortality rates declined (-2.0% annually; 95% CI -3.0 to -1.1). Stillbirth rates at < 26 weeks' gestation increased sharply (36.1% annually, 95% CI 24.9 to 47.4), whereas a smaller increase was observed at ≥ 26 weeks (1.7% annually, 95% CI 0.4 to 2.9). ITS analysis showed a level increase in 2019 and an increasing post-2019 trend in stillbirth rates at < 26 weeks, whereas no corresponding level or post-2019 trend changes were detected at ≥ 26 weeks. Joinpoint regression also identified 2019 as a breakpoint for stillbirths at < 26 weeks.</p><p><strong>Conclusions: </strong>The rise in perinatal mortality in Greece over the past decade has been driven by increased stillbirth rates, largely attributable to changes in stillbirth recording practices at gestational ages < 26 weeks. The modest upward trend in stillbirths at ≥ 26 weeks' gestation warrants further investigation and ongoing monitoring.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Adverse Childhood Experiences and Child Socio-Emotional and Behavioural Outcomes: A Systematic Review of Prenatal Mechanisms.","authors":"Sara Avendano, Aicha Mourchidi, Susana Barbosa, Laetitia Davidovic, Barbara Heude, Cédric Galéra, Judith van der Waerden","doi":"10.1111/ppe.70190","DOIUrl":"https://doi.org/10.1111/ppe.70190","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy represents a crucial period for understanding key pathways contributing to the intergenerational effects of adverse childhood experiences (ACEs). However, prenatal mechanisms linking maternal ACEs to subsequent child mental health outcomes are still poorly understood compared to postnatal ones.</p><p><strong>Objective: </strong>To review the biopsychosocial mechanisms during pregnancy that may contribute to the relationship between maternal ACEs and child socio-emotional and behavioural development.</p><p><strong>Data sources: </strong>We systematically searched PubMed, PsycInfo and Web of Science from inception up to February 2026.</p><p><strong>Study selection and data extraction: </strong>We included peer-reviewed observational studies (cohort, case-control, cross-sectional) evaluating prenatal biological, psychological, or social mechanisms linking maternal ACEs to child socio-emotional/behavioural outcomes (Ages 0-18); qualitative studies and grey literature were excluded. Two reviewers independently screened studies and extracted data on study design, mediators and effect sizes, with disagreements resolved by a third reviewer.</p><p><strong>Synthesis: </strong>Narrative synthesis was used to summarise study characteristics, mediation pathways and analytical strategies in tabular form. Results were synthesised by type of prenatal mechanism.</p><p><strong>Results: </strong>Of 2641 records identified, 122 full texts were assessed and 13 studies met inclusion criteria. Prenatal maternal depression and anxiety emerged as the most frequently studied mechanisms, showing some evidence of independent effects irrespective of postnatal factors, but most of the findings point towards a 'chain-of-risk' model, where prenatal mental health interacts with the postnatal environment. Biomedical antepartum risks and maternal-fetal attachment also showed mediating effects, but without accounting for postnatal influences. The small number of eligible studies underscores the limited exploration of prenatal transmission pathways.</p><p><strong>Conclusions: </strong>Prenatal mental health difficulties, particularly in interaction with postnatal factors, may play a role in the intergenerational transmission of ACEs. Further studies using robust methods to disentangle prenatal and postnatal contributions are needed to inform targeted interventions.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Intrapartum Antibiotic Prophylaxis at Caesarean Section on Childhood Obesity: A Quasi-Experimental Study in Two Bi-Ethnic UK Cohorts.","authors":"Gillian Santorelli, Lucy Pembrey, Sergio Souza da Cunha, Emily S Petherick, Ellena Badrick, Lila Goodwin, Sam Oddie, Neil Pearce, John Wright","doi":"10.1111/ppe.70179","DOIUrl":"https://doi.org/10.1111/ppe.70179","url":null,"abstract":"<p><strong>Background: </strong>Clinical guidelines now recommend administering intrapartum antibiotic prophylaxis (IAP) before skin incision at caesarean section to prevent maternal infection. However, this practice exposes the fetus to antibiotics, raising concerns about potential long-term effects on the infant microbiome and the risk of childhood obesity.</p><p><strong>Objectives: </strong>To assess whether the timing of IAP at caesarean section-before skin incision versus after umbilical cord clamping-is associated with childhood obesity at age 4-5 years.</p><p><strong>Methods: </strong>We conducted a quasi-experimental study of a hospital-wide policy change in clinical practice using data from two birth cohorts (Born in Bradford [BiB] and Born in Bradford's Better Start [BiBBS]). The study included 1985 children of White British or Pakistani heritage born by caesarean section between 2007 and 2019. Children exposed to pre-incision IAP (n = 324) were compared with those unexposed (post-cord clamping IAP; n = 1661). The primary outcome was obesity (BMI z-score > 95th percentile) at age 4-5 years. Adjusted Risk Ratios (aRR) were estimated using multivariable Poisson regression stratified by ethnicity.</p><p><strong>Results: </strong>The prevalence of obesity was 11.9%. Adjusted risk ratios for obesity were 1.25 (95% CI 0.53 to 2.98) for White British children and 1.25 (95% CI 0.64 to 2.43) for Pakistani children. Similarly, estimates for BMI z-score had wide confidence intervals indicating, limited precision.</p><p><strong>Conclusions: </strong>We did not observe a clear difference in childhood obesity at 4-5 years between pre-incision and post-cord clamping prophylactic antibiotics at caesarean section. Confidence intervals were wide, and modest clinically relevant effects cannot be excluded. Findings are compatible with no large adverse effect and may provide reassurance regarding the metabolic safety of current clinical practice.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of the Latency Period Between Weekly Gestational Weight Gain and Fetal Growth.","authors":"Madeleine E St Ville, Kathryn A Wagner, Jessica L Gleason, Katherine L Grantz, Zhen Chen","doi":"10.1111/ppe.70152","DOIUrl":"10.1111/ppe.70152","url":null,"abstract":"<p><strong>Background: </strong>Gestational weight gain (GWG) is associated with fetal growth. However, prior studies have assumed specific timing and latency between GWG and fetal growth.</p><p><strong>Objectives: </strong>We aimed to identify the latency period between the cumulative GWG rate and fetal growth and assess whether accounting for it changes their association.</p><p><strong>Methods: </strong>We analysed data from the NICHD Fetal Growth Studies-Singletons (N = 2445) and NICHD Fetal 3D Study (n = 1946). Maternal cumulative GWG rate was the exposure; fetal growth outcomes were estimated fetal weight (EFW) from 2D ultrasound and fractional arm volume (AVol) from 3D. Weekly cumulative GWG rate and fetal growth trajectories were estimated. Two procedures were used to select latency period: one approach identifies the lag with the largest association, and the other the best model fit. Models were adjusted for sociodemographic, clinical, and lifestyle covariates.</p><p><strong>Results: </strong>Latency selection procedures identified a lag of 7-8 weeks between the cumulative GWG rate and fetal growth. Accounting for this lag, the weekly cumulative GWG rate was positively associated with both EFW and AVol at all gestational weeks evaluated. For example, under the 7-week lag model, for every 1 kg/week increase in the cumulative GWG rate at week 33, there was an average increase of 947 g (95% confidence interval [CI] 894, 1000) in EFW and 7.2 cm³ (95% CI 6.6, 7.8) in AVol at week 40. Results were similar under the 8-week lag specification, with overlapping confidence intervals.</p><p><strong>Conclusions: </strong>Using two common latency selection procedures, we identified a 7-8 week latency period between GWG and subsequent fetal growth, with consistent findings across 2D and 3D fetal growth parameters. These findings highlight the importance of identifying relevant latency periods between GWG and its relationship with fetal growth and the need for improved statistical methods to address the limitations of current latency selection procedures.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"723-732"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}