Objective A blood pressure (BP) of 120-140/80-90 mmHg at <20 weeks’ gestation is associated with risks for preeclampsia. We aimed to explore the effect of maternal metabolic risk factors on the strength of the association between blood pressure thresholds based on 2017 American Heart Association (AHA) guidelines and preeclampsia. Design Retrospective cohort study. Setting The reproductive center is based in Shanghai, China. Population or Sample Data from 78,016 women enrolled between 2014 and 2019 from the medical record system of the center were used. Methods This retrospective cohort study included 78,016 participants. Preeclampsia prevalence was analyzed among women of four BP categories, stratified by maternal BMI and TG. Main outcome measures Incidence of preeclampsia Results Maternal BMI and TG showed a dose-response superimposed impact on the relationships between BPs and preeclampsia rates. Although heightened risks for preeclampsia were found in women with normal BMI (18.5-<25 kg/m2) and TG (<90th, 2.04 mM) women at a BP of 120-140 /80-90 mmHg, women with obesity (BMI ≥ 25 kg/m2) and (or) high TG (≥ 90th) showed higher rates of preeclampsia. The preeclampsia risk was the highest in women with obesity and high TG at a BP of 130-140/80-90 mmHg and over 140/90 mmHg, which was 6-fold, and 13-fold greater than normotensive women with normal BMI and TG respectively. Conclusion Obesity and (or) high TG tended to strengthen the association between BP over 130/80 mmHg and risk of preeclampsia.

Domino effects of COVID-19 in pregnancy：it’s time for action Rui-Hong Xue1, He-Feng Huang2,3,4,5

Letter to the Editor, BJOG Exchange

Crying newborns could breathe into droplets with virus：the discussion of the possibility of intrapartum transmissionRui-Hong Xue1, He-Feng Huang2,3,4,5

The best suggestion for COVID-19 in a non-infected pregnant population is still prevention: a commentaryRui-Hong Xue1, He-Feng Huang2,3,4,5

Sir, We read with interests the article by Lorraine S Kasaven and collegues, entitled “Implications for the future of Obstetrics and Gynaecology following the COVID‐19 pandemic: A commentary”. They discussed the impact of COVID-19 on practice of Obstetrics and Gynaecology, and summarized detailed suggestions. We would like to emphasize the importance of prevention in pregnancy.Though the management guidelines during pregnancy are evolving continuously, pregnant women suffered with COVID-19 mean worse pregnancy outcomes, both physically and mentally, especially during the first or second trimester, both the patient and doctor may stuck in the middle. What is worse, no drug or vaccine has been proved to be effective and safe enough to prevent COVID-19 until now.Physical distancing, face masks, and eye protection have been proved to be effective in preventing person-to-person transmission of SARS-CoV-2 and COVID-19. As confirmed that public health interventions could temporally improve control of the COVID-19 outbreak.“Don’t wait to lose to know how to cherish”, so as to health. After all, it could not be regarded as common flu, COVID-19 has a strong contagion effect and could cause significant morbidity and mortality. In the 1902 paper, Ballantyne said, “as with the premature, the ideal plan of procedure is prevention”, so with the COVID-19. With strong awareness of prevention and effective measures to be taken among the non-infected population, the current situation will gradually get better, and people will definitely defeat the epidemic at the end.Rui-hong Xue,1 He-feng Huang11International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China