| ObjectivesTo describe the distribution of pregnant women’s hemoglobin and anemia,6-month-old and 18-month-old infants’ developmental delay in Ma’anshan City,and explore the status of breastfeeding infants,explore the relationship between pregnant women’s hemoglobin and anemia and infant growth retardation,and breastfeeding and pregnant women’s IQ Level of regulation.MethodsBased on the Ma’anshan Birth Cohort,MABC,this study recruited 3474 permanent pregnant women in Maanshan who were resident within 14 weeks of pregnancy and had no serious mental illness in Ma’anshan Maternal and Child Health Hospital from May 2013 to September 2014.There were 3474 pregnant women with no serious mental illness.Use "Maternal and Child Health Records During Pregnancy(1),(2),(3)" to collect demographic data(including height,weight,education level,and income level of pregnant women in the early,middle and late trimesters)Etc.),previous pregnancy history and disease history(pregnancy and parity,presence or absence of allergic diseases,etc.)information,and at any period of pregnancy,use the Webster’s Adult Intelligence Scale to assess the intelligence of pregnant women.At the same time,blood samples of pregnant women were collected for hemoglobin detection in the early,middle and late stages of pregnancy.The child questionnaire completed by the guardian after the child was born was conducted on the 42 th day of the child,every 3 months from 3 months to 12 months,from 1.5 Follow up every 6 months from the age of 6 years.Breastfeeding information is collected during the physical examination of the infant at 42 days,3 months and 6 months.ASQ-3 is used to evaluate the developmental behavior of infants at 6 months and 18 months.After excluding twins,halted embryo development,spontaneous abortion,therapeutic induction,stillbirth induction,and ectopic pregnancy,there were 3273 single live births.Among them,500 infants and young children who did not complete the ASQ-3 evaluation were excluded,and 154 pregnant women whose hemoglobin value was not tested were excluded.Finally,2619 pairs of mothers and infants were included.A multivariate logistic regression model was used to analyze the relationship between anemia and hemoglobin levels in different pregnancy and infant delays,and the analysis was carried out by stratification of maternal intelligence and breastfeeding.ResultsThe average hemoglobin concentration in the first trimester is the highest(127.57±9.28g/L),the average hemoglobin concentration in the third trimester is the middle(115.88±10.05g/L),and the average hemoglobin concentration in the second trimester is the lowest(114.85±9.42g/L);The prevalence of intermediate and advanced anemia was 3.3%(87/2619),27.0%(707/2619),and 26.8%(701/2619).The rates of communication,gross movements,fine movements,problem solving,and personal-social development delays of 6-month-old infants and toddlers were 3.6%,4.8%,4.5%,5.2%,and 3.8% respectively;18-month-old infants’ communication,gross movements,the rates of fine motor,problem solving,and personal-social ability development delay were 2.1%,3.2%,6.3%,3.7%,and 3.5%,respectively.Compared with infants delivered by non-anemic pregnant women,anemia during pregnancy was not statistically associated with developmental delay in 6-month-old infants;anemia in the second trimester was a risk factor for developmental delay in the communication area of 18-month-old infants(RR= 2.55,95%CI:1.29~5.03),anemia in the third trimester of pregnancy is a risk factor for developmental delay in the personal-social zone of 18-month-old infants(RR=2.16,95%CI: 1.23~3.79).After controlling for the confounding factors,anemia during pregnancy was not statistically associated with developmental delay in 6-month-old infants;anemia in the second trimester was a risk factor for developmental delay in 18-month-old infants(RR =2.86,95%CI:1.36~6.02),anemia in the third trimester is a risk factor for developmental delay in the personal-social zone of 18-month-old infants(RR=2.49,95%CI:1.39~4.47).Stratified by breastfeeding and adjusted for confounding factors,compared with infants delivered by non-anemic pregnant women,anemia during pregnancy in the breastfeeding group was not statistically associated with growth retardation in 6-month-old infants;anemia in the second trimester of the artificial feeding group(RR = 2.45,95%CI: 1.02~5.91)is a risk factor for 6-month-old infants and young children’s communication area developmental delay,anemia in the second trimester(RR=3.07,95%CI:1.10~8.51)and anemia in the middle and late stages(RR=2.68,95%CI:1.03~6.95)is a risk factor for 6-month-old infants’ personal-social developmental delay.Anemia in the second trimester of the breastfeeding group(RR = 3.67,95%CI:1.43~9.38)is a risk factor for developmental delay in the communication area of 18-month-old infants,and anemia in the second trimester(RR=2.35,95%CI:1.05~5.27)Is a risk factor for growth retardation in the gross motor area of 18-month-old infants.Anemia in the second trimester(RR = 2.60,95%CI:1.14~5.91)and anemia in the third trimester are the developmental retardation of 18-month-old infants and young children.The risk factors(RR=2.61,95% CI: 1.22~5.57).Anemia during pregnancy in the artificial feeding group was not statistically associated with the development of 18-month-old infants.Stratified according to the intelligence of pregnant women and adjusted for confounding factors,compared with infants delivered by non-anemic pregnant women,anemia in the second trimester of pregnant women with normal intelligence(RR = 2.20,95%CI: 1.14~4.24)is the 6-month-old infant’s communication ability Anemia in the middle and late trimesters of the mental retardation group(RR = 3.29,95%CI: 1.20~9.07)is a risk factor for 6-month-old infants and young children with personal-social capacity retardation.Anemia in the second trimester of pregnant women with normal intelligence(RR=3.04,95%CI:1.11~8.29)is a risk factor for developmental delay in the communication area of 18-month-old infants;anemia in the second trimester(RR= 2.20,95%CI:1.02~4.72))is a risk factor for growth retardation in the gross motor area of 18-month-old infants.Anemia in the third trimester of the mental retardation group(RR= 4.44,95%CI:1.42~13.86)is a risk factor for 18-month-old infants’ personal-social capacity retardation.After controlling for related confounding factors,it was found that compared with infants delivered by pregnant women with normal Hb levels,low Hb levels in the second trimester(RR =1.61,95%CI:1.02~2.56)are the result of 6-month-old infants’ personal-social energy zone developmental delay Risk factors.Low Hb level in the first trimester(RR=2.30,95%CI:1.08~4.90)is a risk factor for developmental delay in fine motor energy areas of 18-month-old infants;low Hb level in the second trimester(RR = 2.30,95%CI:1.24~4.29)is a risk factor for developmental retardation in the communication motor zone of 18-month-old infants.ConclusionsThe hemoglobin concentration is highest in the first trimester,second in the third trimester,and lowest in the second trimester.The prevalence of anemia is highest in the second trimester,second in the third trimester,and lowest in the first trimester.Anemia in the second trimester affects the development of the communication area of 18-month-old infants,and anemia in the third trimester affects the development of the infant’s personal-social energy area.Breastfeeding and maternal intelligence have a moderating effect on the developmental behavior of infants and young children. |
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