| Objective:Adverse pregnancy outcomes are a major public health problem that affects reproductive health and the quality of the birth population.Nutritional factors are important environmental factors in this disease.Because of the high correlation among nutrients or foods,studies of single nutritional factors are difficult to derive their independent effects,and interventions are difficult and prone to nutritional imbalance.However,no study has yet explored the impact of dietary patterns that integrate multiple foods or nutrients and their dynamics during pregnancy on adverse pregnancy outcomes in a holistic manner.In this study,a birth cohort study design was used to investigate the dietary habits of more than 800 pregnant women at different gestational periods and to collect pregnancy-related outcomes.By analyzing the combined effects of overall dietary patterns and their changes on adverse pregnancy outcomes at different gestational stages,the dietary pattern with the greatest overall effect on the disease was established to provide a scientific basis for maternal dietary interventions.Methods:A prospective cohort study design was used to recruit about 800 women of childbearing age aged 20-45 who were filed in the Department of Obstetrics and Gynecology of Ganzhou maternal and child health hospital from December 2020 to December 2022.Food frequency questionnaire(FFQ)was conducted in the early,middle and late stages of pregnancy to calculate the average daily intake of each food and the intake of nutrients.The pregnancy outcomes were followed up,and 736 pregnant women were finally included according to the inclusion and exclusion criteria.The dietary pattern of pregnant women was extracted by principal component analysis.The socio demographic characteristics of dietary patterns were analyzed by ANOVA.Multiple linear regression models and Logistic regression models were used to analyze dietary patterns and Gestational diabetes mellitus(Gestational weight gain,GWG),gestational anemia,pregnancy induced hypertension(pregnancy induced hypertension),and so on.Pre eclampsia,abortion and overdue pregnancy.The relationship between gestational age,fetal weight for asphyxia(SGA),fetal weight for preterm infants(SGA),and neonatal asphyxia(SGA).All data collected were collected using spss33 0 statistical software for processing.The measurement data is expressed by(x ± s),the inter group data is expressed by independent sample t-test,the intra group data is expressed by paired sample t-test,and the counting data is expressed by(%),χ 2 test,P < 0.05,the difference was statistically significant.Results:(1)A total of 736 pregnant women were included in this study,including 263 pregnant women with adverse pregnancy outcomes(observation group)and 473 pregnant women in the healthy control group.The results of FFQ survey in the third trimester of pregnancy showed that the daily intake of vitamins A and C,shrimp,crab,shellfish,fish,miscellaneous grains,green leafy vegetables and fresh fruits of pregnant women in the observation group were significantly lower than those in the healthy control group(P < 0.05).The dietary fat intake of the two groups was significantly higher than the clinically recommended energy supply ratio(P < 0.05),while the energy supply ratio of carbon and water was lower(P < 0.05).The intakes of vitamin B1,dietary fiber,calcium,iron and other trace elements in the two groups were less than 90% RNI or AI,suggesting the risk of insufficient intake.In addition,pregnant women with adverse pregnancy outcomes are at risk of insufficient intake of Protein,Vitamin C,Vitamin A.(2)Chi-square test shows that pregnant women who mainly use the "fruit and vegetable excellent protein diet mode(F1)" or "animal based food diet mode(F2)" in the early pregnancy have a lower probability of adverse pregnancy outcomes,while pregnant women who mainly use the "high sodium and high fat diet mode(F3)" or "aquatic product diet mode(F4)" diet modes have a higher rate of adverse pregnancy outcomes,The difference was statistically significant(P<0.05). Chi-square test showed that in the second trimester of pregnancy,the rate of adverse pregnancy outcomes was lower for pregnant women who mainly used the "fruit and vegetable protein diet model(F1)" dietary pattern,while the rate of adverse pregnancy outcomes was higher for pregnant women who mainly used the "high sodium and high fat diet model" dietary pattern,with a statistically significant difference(P<0.01).According to the Chi-square test,pregnant women with a "high sodium and high fat diet pattern" in the third trimester of pregnancy have a higher rate of adverse pregnancy outcomes(P<0.01)..(3)In the "fruit and vegetable excellent protein diet mode(F1)",education level and family income and expenditure have an impact on the average score of pregnant women’s "fruit and vegetable excellent protein diet mode(F1)".The F1 score increased with the improvement of pregnant women’s education level and family monthly income(P < 0.05).There were significant differences in the scores of "animal food dietary pattern(F2)" among pregnant women of different ages,education levels and times of delivery(P < 0.05).The scores of pregnant women with higher age and higher education level in this mode were significantly higher than those of pregnant women with lower education level(P < 0.001),and the scores of "animal food diet mode(F2)" of primipara were higher than those of postmenopausal women(P < 0.05).(4)In the dietary pattern of each survey object,the percentile method is used to group the high score,from low to high as Q1 ~ Q4.The distribution differences of different dietary patterns between pregnant women with adverse pregnancy outcomes(observation group)and healthy control group were analyzed and compared.Results there was significant difference in the factor scores of F1,F2,F3 and F4 dietary patterns between pregnant women with adverse pregnancy outcomes(observation group)and healthy control group(P < 0.05).Taking the occurrence of adverse pregnancy outcome as the dependent variable(1 = yes,0 = no),the factor score quartiles of dietary pattern(F1,F2,F3,F4 dietary pattern))Q1~Q4(Z1=0,Z2=0,Z3=0;Z1=1,Z2=0,Z3=0;Z1=0,Z2=1,Z3=0;Z1=0,Z2=0,Z3=1)were analyzed by logistic regression of disorderly classified variables,and then analyzed by linear analysis of ordered classified variables.After adjusting for other environmental factors,such as age,gestational week,pre pregnancy BMI,different types of physical activity,health-related behaviors such as drinking,sleep time,outdoor activities and other confounding factors,the results showed that the maternal F1 and F4 dietary pattern during pregnancy was the protective factor for the adverse pregnancy outcome of pregnant women(or = 0.58,95% CI: 0.25 ~ 0.98),(OR=0.70,95%CI:0.53~1.16);There was no significant correlation between F2 and F3 dietary patterns and adverse pregnancy outcomes(P>0.05).Conclusion:Adhering to the "Fruit and Vegetable Protein Dietary Model(F1)" and "Aquatic Product Dietary Model(F4)" during pregnancy is beneficial for reducing the risk of adverse pregnancy outcomes for pregnant women and their offspring. |
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