Association Of Maternal Micronutrients Levels During Pregnancy With Fetal Overgrowth And Childhood Obesity Based On A Retrospective Birth Cohort

Background: Fetal overgrowth is a common adverse pregnancy outcome,including macrosomia and large for gestational age.Macrosomia refers to newborns with birth weight greater than 4 kg,and large for gestational age refers to newborns with the same sex and gestational age above the 90 th percentile.Delivery of macrosomia can cause adverse short-term and long-term effects on pregnant women and fetuses,including increased cesarean section rate,shoulder dystocia,postpartum hemorrhage,perineal tear,prolonged labor,neonatal birth asphyxia,perinatal trauma,childhood obesity,and metabolic diseases.Studies have shown that large for gestational age infants and macrosomia will increase the risk of childhood obesity and cause a variety of long-term adverse consequences.Excessive weight gain during pregnancy,maternal nutrient intake,gestational diabetes,and high-fat diet are all factors that cause excessive growth of offspring.Among them,maternal nutrient levels play a fundamental role.Therefore,this study investigated the association between maternal nutrient levels during pregnancy and fetal overgrowth and childhood obesity through a large cohort.Objective: This study aims to explore the associations between maternal nutrient levels during pregnancy with fetal overgrowth and childhood obesity.Methods: Firstly,a retrospective birth cohort study sample database was established.The data were selected from pregnant women who underwent prenatal examination and delivery in Wuxi Maternal and Child Health Hospital from January 2012 to December2014.The self-compiled ’ Basic Information of Women and Children in Wuxi Birth Cohort ’ table was used to collect general demographic characteristics of pregnant women,pregnancy during pregnancy,delivery information,and child information.A total of 3823 pairs of mothers and their infants were included in study of association of micronutrients with birth outcomes,and 1005 pairs of mothers and infants were included in study of association of micronutrients with childhood obesity.Linear regression model was used to analyze the correlation between maternal micronutrients content during pregnancy and birth weight.Binary logistic regression model was used to analyze the correlation between maternal micronutrients level during pregnancy and large for gestational age and macrosomia,as well as the correlation between childhood obesity.Results: The average age of pregnant women in this study was(26.93 ± 3.15)years old.There were 2010 pregnant women(52.6 %)giving birth to male infants and 1813 pregnant women(47.4 %)giving birth to female infants.There were 310(8.11 %)women giving birth to macrosomia and 521(13.63 %)women giving birth to large for gestational age infants.The results of single factor chi-square test showed that there were significant differences in pre-pregnancy body mass index(BMI),gravidity,parity,neonatal sex,gestational age and fasting blood glucose levels between pregnant women with large for gestational age and macrosomia and other pregnant women.The results of linear regression analysis showed that maternal iron content during pregnancy was positively correlated with neonatal birth weight,and maternal zinc content during pregnancy was negatively correlated with neonatal birth weight.The results of binary logistic regression showed that insufficient maternal calcium intake during pregnancy increased the risk of greater than gestational age infants(OR = 1.42,95 % CI: 1.09-1.84).Excessive maternal iron intake during pregnancy may increase the risk of large for gestational age infants(OR = 0.61,95 % CI: 0.45-0.85).The results of gender stratification analysis showed that insufficient calcium intake during pregnancy increased the risk of greater than gestational age infants in pregnant women who delivered female fetuses.(OR = 1.54,95 % CI: 1.06-2.25).In pregnant women who delivered male fetuses,excessive intake of iron and zinc during pregnancy may increase the risk of giving birth to large for gestational age infants.(OR = 0.59,95 % CI: 0.38-0.92),and there were gender differences.However,the effect of maternal micronutrient levels during pregnancy on fetal growth and development did not continue into childhood.Conclusion: Maternal calcium,iron and zinc levels during pregnancy significantly affect fetal growth and development.Intake of more Iron and zinc can increase the risk of fetal overgrowth.Intake of less calcium increases the risk of fetal overgrowth,but the effect on fetal overgrowth does not last until childhood.