| Objective To describe the state of mental health of pregnant women during gestation period, access the level of energy and nutriment during pregnancy and associate the birth weight of newborns with psychology and diet nutrition during pregnancy.Method The target population of the study was the pregnant women, who had regularly visited the Hospital-based outpatient gynecology clinic of Anhui Provincial Hospital from Oct, 2008 to Dec, 2009. According to the the inclusion and exclusion criteria, we set up the prospective observation cohort after gaining the informed consent. At last the completed data of 434 subjects were collected. The basic information and the history about former pregnancy and illness and the first trimester prenatal diagnostic profiles of the pregnant women who were in the cohort were gathered through the questionnaire. Subsequently, regular follow-up and measurements about physical indexes were carried out under the obstetricians, the follow-up were not ended until the delivery and the information about the parturition condition and the newborn were collected from the obstetric records. A number of measuring scales, such as BAI (Beck Anxiety Inventory), CES-D (Center for Epidemiological Survey,Depression Scale), and LES (Life Event Scale) were used to evaluate the mental condition of the pregnant and implement the first diet surveys in the mid trimester of pregnancy. And BAI and CES-D were used to evaluate the mental conditions of the pregnant again as well as the second diet surveys during the late trimester of pregnancy. The trophic analysis system was used to analyze the level of energy and nutriment intakes during pregnancy. According to the gestation age and birth weight, the newborns was divided into three groups: small for gestational age infants (SGA), appropriate for gestational age infants (AGA) and large for gestational age infants (LGA). The collected data were analyzed by SPSS (statistical package for social science) 10.0.Chi-square test was used to compare the rate between the psychological and nutritional factors and the birth weight. Paired chi-square was used to analyze the depression rate between the mid trimester and the late trimester of pregnancy. Two-independent-sample t test was used to compare the mean between psychological factors and weight gain during pregnancy or birth weight. ANOVA (Analysis of Variance) and Pearson correlation were used to analyze the relationship between the energy and nutriments intakes and weight gain during pregnancy, and also used to analyze the relationship between the energy and nutriments intakes during pregnancy and birth weight. Multiple logistic regression analyses were used to find out the main influential factors on neonate birth weight during gestational period.Results (1) The relationship between demographic characteristics of pregnant women and birth weight: There were 247 male newborns (56.9%), 187 female newborns (43.1%). the average birth weight was (3385.9±396.4) g. The detection rates of SGA and LGA were 6.7% (29/434) and 22.6% (98/434) respectively. Among the three groups of pregnant women whose age were <25, 25-34 and≥35 years old, the incidences of SGA children were 3.1%, 7.4% and 2.8%; the incidences of LGA were 21.9%, 22.1% and 27.8%, respectively. No significant difference was found between them. The birth weight of newborns by pregnant women of different educational level, family incomes, spouse's education levels and ages showed no significant difference too. The incidence of SGA children of the initial pregnant women was significant higher than that of the pregnant women who had the history of pregnancy. There was no significant difference between the birth weight of newborns by pregnant women with childbirth complications and by normal pregnant women. Newborns'birth weights were significantly different among women with different pre-pregnancy BMI.(2) The relationship between mental condition of the pregnant and birth weight: The depression score was 8.0±5.9 in the mid trimester of the pregnancy, and 8.2±6.3 in the late trimester of the pregnancy;the anxiety score was 30.3±6.9, and 30.3±7.0 in the late trimester of the pregnancy, there was no significantly different between them. There was no relationship between depression, anxiety and weight gain during pregnancy. The birth weight of newborns by pregnant women with depression symptoms showed no significant difference to that of normal pregnant women. The newborn's birth weight of the pregnant women with anxiety in the mid trimester was significantly lower by that of pregnant women without anxiety, while no significant difference was found in late pregnancy. The rate of fetal growth restricted among anxiety group (57.9%) in the mid trimester is significantly higher than that of the group without anxiety(4.3%), and the rate of fetal growth restricted of anxiety group (19.4) in the late trimester of pregnancy was statistically higher than that of the group without anxiety group(5.7%). There was no relationship between the life event and birth weight.(3) The relationship between energy and nutriments intakess and birth weight: The intakess of energy, carbohydrates, VitC, VitE and iron in the mid trimester of pregnancy were significant higher than that in the late trimester of pregnancy. The energy and nutriments intakess of low-weight-gain group in pregnant women were significant lower than that of other groups (2083.5±396.6). There was no significant difference in the late trimester of pregnancy. The energy, protein and VitE intakes in pregnant women of SGA group were significant lower than other groups, and the amount of average intake was 2083.9±310.1,102.1±22.2和11.5±4.1. There was no significant difference in energy and nutriments intakes in the late trimester of pregnancy. Qualitative comparison showed that higher protein and VitE intakess in the mid trimester of pregnancy lead to lower birth rate of SGA infants, the rate were 2.9%,2.9%和4.8% . The nutrition of pregnant women with advanced structure of the three groups is consistent through the pregnancy. The average daily intakes of total energy, protein, VitE, zinc and selenium content and birth weight were positively correlated in the mid trimester. Energy in late pregnancy and dietary nutrient intakes showed no significant relation with newborn's birth weight.(4) The relationship between mental conditions and energy, nutriments intakess in pregnancy: There was no significant difference between depression and energy and nutriments intakes both in the mid trimester of pregnancy and the late trimester. There was no significant difference between anxiety and energy and nutriments intakes both in the mid trimester of pregnancy and the late trimester. The intaks of energy, protein, fat, calcium and selenium of the anxiety group in the late trimester of pregnancy were significant higher than that of the non-anxiety group. There was no relationship between life event in pregnancy and energy and nutriments intakes.(5) Analysis on the multiplicity of newborn's birth weight: After the control of a variety of confounding factors, depression in the mid trimester of pregnancy can increase the rate of SGA infant; more protein intakes and higher BMI in progestation can increase the rate of LGA infants.Conclusion The Social-psychological stress problems are serious during pregnancy. Anxiety both in mid and late trimester of pregnancy may have adverse effect on fetal growth. Inadequate energy and protein intakes can reduce the birth weight. It is important to pay attention to physiological health care and nutrition to pregnant women. |
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