423 Cases Of Maternal Nutrition During Pregnancy And Its Correlation With Neonatal Birth Weight

1. ObjectiveTo understand the mother's nutritional status during the third trimester, At the same time to study maternal nutrition and nutrition-related serum markers during the third trimester and their correlation with neonatal birth weight.2. MethodRandomly select pregnant women who were doing prenatal check in Maternal and Child Health Care Hospital of Yiwu or Dongyang County regularly and had been pregnant for 32 to 37 weeks from February 2010 to January 2011. About 423 cases of pregnant women were included. At the same time, venous blood was drawn from the included pregnant women to test nutrition-related serum markers (for example. Apolipoprotein Al, apolipoprotein B, C peptide, glycosylated hemoglobin, HDL-CH, insulin. LDL-CH, lipoprotein a, cholesterol, triglycerides). All pregnant women were followed up to delivery. According to neonatal birth weight. Pregnant women during the third trimester were divided into normal LBW group, NBW group and LBG group (three groups includes 12 cases,275 cases and 36 cases separately).3.Results①Through variance analysis, the pre-pregnancy weight, maternal BMI index and Weight gain during pregnancy among the three groups were significantly different (weight gain during pregnancy, P<0.05; the rest P<0.01). Through LSD method, the pre-pregnancy weight of LBW group was significantly lower than the NBW group (P<0.05), maternal BMI index and the weight gain during pregnancy of pregnant women between LBW group and NBW group were not significant different(P>0.05); the pre-pregnancy weight, maternal BMI index and Weight gain during pregnancy of LBG group were significantly higher than the NBW group (P<0.01), the pre-pregnancy weight, maternal BMI index and Weight gain during pregnancy of LBW group were significantly lower than LBG group (weight gain during pregnancy P<0.05, the rest P O.01).②Through variance analysis, pregnant women's intake of carbohydrates, dietary fiber. VitB2, VitC, calcium, iron, folic acid per person per day among LBW group, NBW group and LBG group were significantly different (folic acid P<0.01. the rest P<0.05). Intake of energy and the rest nutrients per person per day among LBW group, NBW group and LBG group were not significantly different (P>0.05). Through LSD method, pregnant women's intake of carbohydrates.dietary fiber. VitB2. VitC, calcium, iron, folic acid per person per day between LBW group and NBW group were not significant different(p>0.05); pregnant women's intake of carbohydrates, dietary fiber. VitB2. VitC. calcium, iron, folic acid per person per day of LBG group were significantly lower than the NBW group (carbohydrates, VitB2, iron P<0.05, the rest P<0.01) pregnant women's intake of carbohydrates. VitC per person per day of LBW group were significantly higher than that of LBG group (P<0.05);pregnant women's intake of dietary fiber. VitB2, calcium, iron, folic acid per person per day between LBW group and LBG group were not significant different (P>0.05)。Compared with the recommended nutrition intake (RNI) through one-sample T test, pregnant women's intake of average daily energy, protein, fat, carbohydrates, dietary fiber, VitB1, VitB2, VitC, calcium, iron, zinc, folic acid accounted for a percentage of RNI were 76.21%,94.84%,139.2%,46.51%,68.40%,77.33%,134.7%,82.59%, 63.35%,65.29%,95.76%,44.69%respectively (protein and zinc P> 0.05, the rest P<0.01); Through one-sample T test, pregnant women's intake of average daily carbohydrates of LBW group, NBW group, LBG group accounted for a percentage of RNI were 62.80%,70.33%,49.87% respectively(P<0.01); pregnant women's intake of average daily dietary fiber of the three groups accounted for a percentage of RNI were 62.80%,70.33%,49.87% respectively(P<0.01); pregnant women's intake of average daily VitB2 of the three groups accounted for a percentage of RM were 105.3%, 138.8%,102.4% respectively(NBW group P<0.01, the rest P> 0.05); pregnant women's intake of average daily VitC of the three groups accounted for a percentage of RNI were 101.00%,83.94%,62.37% respectively (LBW group P> 0.05, the rest P <0.01); pregnant women's intake of average daily calcium of the three groups accounted for a percentage of RNI were 64.34%,66.49%,53.31% respectively (P<0.01); pregnant women's intake of average daily folic acid of the three groups accounted for a percentage of RNI were 42.84% RNI,45.75%,34.27% respectively (P<0.01). After an investigation,92.91% of investigated pregnant women added calcium additionally. Respectively.28.84%,36.64%,43.50% and 7.33% of investigated pregnant women added an additional multivitamin preparations, iron, folic acid, zinc.Through one sample t test, energy production of carbohydrates, protein, fat separately had the proportion of total energy as 39.66±11.65%,17.99±3.61%,42.99±10.68%.And carbohydrates'proportion of total energy was less than the recommended proportion of carbohydrates (P<0.01). But the proportion of protein, fat production were higher than recommended proportions (P<0.01). Further compare the three major nutrients'proportion of total energy of three groups with recommended proportion, find the results are consistent with the above results.③Through variance analysis, among all the detected indicators of maternal s serum markers. ApoAl, ApoB, C peptide, HbAlc, LDL-CH, Lp a and cholesterol among the three groups had significant differences (the HbAlc and Lp a, both P<0.05; the rest, P<0.01). HDL-CH, insulin, triglyceride, fasting blood glucose among the three groups had no significant differences (P>0.05).Through LSD method. ApoAl of LBW group were significantly higher than the NBW group (P<0.01). The rest related serum mark-ers had no significant difference between the LBW group and the NBW groups (P> 0.05). Serum ApoAl. LDL-CH. cholesterol of LBG group were significantly lower than the NBW group (blood ApoAl P<0.05. the rest P<0.01). Serum HbAlc, ApoB, C peptide, and Lp a of LBG group were significantly higher than the NBW group (P< 0.05). Serum ApoAl, cholesterol and LDL-CH of LBG group were significantly lower than the LBW group (LDL-CH P<0.05, the rest P<0.01). Serum ApoB, C peptide, HbAlc, and Lp a of LBG group were significantly higher than the LBW group (HbAlc P<0.05, the rest P<0.01).④Though Pearson simple correlation analysis, find that there is obvious positive correlation between pre-pregnancy weight, pre-pregnancy BMI, weight gain during pregnancy, third trimester pregnant women and serum ApoB. C peptide. HbAlc and neonatal birth weight (r=0.288,0.240.0.194.0.210.0.165,0.165. P<0.01). In addition, there is obvious negative correlation between intake of VitC, ApoAl, LDL-CH, cholesterol and neonatal birth weight (r=-0.148,-0.133.-0.176. P<0.01). The rest nutrition-related markers had o significant linear correlation with neonatal birth weight (P>0.05).4.Conclusions ①In this research.all included pregnant women's intake of energy during the third trimester is lower than the RNI. And the structural of the three major nutrients is unbalanced. Intake of carbohydrate during the third trimester is significantly lower than the RNI. Intake of fat during the third trimester is significantly higher than the RNI. Intake of protein during the third trimester is among the normal range; During the third trimester, pregnant women's the daily intake of VitBl, VitC, calcium, iron and folic acid were significantly less than RNI.②here is obvious negative correlation between pregnant women's blood ApoAl-LDL-CH, cholesterol and neonatal birth weight, there is obvious negative correlation between pregnant women's blood ApoB, C peptide, HbAlc and neonatal birth weight.③pregnant women's intake of VitC per person during the third trimester which is lower than 102.98mg/d will increase the risk of LBG.④During the third trimester, pregnant women's serum ApoAl which is lower 2.02g/L or pregnant women's serum C peptide which is higher than 1.03 ug/L, or serum HbAlc which is higher than 5.66%, could be a warning indicator of LBG.