| Objective1) To understand nutritional status of pregnant women in the early and medium term.2) To evaluate the nutritional status of pregnant women in the early and medium term.3) To explore the correlation between the relevant nutrition indicators and pregnancyoutcomes (birth weight, gestational diabetes, postpartum hemorrhage)Method：Randomly select300cases of pregnant women who have filled in obstetricexamination forrms in the department of Obstetrics and Gynecology of the306thhospital of PLA frorm August to December in2010. All pregnant women are singlefetus, primiparous and natural conception, excluding these who have internal andsurgical diseases, and these who have diseases affecting the absorption of nutrientsduring pregnancy (such as gestational hypertension, placenta previa, single umbilicalartery, etc.). Dietary surveys are done in the the early term(11-12weeks) and themedium term (16-28weeks)but to avoid pregnancy vomiting. The lipids (TC, TG, HDLand LDL) and seven trace elements are detected by pumping blood in the early tern. Thedietary surveys are transformed into a variety of nutrients by using nutrition analysissoftware. All pregnant women in surveys are followed up to the end, excluding pregnantwomen who has pregnancy complications or fetal death or not delivery in our hospital.Finally we collect248cases of pregnant women who have filled in obstetricexamination forrms. Pregnant women are divided into three groups by birth weight,8cases of low birth weight (LBW),223cases of normal birth weight (NBW),17cases ofmacrosomia (LBG). Pregnant women are divided into two groups by having gestationaldiabetes or not,14cases of gestational diabetes (GDM),234cases of non-GDM.Pregnant women are divided into two groups by having postpartum hemorrhage or not,237cases of non-postpartum hemorrhage,11cases of postpartum hemorrhage. Data areanalyzed by using statistical software SPSS17. Statistical methods contain a singlesample T-test, independent samples T-test, analysis of variance, LSD method, Pearsonsimple correlation analysis.Results1) Nutritional status in the early term：the average intake of energy,protein, fat,carbohydrates, dietary fiber, vitamin B1,vitamin B2,vitamin C, Ca and Fe in theearly tern are1506.11±422.17Kcal,73.98±43.99g,37.56±20.11g,125.59±138.15g,12.76±10.78g,0.82±0.32mg,1.61±1.42mg,145.81±98.59mg,643.82 ±451.12mg,21.75±10.28mg. The Chinese food composition tables (2002) donot describe the nutrients recommended intake (RNI) of fat, carbohydrates anddietary fiber in the early pregnancy, so the there nutrients fail comparing with RNI.The RNI of energy, protein, vitamin B1, vitamin B2, vitamin C, Ca and Fe are2300Kcal,70g,1.5mg,1.7mg,100mg,800mg,15mg in the early term. Aftercomparison between the above nutrients and RNI, the results as follows: the intakeof energy, vitamin B1and Ca are insufficient(P<0.05), the intake of protein andvitamin B2are consistent with RNI(P>0.05), the intake of vitamin C and Fe arehigh(P<0.05). The average of serum trace elements (Ca, Mg, Fe, of Zn and Cu, ofCd, Pb) are1.17±0.11mmol/L,0.95±0.16mmol/L,110.88±25.18umol/L,105.49±28.87umol/L,13.47±2.32umol/L,0.037±0.013ug/dL,55.95±21.52ug/L, allof them are in reference range. The average of serum blood lipids (TC, TG, HDL,LDL)are4.66±0.78,1.39±0.59,2.04±0.38,2.01±0.52mmol/L, all of them are inreference range.2) The correlation between nutritional status and pregnancy outcome in the early term:the energy, protein, fat, carbohydrates, dietary fiber, vitamin B1, vitamin B2, vitaminC, Ca, Fe and TC, TG, HDL and LDL in LBW, NBW, LBG show no significantdifference (P>0.05). The energy, protein, fat, carbohydrates, dietary fiber, vitaminB2, vitamin C, Ca, Fe, the TC, HDL and LDL in GDM group and the non-GDMgroup show no significant difference(P>0.05). While vitamin B1and TG in the twogroups show significant difference(P<0.05). The energy, protein, carbohydrates,dietary fiber, vitamin B1, vitamin B2, vitamin C, Ca and Fe, the TC, TG and LDL inpstpartum hemorrhage group and non-pstpartum hemorrhage group show nosignificant difference(P>0.05). While fat and HDL in the two groups showsignificant difference(P<0.05).3) The dietary intake conditions in the medium term of pregnancy：the average intakeof energy, protein, fat, carbohydrates, dietary fiber, vitamin B1, vitamin B2, vitaminC, Ca and Fe in the medium term are2005.92±107.38Kcal,127.93±11.63g,46.08±8.47g,257.06±50.54g,18.87±1.90g,0.99±0.24mg,1.42±0.25mg,251.70±53.57mg,781.30±11.40mg,28.83±2.29mg. The Chinese food composition tables(2002) do not describe nutrients recommended intake (RNI) of fat, carbohydrates,dietary fiber in the medium term, so the there nutrients fail comparing with RNI.The RNI of energy, protein, vitamin B1, vitamin B2, vitamin C, Ca and Fe are2300Kcal,80g,1.5mg,1.7mg,130mg,1000mg,25mg. After comparison between theabove nutrients and RNI, the results as follows: the intake of energy, vitamin B1,vitamin B2and Ca in the medium term are insufficient(P<0.05). the intake ofprotein,vitamin C and Fe are high.4) The correlation between nutritional status and pregnancy outcome in the mediumterm：the energy, protein, fat, vitamin B1and vitamin B2in LBW, NBW, LBG show significant difference(P<0.05), after pairwise comparisons, energy intake betweenany two groups show significant difference(P<0.05). The intake of protein, fat,vitamin B1and vitamin B2show significant difference in LBW, LBG and NBW,LBG(P<0.05), but show no significant difference in LBW, NBW(P>0.05). Theintake of dietary fiber, carbohydrates, vitamin C, Ca and Fe show no significantdifference(P>0.05). The intake of energy, fat, dietary fiber, vitamin B1and vitaminC show significant difference in GDM and non-GDM (P<0.05). The intake ofprotein, carbohydrate, vitamin B2, Ca and Fe in the two groups show no significantdifference (P>0.05). The intake of energy, fat, carbohydrates, dietary fiber,vitamin B1, vitamin B2, vitamin C, Ca and Fe in pstpartum hemorrhage group andnon-pstpartum hemorrhage group show no significant difference(P>0.05). Whilethe intake of protein in the two groups show significant difference(P<0.05).Conclusion1) The energy, vitamin B1and Ca in the early term are insufficiently intaked, proteinand vitamin B2are still under the recommended intake, the intake of Vitamin C andFe are high2) The intake of energy, vitamin B1, vitamin B2and Ca in the medium term are lack,the intake of Protein, vitamin C and Fe are high3) Birth weight is positively correlated with prenatal BMI, prenatal weight, weightgain during pregnancy, and the intake of energy, protein, fat, vitamin B1and vitaminB2in the medium term4) The occurrence of GDM and postpartum hemorrhage are probably correlated withthe relevant nutrition indicators in the the early tern and medium term5) Compared to nutrition in the the early term, the nutrition in the medium term hasgreaterly impact on pregnancy outcome... |
