| Objectives:To explore the effects of maternal pre-pregnancy body mass index(BMI) and gestational weight gain on physical development of neonates, and analyze the correlations between pre-pregnancy BMI and gestational weight gain and indexes of neonatal physical development. To investigate the effects of pre-pregnancy BMI, gestational weight gain and feeding patterns on early physical development of infants. To study the relationships between the levels of leptin and adiponectin in cord blood and neonatal growth and possible regulatory mechanisms of leptin and adiponectin in cord blood on neonatal growth. Methods:Total of 546 data of healthy pregnant women without pregnancy complications and their neonates were collected from August 2013 to April 2014 at the obstetrical department of the Third Affiliated Hospital of Zhengzhou University. Total of 382 physical examination data of infants aged 6 week-old were collected. After delivery of the baby, 10 ml of venous cord blood were collected and the sera were separated after centrifugation. The levels of cord serum leptin, adiponectin, total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), and triglyceride(TG) were measured. According to pre-pregnancy BMI, pregnant women were divided into three groups: low weight group, normal weight group, and overweight and obesity group respectively. According to gestational weight gain, pregnant women were divided into three groups: low, normal and high weight gain groups respectively. According to the birth weight and gestational age, the neonates were divided into three groups: small for gestational age group(SGA), appropriate for gestational age(AGA), and large for gestational age(LGA) respectively. According to feeding patterns, infants aged 6 week-old were divided into three groups: breast feeding, mixed feeding, and bottle feeding groups respectively. The statistical methods including t-test, chi-square test, analysis of variance, bivariate correlation analysis and multiple linear regression were used to analyze the data. The relationships between pre-pregnancy BMI and gestational weight gain, and birth weight, length, head circumference and Ponderal index of neonates, between pre-pregnancy BMI, gestational weight gain and feeding patterns, and weight, length, head circumference and Kaup index of infants aged 6 week-old were analyzed. The levels of cord blood leptin, adiponectin, and blood lipid profiles among different gestational age infants and different gender were compared. The relationships between serum levels of leptin and adiponectin in cord blood and growth parameters of neonates were analyzed. Results:(1) The incidence of SGA in low weight group was significantly higher than that in normal weight group and overweight and obesity group(P<0.01). The birth weight, body length, and head circumference of neonates in both normal weight group and overweight and obesity group were higher than that in low weight group(P<0.05). The Ponderal index of neonates in overweight and obesity group was higher than that in low weight group(P<0.05). The birth weight of neonates in overweight and obesity group was higher than that in normal weight group(P<0.05). The neonatal birth weight, body length, head circumference, and Ponderal index were positively correlated with pre-pregnancy BMI(P<0.05).(2) The incidence of LGA, neonatal birth weight, body length, and head circumference in high weight gain group were markedly higher than that in low and normal weight gain groups(P<0.01). The Ponderal index of neonates in high weight gain group was significantly higher than that in low weight gain group(P<0.01). The neonatal birth weight, head circumference, and Ponderal index in normal weight gain group were higher than that in low weight gain group(P<0.05). The neonatal birth weight, body length, head circumference, and Ponderal index were positively correlated with gestational weight gain(P<0.01).(3) There were no significant differences among different pre-pregnancy BMI groups for body weight, length, head circumference, and Kaup index in infants aged 6 weeks(P>0.05), while the body weight, length, head circumference, and Kaup index of infants aged 6 week-old were higher in high weight gain group than that in low and normal weight gain groups(P<0.01). The body weight and head circumference of infants aged 6 weeks-old in normal weight gain group were higher than that in low weight gain group(P<0.05).(4) Both of body weight and net weight gain in breast feeding group of infants aged 6 weeks were higher than that in mixed and bottle feeding groups(P<0.05). The body length of infants aged 6 weeks was larger in breast feeding group than that in bottle feeding group(P<0.01). The net increase of head circumference of infants aged 6 weeks was more in breast feeding group than that in mixed feeding group(P<0.01).(5) The level of cord blood leptin was higher in LGA group than that in SGA and AGA groups(P<0.05). The level of cord blood adiponectin in LGA group was higher than that in AGA group(P<0.01). There were no significant differences between different gender groups for serum levels of leptin and adiponectin in cord blood(P>0.05). The serum levels of TC, HDL-C, LDL-C and TG in cord blood were not significantly different among different birth weight groups(P>0.05), as well as different gender groups(P>0.05).(6) The neonatal birth weight, body length, head circumference, Ponderal index, and placental volume & weight were positively correlated with the levels of cord blood leptin and adiponectin respectively(P<0.05). Conclusions:(1) Both pre-pregnancy BMI and gestational weight gain are positively associated with neonatal physical development. Gestational weight gain is positively associated with the incidence of LGA. Pregnancy nutrition guidance should base on pre-pregnancy BMI, and guide the pregnant women to reasonably control energy intake and to achieve appropriate weight gain during pregnancy for good birth outcomes.(2) Gestational weight gain is positively associated with the physical development of infants aged 6 weeks. The effect of gestational weight on neonatal growth still exists by infancy of 6 weeks.(3) Compared with mixed and bottle feeding, breast feeding is more beneficial to physical growth of infants at 6 weeks of age.(4) The serum levels of leptin and adiponectin in cord blood are positively associated with neonatal physical development. Cord blood leptin and adiponectin may be involved in the regulation of fetal growth. |
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