| ObjectiveThe purpose of this study was to explore the influence and correlation of body mass index(BMI)and weight gain during pregnancy on the growth and development of newborns.By detecting the levels of irisin,acylation stimulating protein(ASP),retinol binding protein-4(RBP-4)and prealbumin(PA)in umbilical cord blood,to explore the factors affecting the growth and development of newborn and the possible regulatory mechanism.Methods603 data of healthy pregnant women without pregnancy complications and their newborns were collected from the Department of Obstetrics of Shandong Provincial Hospital from June 2017 to September 2017.The umbilical vein blood was collected from the pregnant women after delivery and the plasma were separated after centrifugation.The levels of irisin,acylating protein,retinol binding protein-4 and prealbumin in umbilical cord blood were mensurate by enzyme linked immunosorbent assay(ELISA).According to body mass index before pregnancy,pregnant women were divided into four groups:low weight group,normal weight group,overweight and obesity group.According to pregnancy weight gain,pregnant women were divided into three groups:low,normal and high weight gain groups respectively.According to birth weight,newborns were divided into three groups:low birth weight group,normal weight group and macrosomia group;according to birth length,newborns were divided into three groups:the shorter birth length group,the suitable group and the longer group;according to ponderal index(PI),newborns were divided into less PI group,suitable group and larger group.The statistical methods including t-test,chi-square test,analysis of variance,rank sum test,two-variable correlation analysis,multiple linear regression and logistic regression were used to analyze the data.The relationship of between pre-pregnancy body mass index and pregnancy weight gain,and newborn birth weight,body length,and PI were analyzed.The levels of irisin,ASP,RBP-4 and PA in newborns with different body weight and sex were compared,and the relationship between them and neonatal growth and development was analyzed.Results1.The average body weight of boys was higher than that of girls(P<0.01),and the average body length of boys was longer than that of girls(P<0.01),There was no significant difference in PI between different sexes.2.There were significant differences in birth weight and PI of newborns with different pre-pregnancy BMI(P<0.01,P<0.05).The average birth weight of newborns in normal pre-pregnancy weight group and overweight group was significantly higher than that in low weight group(P<0.01,P<0.01).The average PI of the newborns with normal pre-pregnancy weight group and overweight group was higher than that of low body weight before pregnancy(P<0.05,P<0.01).There was no significant difference in the birth length of the newborns with different pre-pregnancy BMI(P>0.05).3.There were significant differences in birth weight,body length and PI among newborns with different gestational weight gain(P<0.01,P<0.01,P<0.01).There were significant differences in average birth weight,body length and PI of newborns between insufficient weight gain group and suitable weight gain group during pregnancy.There were significant differences in average birth weight,body length and PI between insufficient weight gain group and excessive weight gain group(P<0.01,P<0.01,P<0.01).The birth weight,body length and PI of the newborns in suitable weight gain and excessive weight gain group were significantly higher than that in the group of insufficient weight gain group.4.There was a positive correlation between BMI and birth weight before pregnancy(P<0.01)and no significant correlation with birth length(P>0.05).There was a positive correlation between gestational weight gain and birth weight,and body length(P<0.01),and a negative correlation with PI(P<0.01).5.There was no significant difference in the levels of irisin,ASP,RBP-4 and PA in cord blood among different BMI groups before pregnancy(P>0.05).The level of irisin in the insufficient weight gain group was lower than that in the suitable weight gain group and excessive group,and the difference was statistically significant(P<0.01,P<0.01).The irisin level in cord blood of girls was higher than that of boys(P<0.01).The level of irisin in cord blood of low birth weight infants and normal birth weight infants was lower than that of macrosomia,and the difference was statistically significant(P<0.01,P<0.01).The irisin level of cord blood of newborns with short birth length was lower than that of suitable body length group,and both of them were lower than those of macrosomia.The level of irisin in cord blood was lower in less PI group and suitable PI group than that in larger PI group.6.Cord blood irisin level was positively correlated with neonatal birth weight,body length and PI(P<0.01),and cord blood RBP-4 level was positively correlated with neonatal birth weight(P<0.05).7.Multiple stepwise regression analysis showed that pregnant women's parity,cord blood irisin level,gestational weeks of delivery and postpregnancy weight had influence on neonatal birth weight.Age of pregnant women,irisin level of cord blood and body weight after pregnancy have influence on neonatal PI.8.The results of logistic regression analysis showed that the probability of low birth weight and normal birth weight of girls was higher than that of boys with macrosomia as reference group.Much gestational weeks of delivery,high postpregnancy weight and high irisin level in cord blood is a risk factor for macrosomia.Conclusion1.There was a positive correlation between BMI and birth weight before pregnancy,and PI;between weight gain during pregnancy and birth weight,and body length.Irisin level in cord blood was positively correlated with birth weight,body length of newborn,and PI.The level of RBP-4 in cord blood was positively correlated with neonatal birth weight.2.Pregnant women's parity,cord blood irisin level,gestational weeks of delivery and postpregnancy weight had influence on neonatal birth weight.Age of pregnant women,irisin level of cord blood and body weight after pregnancy have influence on neonatal PI.3.Compared with boys,girls are more likely to develop low birth weight and normal birth weight,that is,boys are more likely to be macrosomia.Much gestational weeks of delivery,high postpregnancy weight and high irisin level in cord blood is a risk factor for macrosomia. |
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