| Objective: To explore the influencing factors on infant growth and development during pregnancy,to provide a theoretical knowledge to prevent adverse birth outcomes and diseases in early life and to promote the growth and development of newborns.Methods: A prospective study was applied to enroll the respondents in the survey.The pregnant women who had regularly visited the Hospital-based outpatient gynecology clinic of Wuhan Women and Children Medical Center with plan to delivery in this hospital were recruited in the cohort between Sep,2012 and Oct,2014.The basic information of pregnant women and spouses were collected through self-designed questionnaires,maternal health manuals and medical records,including social demographic characteristics,physical characteristics,reproductive health,living and working behavior and other pregnancy information.Student t test,analysis of variance(ANOVA),SNK and Pearson correlation analysis were used to identify the differences of quantitative data.Chi-square test and Fisher’s exact test were used to analysis the differences of qualitative data.Maternal factors and neonatal birth weight,birth length and gestational age were subjected to multiple linear regression analysis respectively.Binary logistic regression was used to determine the correlation between maternal factors and low birth weight infant and macrosomia.Results:A total of 11,318 respondents were investigated,among those 11311 pregnant women were included into the study finally,excluding 5 cases of incomplete information,2 cases of stillbirth.The average age was 28.21±3.70 years.1.The influence factors of neonatal birth weight,birth length and gestational age factors by multiple linear regression analysis(1)Total annual income of the family,husbands’ education level,iron supplement during middle and terminal pregnancy,iron supplement during the whole period of pregnancy,pre-pregnancy height,pre-pregnancy weight,weight gain during pregnancy,continuing to work during pregnancy,GDM and the number of days of exercise per week during terminal pregnancy had positive influence on the birth weight of newborns.(2)The birth length of the newborns was positively related with total annual income of the family,husbands’ education level,pre-pregnancy height,pre-pregnancy weight,degree of weight gain,weight gain during pregnancy and number of days of exercise per week during terminal pregnancy.However,it was negatively related with smoking during half a year before pregnancy.The most influential factor was weight gain during pregnancy.(3)The gestational age of newborns was positively related with education level of pregnant women,husbands’ education level,total annual income of the family,weight gain during pregnancy and number of days of exercise per week during terminal pregnancy.However,it was negatively related with age,parity,gravidity and GDM.2.The influence factors of low birth weight,macrosomia and preterm by binary logistic regression analysis(1)The risk factors for low birth weight included the education level of spouses as junior high school and below(OR==2.00,95%CI: 1.46-2.72),the education level as junior high school and below(OR=1.64,95% CI: 1.21-2.21),the education level of spouses as high school and secondary school(OR=1.52,95%CI: 1.16-1.98)and exercise no more than 2 days per week in the third trimester(OR=1.46,95%CI: 1.18-1.81).Higher pre-pregnancy weight(OR=0.96,95%CI: 0.95-0.97),more weight gain during pregnancy(OR=0.88,95%CI: 0.85-0.92)and iron supplement during the whole period of pregnancy(OR=0.56,95%CI: 0.40-0.78)were protective factors.(2)The risk factors for macrosomia include GDM(OR=1.94,95%CI: 1.52-2.49),anemia(OR=1.88,95%CI: 1.34-2.64),more weight gain during pregnancy(OR=1.13,95%CI: 1.11-1.15)and the higher pre-pregnancy weight(OR=1.07,95%CI: 1.06-1.08).(3)The risk factors for preterm infants include smoking during half a year before pregnancy(OR=2.97,95%CI: 1.60-5.51),total annual income of husband and wife was less than 30,000 yuan(OR=2.59,95%CI: 1.29-5.18),education level of spouses as junior high school and below(OR=1.96,95%CI: 1.51-2.56),no more than 2 days of exercise in the third trimester(OR=1.84,95%CI: 1.54-2.20),education level as junior high school and below(OR=1.82,95%CI: 1.41-2.34)and spouse’s education level is high school and secondary school(OR=1.49,95%CI: 1.19-1.87).More weight gain during pregnancy(OR=0.93,95%CI: 0.91-0.96),iron supplement during middle andterminal pregnancy(OR=0.67,95%CI: 0.52-0.85)and the whole period of pregnancy(OR=0.66,95%CI: 0.51-0.86)were protective factors.Conclusions: There was a significant positive correlation between neonatal birth length and weight gain during pregnancy,and there was a negative correlation with smoking in the first half of pregnancy.Lower education level of husbands,GDM and smoking in the first half of pregnancy were risk factors of low birth weight children,macrosomia and premature infant respectively,suggesting that pregnant women should pay attention to pregnancy blood sugar,keep weight gain within a normal range,quit smoking half a year before pregnancy,and her husband should also enhance their education level. |
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