The Associations Of Dietary Quality During Late Pregnancy With Fetal Immune Function And Fetal Growth

BackgroundThe body develops rapidly in the fetal period,and needs sufficient dietary nutrition to ensure the normal development,maintenance and expression of various systems of the body.The theory of "fetal programming" points out that nutrition exposure during pregnancy may affect the coding of fetal organ system and homeostasis pathway of internal environment,thus affecting the subsequent pregnancy outcome and even the occurrence and development of diseases.Thus finding out the regulation and effect of nutrition during pregnancy on fetal intrauterine growth and development and immune function is not only of great significance to obtain a good pregnancy outcome,but also can lay a foundation for preventing adult disease risk from the source.Objective1.Explore the relationship between the dietary quality of pregnant women in late pregnancy and the immune function and growth of the fetus2.Analyze the main dietary factors affecting the growth and development of the fetus and its immune function3.Provide scientific basis for taking targeted nutritional intervention measures to obtain a good pregnancy outcomeMethodsA cross-sectional study method was adopted in this study.533 pregnant women in the third trimester who were going to give birth in Yuexiu District and Baiyun District Maternal and Child Health Care Hospital of Guangzhou were selected as the research objects.The general information of the population was collected at the time of recruitment,and a 3-day 24-hour dietary review questionnaire was used to investigate the dietary status.The quality of diet during pregnancy was evaluated by DQI-P,DBI-P and aMED and the dietary patterns was extracted by principal component analysis.The physical data of newborns were measured and cord blood was collected at delivery.Laboratory detection of immunological indicators included IgG,IgA,IgM,IFN-y and IL-6.Spearman correlation analysis and multiple linear regression analysis were used to explore the correlations between dietary quality during pregnancy and fetal immune function,fetal growth.Resultsl.Compared with the diet pagoda during pregnancy,the daily intakes of cereals(254.1±132.2g/d of 225～275g/d)and aquatic products(87.6±88.0g/d of 75-100g/d)of study population reached the recommended level.Nuts(8.1±23.4g/d of 10g/d),vegetables(328.9±155.3g/d of 400～500g/d),fruits(170.7±145.5g/d of 200～350g/d)and eggs(40.5±41.3g/d of 50g/d)were slightly less than the recommended amount.Potatoes(9.5±27.4g/d of 75g/d),beans(6.8±14.9g/d of 20g/d),milk products(208.55±195.90g/d of 300～500g/d)were far below the recommended intake,and the intake of livestock and poultry meat(212.3±130.8g/d of 50～75g/d)was far more than the recommended level of the dietary pagoda.In addition to protein,fat and niacin,there was a serious imbalance in the intake of other nutrients.Over 30%objects’ daily average intake cannot reach 80%RNI/AI.2.The DQI-P score of this study is 99 points,with a total average score of 55.8±10.0 points.The average score for dietary diversity(0～20 points)is 16.8±2.6 points,the average score for dietary adequacy(0～45 points)is 27.5±6.1 points,the average score for dietary suitability(0～24 points)is 10.9±5.5 points,and the average score for overall balance(0～10 points)is 0.7±1.4 points,It showed that the dietary diversity of the study population was good,but the dietary adequacy,suitability and balance were poor.The overall dietary quality was low.DBI-P showed that only 0.6%of the study population had a balanced diet as a whole,and more than 67.9%of pregnant women had a moderate and high intake imbalance.AMED showed that there was a serious imbalance in the intake of beans and nuts in the study population,with 62.5%and 79.1%less than the median of the population.3.Through principal component analysis,three main dietary patterns of women in late pregnancy in Guangzhou were extracted:the "Mediterranean like diet" pattern,the "high grain potato and high vegetable meat diet" pattern and the "high bean and high poultry meat diet" pattern.4.DQI-P and IgG were positively correlated(β=0.143,P=0.038).DBI-P and IL-6(β=-0.177,P=0.005),DQI-P and IL-6(β=-0.155,P=0.010),aMED and IFN-γ(β=-0.161,P=0.006)were negatively correlated.There was a negative correlation between the mediterranean-like diet pattern in the third trimester of pregnancy and the level of fetal IL-6(β=-0.124,P=0.038).The "high grain potato and high vegetable meat diet" pattern is positively correlated with IgA(β=0.122,P=0.049)and IFN-γ(β=0.134,P=0.030).5.DQI-P and DBI-P had a positive regulatory effect on fetal birth weight(β1=0.125,P1=0.003,β2=0.088,P2=0.044)and birth length(β1=0.159,P1=0.009;β2=0.151,P2=0.001).The "Mediterranean like diet" pattern was positively correlated with fetal birth weight(β=0.087,P=0.043).The "high grain potato and high vegetable meat diet" pattern had a positive regulating effect on birth length(β=0.093,P=0.042).Conclusion1.The dietary quality of women in late pregnancy in Guangzhou is low,the dietary structure is unbalanced,and the intake of multiple nutrients is insufficient or excessive.It is recommended that pregnant women reasonably improve the dietary structure according to DQI-P and DBI-P,pay attention to the diversity,adequacy and suitability of dietary nutrition,and try to achieve a balanced diet.2.3 dietary patterns in the late pregnancy of women in Guangzhou were extracted:"Mediterranean like diet","high grain potato high vegetable meat diet" and"high bean high poultry meat diet"."Mediterranean like diet" and "high grain potato high vegetable meat diet" have a positive effect on the immune function and growth of the fetus.Pregnant women should refer to the 2 dietary patterns of "Mediterranean like diet" and "high bean and high vegetable meat diet",appropriately increase the intake of aquatic products and poultry meat,so as to promote the immune function and growth of the fetus.