The Birth Cohort Study Of The Association Between Dietary Energy During The Second Trimester And Gestational Weight Gain And Development In Infancy

Objective: In recent years,the situation of children’s overweight and obesity in China has become more and more serious,moving forward the time of the prevention of childhood obesity has becoming more and more important.Previous studies have shown that gestational weight and infant growth can affect the risk of childhood overweight and obesity,improving gestational weight and infant growth and development level may reduce the risk of childhood overweight and obesity.Studies have shown that energy intake and macronutrients energy ratio during pregnancy have significant associations with gestational weight and infant growth.This study aimed to describe the level of dietary energy intake and macronutrients energy supply ratio of women of childbearing age in Shenyang,considering the association between energy intake and macronutrients energy ratio in the second trimester of pregnancy and weight gain during pregnancy and growth and development in infancy,which provided evidence for the early prevention and treatment of overweight and obesity in children.Method: Prospective birth cohort studies were used.Healthy pregnant women with gestational ages of 21-24 weeks were recruited in 54 hospitals and community health service centers in Shenyang,and 902 pregnant women and their offspring were enrolled according to the exclusion criteria with informed consent.Collect basic information and lifestyle behavior information of pregnant women through questionnaires;Through a 3-day,24-hour questionnaire,information on maternal food intake in the second trimester was collected;Birth weight,birth length,weight from 1 to 12 months,and length from 1to 12 months were obtained through hospital birth records and follow-up of infants aged1-12 months.Results: 1.Among the 902 pregnant women,77.8% had a college degree or above,77.8%were pregnant women who were giving birth for the first time,26.1% were overweight and obese pregnant women,68.2% of pregnant women had excessive weight gain during pregnancy,the average daily energy intake in the second trimester was 1949.8kcal,59.7%of pregnant women had a high fat energy supply ratio,and 53% of pregnant women in the second trimester had a low carbohydrate energy supply ratio;Among the 902 infants,the incidence of macrosomia and large-for-gestational-age infants was 10.2% and 36.3%,respectively.2.Analysis of maternal and infant characteristics and weight in infancy showed that maternal ethnicity,education level,parity,body mass index before pregnancy,gestational weight,and infant gender may affect the weight of offspring.3.Compared with the Q1 quantile of average dietary energy intake in the second trimester,the risk of excessive gestational weight gain was increased by 1.14 in Q2(OR=2.14,P<0.001),and the risk of excessive gestational weight gain in Q4 decile(OR=2.01,P=0.001)was increased by 1.01,and too low dietary carbohydrate energy ratio had a protective effect on excessive gestational weight gain(OR=0.64,P=0.004).4.Compared with the Q1 quantile of average dietary energy intake in the second trimester,the Q2 quantile was positively correlated with 1 month age(β=0.26,P=0.030),8 months age(β=0.33,P=0.004)and 12-month age length(β=0.32,P=0.004);there was a negative correlation between Q2 quantile and weight-for-length z-score at 1 month of age(β=-0.30,P=0.010),and Q4 quantile was negatively correlated with weight-for-length z-score at 8 months of age(β=-0.28,P=0.007)and weight-for-length at 12 months.5.Low fat energy supply ratio in the second trimester was negatively correlated with the length of infants at 1 month of age(β=-0.47,P=0.009);high protein-to-energy ratio in the second trimester was positively correlated with infant length at 6 months(β=0.25,P=0.013).Conclusions: 1.Excessive maternal energy intake in the second trimester is a risk factor for excessive weight gain during pregnancy,low carbohydrate energy ratio is negative associated with excessive gestational weight gain,and the effect of fat energy supply ratio and protein energy supply ratio on excessive weight gain during pregnancy is not significant.2.Maternal energy intake in the second trimester may affect infant length rather than infant weight in the ratio of energy intake to macronutrient supply;high energy intake in the second trimester increases infantile length and decreases weight-for-infancy;high protein energy supply ratio in the second trimester increased the length of infants aged 6months;low fat energy supply ratio in the second trimester was negatively associated with the length of infants aged 1 month.The effect of carbohydrate energy supply ratio on infant growth and development in the second trimester was not significant.