| Objective: The nutritional status of pregnant women has a vital impact on the shortterm and long-term health of both mother and child.Gestational Weight Gain(GWG)refers to the difference between the weight in the late pregnancy(within three days before delivery)and the weight before pregnancy,which is an intuitive indicator of pregnant women’s nutritional status.At present,the phenomenon of excessive GWG in pregnant women at home and abroad is serious,and the research conclusions about the influencing factors of GWG in pregnant women and its influence on the physical development of infants are still controversial.Therefore,in this paper,the China pregnant women’s GWG guidelines issued by China Nutrition Society in 2021 were used to define the suitability of pregnant women’s GWG,to study the influence of pregnant women’s GWG on infant’s physical development and leptin level in cord blood,to investigate the possible regulatory role of leptin in the influence of pregnant women’s nutrition on the physical development of infants,and to further study the influencing factors of excessive GWG in pregnant women,so as to provide reference for taking effective measures to control pregnant women’s GWG within a reasonable range,to provide reference for formulating effective intervention measures to prevent the occurrence and development of overweight and obesity in children and adolescents from early life.Methods: This study is a mother-child cohort study.A total of 464 mother-child pairs hospitalized and delivered in a third-class hospital in Shenyang were selected as the study participants from September,2019 to September,2020 by the convenient sampling method.With the pregnant women’s informed consent,a face-to-face questionnaire survey was conducted by trained pediatricians to collect information about pregnant women’s basic characteristics,frequency of common food intake during pregnancy,diet and drinking,exercise and sleep,and to measure their height and weight within three days before delivery.Through the delivery records,the information of newborn’s gender,gestational age,birth length,birth weight,birth head circumference,birth chest circumference and so on was collected.Obstetric medical staff collected umbilical vein blood samples of newborns,and randomly selected 74 samples to detect the leptin level of umbilical cord blood.A pediatrician with unified training followed up 6-month-old and 1-year-old infants,collected information on infant feeding methods and complementary foods,and measured infant weight and body length.Results:(1)A total of 464 mother-child pairs were included in this study,and 414 6-month-old infants and 408 1-year-old infants were followed up.The average GWG of pregnant women was 16.52±5.77 kg,The detection rate of insufficient GWG in pregnant women was 6.3%,and the detection rate of excessive GWG was 70.9%,and only 22.8%had suitable GWG.The detection rate of macrosomia was 7.1%,and the detection rates of small for gestational age(SGA)and large for gestational age(LGA)were 6.3% and10.6% respectively.(2)The results of linear regression analysis showed that after adjusting various confounding factors,The excessive GWG in pregnant women would significantly increase the birth weight(β=0.199,95%CI: 0.118-0.280,P<0.001),birth length(β=0.441,95%CI: 0.111-0.771,P<0.05),birth head circumference(β=0.544,95%CI:0.220-0.867,P<0.05)and birth chest circumference(β=0.533,95%CI: 0.242-0.896,P<0.05)in newborns.Logistic regression analysis showed that after adjusting various confounding factors,excessive GWG in pregnant women would increase the risk of LGA(OR=7.291,95%CI: 1.729-30.750).(3)The results of linear regression analysis showed that after adjusting various confounding factors,pregnant women’s GWG had no significant effect on the weight and length of 6-month-old and 1-year-old infants,But Pearson correlation analysis showed that the birth weight of newborns was positively correlated with the weight of6-month-old and 1-year-old infants(r=0.341,P<0.001;r=0.297,P<0.001).(4)Spearman correlation analysis showed that the level of leptin in cord blood was positively correlated with GWG of pregnant women and birth weight of newborns(r=0.255,P=0.028;r=0.434,P<0.001),but was not associated with the weight of 6-month-old and 1-year-old infants.(5)The results of univariate analysis showed that pregnant women’s body mass index(BMI)before pregnancy,education level,daily fruit intake frequency,daily lean meat intake frequency,meal times after pregnancy,liking sour taste after pregnancy and TV watching time every day were the influencing factors of pregnant women’s excessive GWG.(6)Multivariate Logistic regression analysis showed that pregnant women liked sour taste after pregnancy(OR=1.824,95%CI: 1.011-3.292)and watched TV for ≥ 1 hour every day(OR = 1.847,95% CI: 1.138-2.996)were the risk factors for excessive GWG.In addition,compared with pregnant women with normal weight before pregnancy,pregnant women with low weight before pregnancy had a lower risk of excessive GWG(OR=0.481,95%CI: 0.250-0.923).Compared with pregnant women who take meals 3times a day after pregnancy,pregnant women who taked meals 2 times a day after pregnancy had a lower risk of excessive GWG(OR=0.241,95%CI: 0.081-0.711).Conclusion:(1)The phenomenon of abnormal GWG in pregnant women was serious in this study.The detection rate of insufficient GWG in pregnant women was 6.3%,and the detection rate of excessive GWG was as high as 70.9%,which is higher than the previous research results.(2)Excessive GWG in pregnant women will affect the physical development of newborns.Leptin may play a regulatory role in neonatal birth weight gain caused by excessive GWG in pregnant women.The birth weight of newborns is positively correlated with the weight of 6 months and 1 year old infants.(3)The risk factors of excessive GWG in pregnant women are: liking sour taste after pregnancy,and watching TV for ≥1h every day. |
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