Study On Dietary Quality Index And The Effect Of Weight Gain During Pregnancy On Their Newborns’ Bitrh Weight

Objectives To synthetically evaluate the dietary quality of pregnant women in Hefeiby using the adjusted Chinese Diet Balance Index （DBI） Evaluation System; and todiscuss the association of dietary nutrition factors during pregnancy and pregnancyweight gain with birth weight.Methods The participants of the present study were women of singleton pregnancywho had received a regular prenatal care in the Hospital-based outpatient gynecologyclinic of one of the hospitals in Hefei from Jan2010to Jan2011. All participants wererequested to provide written informed consent, and women who were ineligible wereexcluded. A total of511women were enrolled in the cohort study at last. Theinformation about their baseline, pre-pregnancy history, past medical history, thehealth examination and weight gain of first trimester were gain from aself-administered questionnaire. Followed up the participants until delivery andcollect the information about the mother and newborn from the obstetric medicalrecords. Used24-hour dietary recalls and three days24-hour dietary records with foodmodel, obtained the data about women’s dietary intake during pregnancy and analyzethe intake of energy and nutrients of the pregnant women by using nutrition analysissoftware. As to the score and the calculation of every food index in the adjustedDBI-07system, we evaluate the quality of the dietary with DBI-LBS, DBI-HBS andDBI-DQD. According to the range of the suitable BMI for China’s adultsrecommended by China Obesity Task Group of China office of International LifeSciences Institute in2002, the participants were classified as underweight if theirpre-pregnancy BMI<18.5, as normal weight if their pre-pregnancy BMI was between18.5and24.0, as overweight if their pre-pregnancy BMI was between24.0and28.0,and as obesity if their pre-pregnancy BMI>28.0. According to the range of weightgain during pregnancy recommended by the IOM, the weight gain was classified into three groups:<11.5kg,11.5~16kg and≥16kg. The newborn were classified as smallfor gestational age infant （SGA）, appropriate for gestational age infant （AGA）,large for gestational age infant （LGA） according to the neonatal birth weight valuesof different gestational age of15cities in China. We use Epidata3.0for the entry ofthe data and SPSS11.0（statistical package for social science） for the statisticanalysis. The Kruskal Wallis H rank sum test was used to compare the overalldistribution between groups of their dietary assessment. Chi-square test was used tocompare the rate of the groups, for the relationship among maternal socialdemographic characteristics, weight gain during pregnancy and the weight of thenewborn. When we compare the relationship of the dietary factors during pregnancy,weight gain during pregnancy and the neonatal birth weight, ANOVA, twoindependent sample t-test and Pearson correlation were used for the measurement dataand Chi-square test was used for the count data. Multiple-logistic-regression was usedto analyze the main factor that affect the dietary intake during pregnancy and theneonatal birth weight.Results （1）Maternal social demographic characteristics and neonatal birth weight:the average age of pregnant women is wa（s28.03±3.52）year-old and the height was（161.43±4.72） cm, the pre-pregnant weight was（55.72±7.54)）kg, pre-pregnantBMI wa（s21.33±2.70）and the neonatal birth weight wa（s3373.6±555.05）g. Therewere33SGA infants,329AGA infants,149LGA infants in the sample and theincidence was6.5%（SGA）,64.4%（AGA）,29.2%（LGA）. The maternal age wasdivided into four groups:<25year-old,25to30year-old,30-35year-old and≥35year-old. Detection rate of SGA children gradually decreased with increasing maternalage and there was no significant difference between the groups（P>0.05）. Moreover,there was no significant difference among the neonatal birth weight after divided intogroups according to the pregnant women’s educational level and occupation andparents’ income. There were67ones of underweight（13.1%）,365of normal weight（71.4%）,68of overweight（13.3%）,11of obesity（2.2%） according to the rangeof the suitable BMI for China’s adults recommended by China Obesity Task Group ofChina office of International Life Sciences Institute in2002, this study shows that with the reduce of prepregnancy weight, detection rate of SGA（small forgestational age）infants is higher, the difference between group with a statisticalsignificance. By using four points digits method, the pregnant woman have beendistributed according to the growth of BMI, the result display: value-added ofBMI small than4.78group gets the highest detection rate of SGA（39.4%）. Withthe maternal pregnancy weight gain, birth weight also increases accordingly.value-added of BMI more than7.10group gets the highest detection rate of largefor gestational age（LGA,31.5%）. There was a statistical significance differencebetween the groups.（2）Pregnancy dietary quality evaluation: this study groupis mainly excessive intake, while have the problems of insufficient intake. Takethe Diet Quality Distance（DQD)）analysis,48.1%of the pregnancy diets is moresuitable to the overall balance,51.1%of the overall balance diets in low levelsection, No one has serious dietary imbalance. Between the different educationdegree of the crowd, dietary quality have many differences. Low education levelof pregnancy women either inadequate or excessive intake of degree is higherthan the high cultural degree female. Age and economic income are alsoimportant factors which influence pregnancy dietary quality（.3）The relationshipbetween dietary intake of pregnant women on second-trimester and thirdtrimester with birth weight of newborn: In the second trimester to third trimester,energy intake of pregnant women above recommended nutrient intake （RNI）.Energy and protein intake during the second trimester and trimester of pregnancyare statistically significant differences （P<0.05）. According to neonatal birthweight and gestational age group analyses: In the second trimester, LGA infantsgroup’s average daily intake of energy, fat, carbohydrates, vitamins and mineralsare higher than the pregnant women of SGA infants group, three groups ofpregnant women’s daily energy intake, calcium, potassium, selenium arestatistically significant differences; in the third trimester, among theenergy-yielding nutrient of SGA infants group’s, fat and carbohydrate both higherthan the AGA infants group’s and SGA infants group’s, the others each nutrientsand minerals intake without too much difference, there were no significant differences of variance analysis.（4）By multivariate logistic regression model,it demonstrated that obesity before pregnancy and high intake of energy, calcium,and zinc during mid trimmest pregnancy were risk factors of LGA infants，andlow intake of energy was the protection factor.Conclusions The present study subjects had a diversiform diet during pregnancy,and dietary intake was appropriate as a whole, but excessive dietary intake wasexistent, we suggested strengthening health education on dietary nutrition ofpregnant women during pregnancy, and controlling energy and protein intakewhile the nutrients fulfilling pregnant women and fetal growth were confirmed.The BMI before pregnancy and pregnancy weight gain have effect on birthweight, we should strengthen the nutrition education and weight monitoring onpregnant women during the mid and late trimester.