| Objectives:The aim of this study is to explore women’s dietary patterns during pregnancy and analyze their correlative factors in rural Yunnan,and to investigate the association between pregnant women’s dietary patterns and their infants cognitive development.Methods:1)A ambispective cohort study on the effects of women’s dietary patterns during pregnancy on infants cognitive development was established based on a birth cohort study in Xuanwei.The data about pregnancy were collected from previous study,infants were followed up for one year.2)Pregnant data included the social demographic characteristics(age,ethnic,occupation,the level of education,the annual household income),the history of pregnancy,previous health information,perceived stress status and passive smoking in the three trimesters,nutrient supplementation before pregnancy,husband’s alcohol consumption before one month of pregnancy.Moreover,gestational age,type of delivery,sex for infant,lengths,weights,and head circumferences at birth,neonatal asphyxia,birth defect.3)A self-designed questionnaire was conducted among the infant’s mother or primary caregivers by face-to-face when the infants were one-year old,including infants’health status,disease history,supplementary food,main caregiver,the duration of playing with infants everyday,lengths,weights,head circumferences.Meanwhile,12-months infants’ cognitive development was assessed by the Bayley Scales of Infant Development-Third Edition(BSID-Ⅲ).4)Women’s dietary patterns during pregnancy were divided into T1(low score)and T2(high score)according to the factor scores through Principal Component Analysis(PCA).Statistical methods included Independent-sample T Test,One Way ANOVA,Correlation Analysis,Chi-square Test,Logistic Regression and Multiple Linear Regression.And SPSS 26.0 was used for date analysis.Results:1)A total of 228 mother-child pairs were enrolled and followed in the study.The average age of pregnant women was 25.53±5.64.Han were the majority(88.6%).Women with middle school or below education were 82.0%.Farmers were 80.3%.Women with annual household income less than 30,000 yuan RMB accounted for 69.7%.The percentage of pre-pregnancy women had normal BMI was 68.0%and 53.1%of the women gained weight between 9 and 12 kg during pregnancy.Women fasting blood-glucose during pregnancy<7 mmol/L was 97.4%.Women had mild vomit in first trimester accounted for 81.8%.The majority of pregnant women(68.8%)were had two or more children.Women delivery types were natural birth accounted for 76.9%.The average gestational weeks of women delivery were 39.26±1.12 week.Among the infants,53.5%were girls.The average birth weight,length and head circumference of newborn were 3211.34±383.35g,50.26±1.34cm,33.89±1.67cm,respectively.Infants were taken care by mother were 94.6%and added supplementary food below 6 months of age account for 55.7%,supplementary food were eggs(96.2%),fruits(94.7%),cereals(93.8%),vegetables(92.8%)and meat(88.4%).Given nutrients supplements mainly calcium and vitamin D were 53.9%.Infants did not add milk powder were 67.4%.2)Three dietary patterns were gained in three trimesters as well as in the combined second and third trimester of pregnancy.The first pattern was the pickling(Chinese sauerkraut,ham).The second pattern was animal protein(animal organs,livestock meat,poultry meat,fish and shrimp).The third pattern was the traditional(potato/sweet potato,rice noodles and products,vegetables).T2 group in three patterns were 60.1%,49.1%45.6%,respectively.3)Binary Logistic Regression Analysis showed that the pregnant women in summer and autumn in the third trimester were 13.607 times(P=0.004)and 6.599 times(P=0.009)more likely to choose the pickling pattern T2 group than those in winter.Pregnant women with high perceived stress in the second trimester was 0.275 times(P=0.004)more likely to choose the animal protein pattern T2 group than those with low perceived stress.4)Infants composite scores of cognitive was 98.84±16.66,ranged from 55 to 145.The incidence of Cognitive development delay and edge level at 12 months of age were 1.8%and 7.0%,respectively.Most of infants had average cognitive development accounted for 44.7%.5)The cognitive scores of 12-month-old infants was defined as the dependent variable,after controlling for other confounders,Multiple Linear Regression Analysis indicated that the traditional pattern(β=-12.272,P=0.002)was negatively associated with cognitive development of 12-month-old infants,primary caregiver with high school degree or above(β=12.476,P=0.035)was positively associated with cognitive development of 12-month-old infants.Conclusions:The dietary patterns of pregnant women in rural areas of Xuanwei can be divided into three types:the pickling pattern,the animal protein pattern and the traditional pattern in rural Yunnan.Pregnant women with low educational,high perceived stress in the first trimester,the season of summer and autumn in the third trimester are more likely to choose the pickling pattern.The cognitive development of infants in rural areas is moderate.The traditional pattern may delay infants of cognitive development. |
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