| Objective To understand the characteristics of dietary structure and nutritional status of pregnant women in late pregnancy in Huaibei City,Anhui Province,analyze the level of energy-adjusted dietary inflammatory index(E-DⅡ)in late pregnancy and assess the effectiveness of E-DⅡ using inflammatory indicator,and explore the effect of E-DⅡ levels on low birth weight(LBW)in late pregnancy,so as to provide a basis for formulating scientific and reasonable dietary nutrition interventions during pregnancy.Methods Pregnant women who were registered and regularly examined for pregnancy at the Maternal and Child Health Hospital in Huaibei City,Anhui Province,from April 2021 to January 2022 were selected as the study population.The basic characteristics,maternal history and physical examination data of pregnant women were collected.The food frequency questionnaire was used to investigate the dietary intake of late pregnancy for 3 months,and the matrix idea of R language was applied to calculate the daily intake of energy and nutrients of pregnant women with reference to the Chinese food composition table(2018 version),and E-DⅡ was further calculated according to the formula.In addition,fasting venous blood was collected from pregnant women in late pregnancy and related inflammatory indicators were detected.Follow-up until delivery,recording gestational age at delivery,birth weight,length,mode of delivery,sex of the newborn,and the presence of LBW.Multiple linear regression and binary logistic regression were used to investigate the association of E-DⅡ scores with inflammatory indexes and low birth weight in late pregnancy,respectively.Results A total of 237 pregnant women who met the criteria were included.The intake of livestock and poultry meat,eggs and fruits during late pregnancy was appropriate,with the actual average daily intake accounting for 80.20%,112.00% and 119.64% of the reference intake,respectively;the intake of whole grains(20.64%),fish,shrimps and crabs(33.28%),fats and oils(36.36%),dairy(42.75%),potatoes(47.95%),nuts(51.20%)and vegetables(77.20%)was inadequate;excess intake of cereals(134.64%)and soybeans(166.65%).The ratio of macronutrient energy supply for pregnant women in late pregnancy was reasonable,with carbohydrate,fat and protein supplying 64.06%,29.6% and 15.04%,respectively.Carbohydrate,fat,magnesium,zinc,vitamin C,niacin,and vitamin E were sufficient,accounting for 111.41%,118.48%,113.45%,129.68%,130.05%,142.67% and 240.14% of the energy supply ratio or RNI/AI in late pregnancy,respectively;energy(85.68%),protein(85.29%),total vitamin A(89.75%),iron(97.17%)accounted for more than 80% of the energy supply ratio or RNI/AI in late pregnancy;while thiamin(56.67%),folic acid(63.59%),insoluble dietary fiber(67.64%),selenium(72.22%),riboflavin(75.33%)do not reach 80% of the RNI/AI,making it difficult to meet the nutritional needs of pregnant women in late pregnancy.The mean E-DⅡ in late pregnancy was 1.97 ± 0.84,with E-DⅡ values ranging from-0.61 to 3.64,and the overall late pregnancy diet showed a pro-inflammatory tendency.The E-DⅡ was grouped in three levels from low to high,with Q1 being the low E-DⅡ score group(-0.61 ≤ E-DⅡ ≤ 1.70),Q2 being the intermediate group(1.71 ≤ E-DⅡ ≤ 2.27),and Q3 being the high E-DⅡ score group(2.28 ≤ E-DⅡ ≤ 3.64).Comparison of the mean daily intake of food and nutrients in different E-DⅡ score groups in late pregnancy showed that the intake of food and nutrients was significantly reduced in the Q3 group compared to the Q1 and Q2 groups,except for refined grains and carbohydrates,which were increased(p<0.001).Correlation analysis of E-DⅡ scores with food and nutrients in late pregnancy revealed that food and nutrient intakes were low to moderately negatively correlated with E-DⅡ scores,except for refined grains(rs=0.693,P<0.001)and carbohydrates(rs=0.156,P=0.016),which were positively correlated with E-DⅡ scores.Comparing the levels of inflammatory indicators in different E-DⅡ score groups in late pregnancy revealed that PLR and NLR were higher in Q3 group than in Q1 and Q2 groups(P<0.05),and further multivariateadjusted linear regression analysis showed that for every 1 unit increase in E-DⅡ score in late pregnancy,PLR increased by 19.577 units(P<0.05)and NLR by 0.590 units(P<0.05);subgroup analysis showed no association between E-DⅡ score and PLR and NLR in Q2 group compared with Q1 group(P<0.05),while E-DⅡ score in Q3 group was positively associated with PLR and NLR(P<0.05),that is,for every 1 unit increase in E-DⅡ score in the Q3 group,PLR increased by 45.670 units(P<0.05)and NLR increased by 1.206 units(P<0.05),with a P value <0.05 by trend test,suggesting a significant upward trend.Analysis of the association between E-DⅡ score and LBW in late pregnancy revealed that the higher the E-DⅡ score in late pregnancy,the greater the pro-inflammatory tendency of diet and the higher the incidence of LBW(P<0.05).After adjusting for maternal age,neonatal sex,pre-pregnancy BMI,pregnancy frequency,education level,per capita monthly household income,smoking status,and alcohol consumption,the results showed that the risk of LBW was 8.164 times higher in the Q3 group compared to the Q1 group(95% CI: 1.648 40.440),i.e.,an increased level of dietary inflammation in late pregnancy increases increase the risk of LBW in newborns.Conclusion The total dietary intake of pregnant woment in late pregnancy in Huaibei City,Anhui Province can basically meet the physiological needs,but the dietary structure lacks certain rationality.The E-DⅡ score in late pregnancy can effectively assess maternal dietary inflammation,higher E-DⅡ score in late pregnancy is associated with greater dietary inflammatory potential,and high E-DⅡ score increases the risk of LBW. |
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