Effects Of Dietary Supplements At Different Gestation Period On The Pregnant Women And Neonate

Objective:Through investigation and animal experiment, to study the effects of dietary supplements on pregnant women and neonate growth index during progestation and different stages of gestation, to provide scientific basis for the selection of the rational and optimal use period of dietary supplements at pregnancy.Methods:Population-based study1.(1) Pregnant women were selected from department of gynecology and obstetrics of Shandong Qi Lu Hospital, and 473 subjects voluntarily participated after signing informed consent. All of them were singleton pregnancy, without alcohol and tobacco habit, and could fill in the questionnaire personally. (2) The basic information of pregnant women, food intake, knowledge and attitude to dietary supplements, consumption of dietary supplements and birth information of neonate were obtained by questionnaires. (3) All the pregnant women were grouped into control group, progestational group, gestation group, progestational and gestation group. Gestation group were sub-grouped into early pregnancy group, mid-pregnancy group, late-pregnancy group and entire gestation group. (4) SPSS 16.0 statistical software was employed to analyze the body weight, per capita intake of food, scores of awareness of dietary supplements of pregnant women, and the body weight, length, head circumference, chest circumference, Apgar score of neonate in different groups.Animal experiments2. (1) Forceval softgel capsules provide by Unigreg Pharmaceutical Company UK.60 female Wistar rats (220-240g) and 30 adult male rats (300-320g) were obtained. Female and male were mated by 2:1. The 50 pregnant rats obtained were randomly classified into 5 groups as wl-d0 pre-pregnancy group (be given Forceval solution a week before pre-pregnancy), d0-dll pregnancy group, d12-d16 pregnancy group, d17-birth pregnancy group and control group, with 10 in each group 0.14g/kg.bw(0.94ml/kg.bw) was administered to rats by gavage, with same volume soybean oil to control group. (2) Pregnant rats' weight and food consumption were monitored every other 3 days. The number of alive, dead and monster fetus were recorded after natural delivery. Indexes of growth including body length (from head to buttock), tail length, body weight, head weight were measured also. (3) Collect blood of pregnant rats for serum preparation, and the content of Ca, Mg, Fe, Zn were analyzed by atomic absorption spectrophotometry. (4)The Ca, Mg, Fe, Zn levels of neonate were also measured. All the data were analyzed by SPSS 16.0.Result:Population-based study1. Situation of the selection and apply of dietary supplements in the period of gestationAmong 473 respondents,274 selected dietary supplements in gestation, account for 57.93%; while 199 didn't, account for 42.07%. (1)Among the respondents who selected dietary supplements, different age group varied a lot in the selection of dietary supplements:in pregnant women who less than 20 years old, no one selected dietary supplements; 44 respondents aging from 21 to 25 years old selected dietary supplements, account for 16.06%; there were 161 ones selected dietary supplements in respondents of 26 to 30 years old and account for 58.76%; 55 people aging from 31 to 35 years old selected dietary supplements, account for 20.07%; in those who over 36 years old,14 ones selected dietary supplements, and account for 5.11%. In pro-gestation group and gestation group respectively, it was both the group aging 21 to 25 that consumed the most dietary supplements, while the group aging 31 to 35 used the most both in the pro-gestation period and in gestation period. (2) Pregnant women with different education background and occupation varied a lot in the selection and apply of dietary supplements. Subjects with higher education background were more than others, people who work in the national department, the area of scientific research, teaching, household chores and commerce and service industry were more than medical stuff, workers, farmers and others in consuming dietary supplements, while in high-income group, the number who use dietary supplements were relatively less. (3)Among those who selected dietary supplements in gestation period,41.67% followed the doctors' recommendation,26.04% due to their own needs,20.49% came from friend's recommendation; types of dietary supplements selected most were vitamins and compound of vitamins and minerals, and 31.75% subjects took two or more types of dietary supplements in the same time.2. Knowledge and attitude to dietary supplementsThose who have higher educational level showed better cognition of dietary supplements; the scores of office workers, researchers, teachers and medical workers were higher than the others. In terms of the attitude towards dietary supplements, 86.47% of the respondents disapproved of taking dietary supplements for a long time and 58.35% considered it harmful to take dietary supplements for long. But 50.74% of respondents believed the dietary supplements have positive effects on health. Only 51.37% of the respondents expressed their desire to get more related information.3. Effect on the indexes of pregnant women and neonate(1) In the diet, pregnant women who took dietary supplements in gestation period were more than those without taking dietary supplements in the amount of per capita intake of cereals, animal derived food, vegetables, fruits, eggs, pulses and derived products. (2) Average increment in weight of pregnant women during pregnancy was all above 16.5kg, no matter the weight before pregnancy. Average increment in weight of pregnant women during pregnancy was all beyond 15kg, which was the maximal proper increment, however, there was no statistical difference between the four groups(P>0.05). (3) After controlling the weight of pregnant women before pregnancy and increment during pregnancy, covariance analysis showed that dietary supplements made no difference on neonate's body weight, body length, head circumference and Apgar score (P>0.05), it had influence on chest circumference of neonate (P＜0.05), neonate's chest circumference of gestation group and "pro-gestation and gestation" group were longer than control group. Neonate's chest circumference of early-pregnancy group was longer than mid-pregnancy group and the entire gestation group(P<0.01), while late-pregnancy group was longer than entire gestation group(P<0.05). (4) Neonate's body weight was divided into infant of low-birth weight, normal-birth weight and macrosomia, and there was significant difference in the four groups in body weight (χ2=23.773, P<0.01), the difference between pro-gestation and gestation group and control group was statistical significance(χ2=11.641, P<0.01), rate of macrosomia in pro-gestation and gestation group was higher than control group, but rates of infant of low-birth weight and normal birth weight were lower than control group.Animal experiments1. The results of animal experiments showed that increment in weight of d0-d11 pregnancy group and d12-dl6 pregnancy group were more than control group (P<0.05) during early-pregnancy period (d0-d11). The four groups had no statistically significant differences in increment during mid-pregnancy (dl2-dl6) and late-pregnancy (d17to birth) period (P>0.05). Weight gain of pregnant rats of d12-d16 pregnancy group was significantly higher than other groups (P<0.05). The number of fetus of pregnant rats which were given dietary supplements more than control group, and the difference had statistical significance (P＜0.05).2. Results of the content of mineral substance in serum revealed that there was no statistically significant difference in the content of Ca, Mg, Zn among different groups (P>0.05). The content of Fe in serum of d0-d11 pregnancy group and d12-d16 pregnancy group were higher than the control group, and there was statistically differences (P＜0.05).3. Eliminated the impact of pregnant rats weight gain during pregnancy, the results of covariance analysis showed that there were no significant difference in tail length, body weight and head weight of fetus between pro-gestation and different stages of pregnancy(P>0.05), however, body length of fetus in every experimental group were less than control group(P<0.05). For the fetus, the content of Ca in groups which were given dietary supplements in pregnancy was all higher than both control and pro-gestation group(P<0.05); the content of Mg in wl-d0 pro-gestation group and d12-d16 pregnancy group was higher than control group(P<0.01, P＜0.05); the content of Zn in d17-birth pregnancy group was higher than other groups(P<0.05); There are no significant differences in the content of Fe among groups (P>0.05).4. The phenomenon of Subcutaneous hemorrhage in d17-birth pregnancy group was more than the other groups (P＜0.01).Conclusion:1. It's universal to use dietary supplements during gestation. In pro-gestation group and gestation group respectively, it was both the group aging 21 to 25 that consumed the most dietary supplements, while the group aging 31 to 35 used the most both in the pro-gestation period and in gestation period.2. Doctor's recommendation is the main and the most important reason for pregnant women to choose dietary supplements, which could draw the conclusion that the pregnant women quite trust the doctor. Therefore, it will be very significant to enhance doctor's reasonable understanding on the dietary supplements.3. Selection of dietary supplements varies a lot in people of different education background and career. Pregnant women who have higher education or work in national department, or in the area of scientific research and teaching tend to use more dietary supplements, while the dosage of the high-income group is very low, which is unreasonable and need to do further study.4. Taking in dietary supplements during pregnancy have no impact on the newborn's avoirdupois, height, weight of head, and the grade of "Apgar", while pregnant women with dietary supplements could increase the newborn's chest, the effect is more obvious if using them during early and late period of pregnancy. However, taking dietary supplements continuously before and during pregnancy will increase the birth rate of huge children.5. The weight of animal's body during the early period of pregnancy can increase if we give it dietary supplements before its pregnancy or the early period of pregnancy; if during intermediate stage of pregnant can increase the total body weight of the pregnant animals; giving dietary supplements during early and intermediate stage of pregnancy can increase levels of serum iron, which is conducive to the iron storage of embryo.6. Supplementing calcium during the period of pregnancy can improve the content of calcium in fetal tissue; supplementing magnesium before and the early period of pregnancy can increase the content of magnesium in fetal tissue, and in the late period of pregnancy to supplement zinc is able to enhance the content of zinc in fetal tissue. But, it has no effect on the content of ferrum in fetal tissue.7. Delivering dietary supplements during pregnancy can increase the number of young, but the factors that affect fetuses'length require to do further research.8. Delivering dietary supplements during late-pregnancy can increase the rate of monster fetus, but the factors require to do further research.