| Ojective:1 To explore the overall levels of common nutrients and thedeficiency status inpregnant and puerperal women in Shijiazhuang.2 To investigate thedifferences in nutrient content among pregnant and puerperal womenunder different conditions.3To study the prevalence ofpregnancycomplicationsamong pregnant and puerperal women in Shijiazhuang, to ascertain the related factors for the complications, and to formulateeffective measures to prevent their occurrence.Methods:The pregnant women who had delivered from June to September 2015 in one hospital in Shijiazhuang were selected as study subjects. The subjects should have done screening of gestational diabetes during pregnancy and antenatal examination. The antenatal examinationincluded general inspection(height, weight, blood pressure, etc.), blood routineexamination, thyroid function, serum nutrients(total protein, calcium, iron, zinc) detection. The study used Epidata software toinput the data. Then used SPSS19.0 software to describe and analyzeit.Results:1 Thegeneral characteristics of the research subjects: Out of the 4431 total research subjects included in this study, those aged 25 to 30 years were 2203 people, accounted for 49.7%. Comprising 42.7 %(1892)unemployed. 66.4% of the participants were urban dwellers, 33.6% were rural dwellers. 63.4% had pre-pregnancy weight within the normal range, 15.5%, 16.5%and 4.6% had within the angular, overweightand obese range respectively. 42.2%(1871), 37.8%(1677) and 19.9%(883) hadpregnancy weight gain of?15kg, 15~20kg and ? 20 kg respectively. 96.2% were withinthe gestationalage rangingfrom 37 to 42 weeks. The number of primipara and multipara among the subjectswere 2936(66.3%) and 1495(33.7%).2 Detection of nutritional status: 3755 of the subjects who underwentbloodprotein test, were found to have anaverage total serum protein of60.53 ± 5.80 g / L, with the deficiency rate of 36.7%.The average total bloodcalcium test result for3594 ofthe subjects was 2.11 ± 0.31 umol / L, and the deficiency rate was 69.3%. The average total serum iron content in 3616 ofthe subjects who were tested for iron was 11.73 ± 6.45 umol / L, and the deficiency rate was 40.1%.The serum zinc content was 8.74 ± 1.89 umol / L among3590 of the women who tested for zinc, and the deficiency rate was 60.4%.3 Single-factor analysis results of total serum protein content: The totalserum protein content decreased with an increase in age of thepregnant and puerperalwomen, and the difference was statistically significant(P<0.001). The average serum protein level wassignificantly(P<0.05)higher in the rural dwellers(60.80 ± 5.80 g / L)thanthe urban dwellers(60.39 ± 5.79 g / L). Therewas astatistically significant(P<0.05)reduction in pregnancy weight gain between the two groups.The women within the extreme ends of the gestational age range had significantly lower(P<0.001) total serum protein concentration than those within the middle gestational age range.4 Single-factor analysis results of serum calcium concentration: The effect of age, occupation, region, pre-pregnancy BMI, weight gain during pregnancy, gestational age and frequency of deliveryon maternal serum calcium concentration was not statistically significant(P> 0.05).5 Single-factor analysis results of serum iron content: There was astatistically significant difference(P=0.002)between theserum iron content in primipara(10.19 ± 1.64umol/L)and the multipara(10.72 ± 1.59umol/L)groups.6 Single-factor analysis results of serum zinc content: The results showed statistically significant difference(P<0.05)betweenserum zinc levels among the women who engaged indifferent occupations as well as those with different residential locations.The serum zinc concentration was significantlyhigher(P<0.05) in the multipara than the primipara.7 The prevalence rates of gestational diabetes, hypertension, anemia and hypothyroidism during pregnancy were 8.4%,6.1%,47.4% and 5.4% respectively.8 Analysis of related factors for gestational diabetes : Single-factor analysis showed differences in prevalence of gestational diabetes among different age groups, region, pre-pregnancy BMI, weight gain during pregnancy, gestational age, calcium and iron concentrations in blood; the difference between the groups was statistically significant(P<0.05). Multivariate logistic regression analysis results also showed statistically significant variation(P<0.05) in the prevalence of maternal gestational diabetes among the women in different age groups, place of residence, pre-pregnancy BMI, weight gain during pregnancy, gestational age, and serum iron concentration, apart from the other confounding factors. Age and pre-pregnancy BMI were the risk factors of gestational diabetes; any additional increase in pre-pregnancy BMI led to an increase in the risk of gestational diabetes by 2.012 times.9 Analysis of related factors for gestational hypertension: Single-factor analysis showed that among different age, occupation, region, pre-pregnancy BMI, weight gain during pregnancy, gestational week, serum total protein and serum zinc concentration, the difference in prevalence of gestational hypertension was statistically significant(P<0.05). Apart from the other confounding factors, age and serum zinc concentration had effects on gestational hypertension, but the effect was not statistically significant, however, the number of times of birth had a statistically significant(P<0.05) impact on gestational hypertension.The risk of gestational hypertension is lower in the commerce managerial and professional occupation group, individual and freelance group and other occupation group than unemployed group(OR<1), but the prevalence rate was not different between the science-education-culture-health occupation group and unemployed group(P>0.05).The results also showed that when pre-pregnancy BMI and weight gain during pregnancy increased by one, the risk of hypertension increased by 2.338 and 1.442 times respectively. Serum protein was found to act as a protective factor for gestational hypertension. It was therefore observed that, the higher the total serum protein concentration, the lower the likelihood of developing high blood pressure(OR=0.442).10 Analysis of related factors for gestational anemia: Univariate analysis results also showed statistically significant difference(P<0.05) in the prevalence of gestational anemia among the women who belonged to different age groups, occupation, region, pre-pregnancy BMI, weight gain during pregnancy, serum calcium, serum iron and serum zinc concentrations. Multivariate logistic regression analysis displayed that region, pre-pregnancy BMI, weight gain during pregnancy, serum calcium, serum iron and serum zinc concentration still remained as risk factors for gestational anemia(P<0.05).Weight gain during pregnancy was identified as a risk factor for gestational anemia(OR>1).For each additional increase in the level of weight gain during pregnancy, the risk of anemia increased by 1.108-folds, 95% CI 1.005 ~ 1.221. Serum calcium, iron and zinc concentrations were identified as protective factors for pregnancy-related anemia. The rate of anemia decreased with an increase in elemental concentrations(OR = 0.521, 0.625,0.847).11 Analysis of related factors for gestational hypothyroidism: Univariate and multivariate analysis revealed that the place of residence influenced the prevalence of gestational hypothyroidism significantly( P<0.05) The possibility of the urban dwellers becoming affected by hypothyroidism was 1.577 times higher than rural dwellers, 95% CI = 1.059 ~ 2.351.Conclusion1 The nutrientdeficiency rate among pregnant and puerperal women is high in Shijiazhuang, and the nutrient levels should be improved.2 The totalserum protein concentration is lower in pregnant and puerperal women who are older andin those who gainexcessive weight during pregnancy; The serum iron and zinc concentrations in the women who have given birth more than twiceare higher than the women who have only given birth once; It's rare for the women who have less stressfuloccupationsto have zinc deficiency.3 The prevalence rates of pregnancy-related complications among pregnant and puerperal women in Shijiazhuangwere higher.4 Controlling maternal age, pre-pregnancy BMI, weight gain during pregnancy, and ensuring adequate nutrient intake during pregnancy, can effectively control the occurrence of pregnancy complications. |
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