Study On The Use Of Nutrient Supplements During Pregnancy And Its Correlation With Pregnancy Outcome In Zibo City

purpose1.Insufficient or excessive nutrient intake is closely related to fetal growth and development and pregnancy outcome.At present,there are many kinds of nutritional supplements for pregnant women and their use is not standardized,which is liable to cause insufficient or excessive intake of certain nutrients for pregnant women.Therefore,based on the analysis of dietary nutrition intake of pregnant women during pregnancy,this study will study the use of nutritional supplements and related influencing factors for pregnant women during pregnancy,so as to provide reference for scientific and rational use of nutritional supplements during pregnancy.Methods:Part I: Current use of nutrient supplements during pregnancy and related influencing factors: A total of 660 pregnant women who met the inclusion criteria in 3 Grade A hospitals and 8 township hospitals in Zibo City from June 2017 to June 2020 were selected as the research subjects.A questionnaire survey was conducted on the basic information of all pregnant women to understand their basic information.The dietary habits,dietary structure,food types and nutrient intake of pregnant women were investigated by the 24-hour 3-day dietary review method.The types and quantities of nutritional supplements used by pregnant women and their possible influencing factors were investigated by means of questionnaire,field interview and follow-up survey.The evaluation criteria of nutrient intake were mainly based on Reference Intake of Dietary Nutrients of Chinese Residents(2013).Statistical methods: Independent sample t test,Chi-square test and other statistical methods were used for statistical analysis.The influencing factors were analyzed by Logistic regression analysis.Odds ratio(OR)and 95% confidence interval(95% CI)were calculated.Part II: The relationship between iron supplement use and pregnancy outcome: The subjects were selected to follow the delivery of pregnant women and the fetal length and weight.To analyze the relationship between the use of nutritional supplements during pregnancy and anemia during pregnancy,birth weight and length of newborns.The evaluation criteria of nutrient intake were mainly based on Reference Intake of Dietary Nutrients of Chinese Residents(2013).The venous blood of pregnant women was collected and analyzed by Olympus AU 400 automatic biochemical analyzer.The distance from the top of the head to the sole of the foot was measured with a horizontal measuring bed.The newborn’s birth weight was measured with a baby scale.Results:Part I: The dietary protein intake of pregnant women did not reach the recommended intake,vitamin E and vitamin C reached 104.42% and 164.34% of the recommended intake,respectively,and other nutrients were lower than the recommended intake.Pregnant women generally pay attention to the intake of nutrients,among which the use of folic acid(90.35%)and calcium(77.07%)accounted for a relatively high proportion,the use of multivitamin supplements accounted for 50.98%,the use of iron agents accounted for 12.22%.77(11.67%)had folic acid intake above the maximum tolerable limit(UL);There were 12 pregnant women whose daily dietary calcium intake was more than 2000 mg,among which the dietary calcium intake was 812.47±37.10 mg and the calcium supplement intake was1203.31±132.25 mg.The total intake was 2015.03±62.09 mg.There were 29 pregnant women whose daily iron intake was greater than 42 mg,among which the dietary iron intake was20.04±9.27 mg,and the intake of iron supplement was 26.07±6.03 mg,and the total intake was 46.09±4.07 mg.The analysis of the reasons for pregnant women to use nutritional supplements showed that the highest proportion was 50.53% under the guidance of doctors,39.06% who thought they should take supplements,16.59% recommended by relatives and friends,and 3.62%others.The results of Logistic analysis of maternal age,maternal education level,gestational time and access to nutrition knowledge with calcium,iron,folic acid and multivitamin showed that older age was the protective factor for the use of two OR more nutritional supplements,OR(95%CI)was 1.29(1.01-1.65).A bachelor’s degree OR higher was a protective factor for the use of two or more supplements compared with a high school degree or less,OR(95%CI)of 2.31(1.23-4.31).Knowledge obtained from a doctor OR dietitian(OR(95%CI)was 3.49(2.03-5.99)and information obtained from television and Internet media(OR(95%CI)was 2.89(1.65-5.05)compared with information obtained from family and relatives as a protective factor for the use of two or more supplements.Part II: The results of binary Logistic regression analysis related to adverse pregnancy outcomes in pregnant women showed that pre-pregnancy obesity and excessive energy intake during pregnancy could increase the risk of macrosomia,OR(95%CI)was 4.00(1.23-13.19)and 1.002(1.001-1.004),respectively.Both low and high iron intake during pregnancy can increase the risk of macrosomia,The OR(95%CI)intakes of iron < 29mg/d,29-42mg/d and > 42mg/d were 6.63(1.36-32.18),5.43(1.16-25.42)and 2.04(1.38-10.97),respectively.Due to the low incidence of low birth weight and preterm birth in this study,no risk factors associated with low birth weight and preterm birth have been identified.Conclusion:1.It is common for pregnant women to use nutritional supplements,mainly folic acid,calcium,iron and multivitamin.The coexistence of insufficient and excessive nutrient intake should be paid attention to.2.Iron deficiency is a risk factor for anemia in the third trimester.Both insufficient and excessive iron intake during pregnancy can increase the risk of macrosomia.