Optimal gestational weight gain in Chinese pregnant women by Chinese-specific BMI categories: a multicentre prospective cohort study.

OBJECTIVE: To establish optimal gestational weight gain (GWG) in Chinese pregnant women by Chinese-specific BMI categories and compare the new recommendations with the Institute of Medicine (IOM) 2009 guidelines. DESIGN: Multicentre, prospective cohort study. Unconditional logistic regression analysis was used to evaluate the OR, 95 % CI and the predicted probabilities of adverse pregnancy outcomes. The optimal GWG range was defined as the range that did not exceed a 1 % increase from the lowest predicted probability in each pre-pregnancy BMI group. SETTING: From nine cities in mainland China. PARTICIPANTS: A total of 3731 women with singleton pregnancy were recruited from April 2013 to December 2014. RESULTS: The optimal GWG (ranges) by Chinese-specific BMI was 15·0 (12·8-17·1), 14·2 (12·1-16·4) and 12·6 (10·4-14·9) kg for underweight, normal weight and overweight pregnant women, respectively. Inappropriate GWG was associated with several adverse pregnancy outcomes. Compared with women gaining weight within our proposed recommendations, women with excessive GWG had higher risk for macrosomia, large for gestational age and caesarean section, whereas those with inadequate GWG had higher risk for low birth weight, small for gestational age and preterm delivery. The comparison between our proposed recommendations and IOM 2009 guidelines showed that our recommendations were comparable with the IOM 2009 guidelines and could well predict the risk of several adverse pregnancy outcomes. CONCLUSIONS: Inappropriate GWG was associated with higher risk of several adverse pregnancy outcomes. Optimal GWG recommendations proposed in the present study could be applied to Chinese pregnant women.

[Association of pre-pregnancy body weight, gestational weight gain and postpartum weight retention among women in Beijing].

OBJECTIVE: To investigate the relationship of pre-pregnancy body weight, gestational weight gain and postpartum weight retention among women in Beijing. METHODS: Using a cohort design, 600 pregnant women who went to district obstetrics and gynecology hospital in Beijing to establish preconception health care card from 5(th) February to 15(th) March 2009 were recruited. A total of 112 subjects (109 with valid data), 20% of that in baseline, were followed up at 6 months after delivery.70 subjects (66 with valid data) were followed up at one year after delivery. Weight, weight changes and postpartum weight retention were measured for low weight (BMI < 18.5 kg/m(2)), normal weight (18.5 kg/m(2) ≤ BMI ≤ 24.0 kg/m(2)) and overweight or obesity (BMI > 24.0 kg/m(2)) group. RESULTS: The pre-pregnancy weight and antenatal weight were (54.8 ± 8.0) and (70.8 ± 9.3) kg respectively. Gestational weight gain was (16.0 ± 7.0) kg. The postpartum weight of 6 and 12 months were (60.5 ± 9.4) and (57.6 ± 8.6) kg respectively. Comparing to pre-pregnancy, postpartum weight retention in 6 months and 12 months were (5.7 ± 4.5) and (2.7 ± 4.5) kg, weight retention rates were (10.6 ± 8.6)% and (5.2 ± 9.3)%. Antenatal weight among low pre-pregnancy weight group, normal weight and overweight and obese women were (62.6 ± 5.7), (69.9 ± 6.6) and (84.2 ± 9.9) kg, and weight at postpartum 12 months among 3 groups were (49.3 ± 3.2), (56.5 ± 6.9) and (70.5 ± 6.0) kg respectively (F = 25.3, P < 0.01); At postpartum 12 months, low pre-pregnancy weight group ((5.6 ± 5.9) kg), overweight and obese women group ((4.7 ± 1.9) kg) postpartum weight retention was significantly higher than that of the normal weight group ((1.8 ± 4.3) kg) (F = 3.82, P < 0.05). CONCLUSION: The pre-pregnancy body weight is a key risk factor in weight gain during pregnancy and postpartum weight retention.

[Evaluation of feeding behavior among infants and young children aged from 6 to 24-month-old in Chengdu by feeding index method].

OBJECTIVE: To evaluate the feeding behavior of infants and young children aged from 6 to 24-month-old in Chengdu by feeding index. METHODS: 608 infants and young children were randomly selected from Chengdu and divided into 6-, 9-, 12 - 24 month-old groups. Data including basic information, breastfeeding, and complementary feeding were collected through questionnaire. The feeding status of subjects was evaluated by feeding index system (the total score was 19) established by infant feeding principle of WHO. RESULTS: The total feeding index score (FIS) of 608 subjects was 11.0 ± 2.4. The FIS of 6-(192), in 9-(174) and 12 - 24 month-old (242) groups were 9.6 ± 2.8, 11.1 ± 2.1, 11.9 ± 1.6, respectively. The FIS was increased with month of children (F = 61.311, P < 0.05). The ratios above 60% (the score of 11.4) and 80% (the score of 15.2) of FIS were 46.4% (282/608) and 0.7% (4/608) respectively. The ratios above 60% of FIS were 26.5% (51/192), 45.4% (79/174), 66.9% (162/242) in 6-, 9-, 12 - 24 month-old groups respectively. The percentages of bottle feeding and breastfeeding were 94.2% (573/608) and 25.2% (153/608) respectively.45.1% (274/608) of them were fed by recommended feeding frequency, and 73.0% (444/608) were given enough types of food. With the month-old increasing, the foods of higher intake frequency were vegetables/fruits, cereals, milk and diary product, eggs. The intake frequency of meat was higher in 9 to 24 month-old group, but intake frequency of fish and beans was low in all groups. CONCLUSION: The feeding behavior of infants and young children in Chengdu is not optimistic, especially for the lower month infants.

[The impact of experience in bearing child on the body mass index and obesity in women].

OBJECTIVE: To analyze the relations of body mass index(BMI)and obese prevalence in differently aged women and explore the effective strategy for preventing obesity among adult Chinese women. METHOD: This study was based on the data from 2002 National Nutrition and Health Survey. The method of multi-steps cluster sampling was adopted. Total subjects including unmarried women (n = 2474), married women without the experience of childbearing (n = 10,816), and married and bearing-child women (n = 4103), were 17,393. RESULTS: In urban areas, the average body weights of unmarried, married and without childbearing experience, and the married with born-child were (53.7 +/- 9.0) kg, (57.6 +/- 9.4) kg and (54.5 +/- 8.5) kg respectively; the body weights of unmarried, married and without childbearing experience were significantly higher than that of the married with born-child women (t = 12.25, P < 0.001; t = 8.32, P < 0.001); the BMIs of unmarried, married without childbearing experience, and the married with born-child women were (21.1 +/- 3.3) kg/m(2), (22.8 +/- 3.4) kg/m(2) and (22.0 +/- 2.9) kg/m(2) respectively; the BMIs of married without childbearing experience and married with born-child women were significantly higher than that of unmarried women (t = 14.88, P < 0.001; t = 5.76, P < 0.001). In the rural areas, the body weights of unmarried, married without childbearing experience, and the married with born-child women were (52.3 +/- 7.8) kg, (55.3 +/- 8.6) kg and (52.8 +/- 8.1) kg respectively; the body weights of unmarried, the married with born-child women were significantly higher than that of married without childbearing experience (t = 11.67, P < 0.001; t = 14.15, P < 0.001); the BMIs of unmarried, married without childbearing experience, and the married with born-child women were (21.2 +/- 2.8) kg/m(2), (22.5 +/- 3.1) kg/m(2), and (21.8 +/- 3.0) kg/m(2) respectively; the BMIs of married and the married with born-child were significantly higher than that of unmarried women (t = 13.80, P < 0.001; t = 5.34, P < 0.001). In urban areas, the rate of low body weight of unmarried women (18.1%) was higher than that of married without childbearing experience and married with born-child group (7.3% vs. 9.1%; comparing with married without childbearing experience: chi(2) = 113.69, P < 0.001; comparing with married with born-child: chi(2) = 29.65, P < 0.001); the prevalence of overweight and obesity (32.7%) in married without childbearing was significantly higher than that of unmarried women (14.4%) (chi(2) = 28.257, P < 0.001). In rural areas, the rate of low body weight of unmarried women (12.4%) was higher than that of married without childbearing group (6.7%, chi(2) = 50.040, P < 0.001); however, the prevalence of overweight (22.4%) in the married without childbearing was significantly higher than that of unmarried women (12.3%) (chi(2) = 69.119, P < 0.001) and the married with born-child women (15.4%) (chi(2) = 69.866, P < 0.001). The prevalence of overweight and obesity of the married with born-child women was decreasing with extending time of postpartum in urban and rural areas. CONCLUSION: Weight retention of married with born-child women was one of the most important factors leading to the obesity in the adulthood. However, more attentions should be paid to the changing trend of body weight in the married without childbearing experience.

[Effects of nutritional education on improvement of nutritional knowledge of infant's mothers in rural area in China].

OBJECTIVE: To investigate the knowledge, attitude and practice (KAP) of young children's mothers on infant feeding and to evaluate the effects of nutritional education in the rural areas. METHODS: A cluster sampling method was used to select the local health station. Five hundred and fifteen mothers, who had infants with age of 4 - 6 months, were recruited for the questionnaire survey on the nutritional knowledge in rural areas of Tianjin municipality. The mothers were randomly divided into intervention group I (160), intervention group II (180) and control group (175). The mothers in the intervention group I were educated with feeding guideline on infants and young children and had had Group lectures and advisory from experts about maternal and child nutrition for teaching them how to feed their children; while, the mothers in the intervention group II were trained with feeding guideline on infants and young children by themselves; and the mothers in the control group received routine guidance at the local health station. The follow-up evaluation on nutritional knowledge of the mothers in each group was carried out after 3 and 6 months intervention, respectively. RESULTS: The educational background had significant effect on KAP scores: KAP scores of the mothers with primary education or less (8.3 +/- 2.2) were significantly lower than that of the mothers educated with high school (9.4 +/- 1.6) and university (9.6 +/- 1.8) (LSD t = 3.70, P < 0.001). After being educated with feeding guideline on infants and young children, the knowledge of infant's mothers was greatly improved and KAP scores of the mothers after intervention were higher than that of the baseline (F = 183.556, P = 0.006); the percentage of correct answer on nutrition knowledge in the intervention groups was significantly higher than that of the control group. At six months of intervention, the KAP scores of intervention group I (12.0) and intervention group II (11.6) were higher than that of the control group (10.5) (LSD t = 5.96, P < 0.001; LSD t = 4.25, P < 0.001). CONCLUSION: Providing nutritional and health education to the infant's mothers should be helpful for improving infant's feeding pattern and ensuring the adequate growth and development of infants.

[Effects of different feeding patterns on body weight of perinatal women in rural area].

OBJECTIVE: To study the relations between different feeding patterns and the body weight retention of the perinatal women living in rural areas of China. METHODS: A cluster sampling method was used to investigate 409 women, who are currently living in rural areas of Tianjin, at pregnant and perinatal status. While, their body weights and heights before pregnancy, antepartum and postpartum were measured, respectively. Body weight retention was the difference of the measured data after postpartum minus pre-pregnant weight. Variance analysis was used for statistic comparison. RESULTS: The rate of exclusive breastfeeding was 70.9% (290/409) within four months. The net body weight retention of women (5.8 kg) using the exclusive breastfeeding was lower than that of the women (7.0 kg) using artificial feeding within 4 - 6 months, but there was no significantly statistic difference (F = 1.45, P = 0.236). However, there was the opposite result within 7 - 9 months, the data showed that the body weight retention in the women using the exclusive breastfeeding was 4.9 kg, which was significantly higher than that the women (2.9 kg) with artificial feeding (F = 3.17, P = 0.043). The food consumption of the women (901 g) using exclusive breastfeeding was the highest, followed by those (877 g) using mixed feeding and the women (750 g) using artificial feeding. CONCLUSION: The body weight retention after postpartum should be related to infant feeding patterns. After postpartum, the weight loss of women using the exclusive breastfeeding is relatively low. While, for the women using the exclusive breastfeeding, the net weight retention during pregnancy and after postpartum were lower than those with artificial feeding. Therefore, it is necessary to enhance health education and guidance on promoting exclusive breast-feeding as well as increasing awareness on pre-pregnant health.

[The relationship of milk consumption and development of 3 - 6 years old preschool children].

OBJECTIVE: To study the relationship between milk intake of 3 - 6 years old preschool children and their growth. METHODS: The data bank of 2002 China National and Health Survey were used to analyze the relationship of milk consumption and the growth of children aged 3 - 6 in urban and rural areas. RESULTS: The percentages of the diet with milk in urban and rural areas were 46.9% and 8.2% respectively, there was significant difference between the urban and rural areas. The averaged milk intake of preschool children were 23.8 g/d, the milk intake of urban children was significantly higher than that in the rural areas (P < 0.01). The height and weight of children with milk or its products in their diets in the group aged 4, 5 and 6 years were significantly higher than those of children without milk or its products in their diets (P < 0.05). CONCLUSION: There was close relationship between milk intake of children 3 - 6 years old and their growth, the volume of milk intake of preschool children should be improved in urban and rural areas.

[Association between hemoglobin level of children < or = 3 years and anemia of their mother].

OBJECTIVE: To study the relationship between the hemoglobin level of children < or = 3 years and anemia of their mothers. METHODS: Multi-steps cluster sampling was adopted. In order to ensure sufficient number of babies and young children and postpartum in this survey, additional subjects were included in the sample. The subjects in study were collected in the same family. RESULTS: The average anemia prevalence of children < or = 3 years was significant different between urban and rural (26.9%, 94/350 and 32.4%, 594/1835, P < 0.05) areas. The birth weight of anemia children < or = 3 years was significant lower than nonanemic children (P < 0.05); the incidence of low birth weight of anemia children < or = 3 years was significant higher than nonanemic children (P < 0.05); the percentage of Hb < 100 g/L and < 110 g/L were 7.6% (166/2185) and 24.9% (544/2185); the Hb levels of children fed by anemia mother and nonanemic mother were significantly different (115.6 +/- 17.4) g/L, (115.2 +/- 16.7) g/L and (123.3 +/- 14.9) g/L, (122.2 +/- 15.3) g/L, P < 0.001. CONCLUSION: There should be significant relation between the Hb level of children < or = 3 years and anemia of their mother.

[Effects of ferrous sulfate supplementation on bone marrow hemopoiesis in rats].

OBJECTIVE: To explore the influences of different dosage ferrous sulfate supplements on bone marrow hemopoiesis in rats. METHODS: Female weaning Wistar rats were fed with an iron deficient diet (< 10 mg/kg diet) until the level of hemoglobin of rats was lower than 100 g/L. Rats (n = 50) were randomly divided into five groups according to the levels of hemoglobin and body weight, iron deficiency control (ID), daily low iron diet supplement (LDs), daily high iron diet supplement (HDs), weekly low iron supplement (LWs), and weekly high iron supplement (HWs). RESULTS: After 12 weeks, bone marrow stainable iron was seldom in ID group, and ample in supplement groups. The proportions of iron staining of bone marrow smear in supplement groups were more than 30%. Bone marrow cells in all rats were hyperplastic or active hyperplastic. CONCLUSIONS: Daily high iron supplement or once weekly high iron supplement were safe to bone marrow hemopoiesis in rats.

[Observation on the efficacy of glycine chelated iron (II) in improving nutritional anemia in children].

OBJECTIVE: To observe the efficiency of glycine chelated iron (II) on nutritional iron-deficient anemia. METHOD: The iron-deficient anemic children (120 subjects), aged 7 - 12 were randomly divided into two groups, one group as a control group given with a placeboes and another group treated with glycine chelated iron (II) for one month. RESULTS: Compared with the control group, the addition of glycine chelated iron (II) group had a significantly higher hemoglobin level ( > 10 g/L) in whole blood and a lower free erythrocyte protoporphyrin (FEP) content. CONCLUSION: The iron from glycine chelated iron (II) have a role in improving nutritional iron-deficient anemia in children.

[Distribution of feeding index and association between feeding index and growth of infants and young child aged 6 - 24 months].

OBJECTIVE: Data from the Nutrition and Health Survey of the Chinese People on 2002 were use to explore the feasibility of creating a composite feeding index and examine the association between feeding practices and growth of infants and young child. METHODS: The variables used for index were as follows: current breast-feeding, introduction of complementary foods, the past month and feeding frequency. The index was made age specific for 6- to 9-, 9- to 12- and 12- to 24-month-old age groups, age-specific feeding terciles were created to evaluate the association between feeding index and growth. RESULTS: the socres of feeding practice were different significantly between urban and rural. Bivariate analyses showed that feeding practices were strongly and significantly associated with child growth in China, especially with increasing age, the scores of feeding practices were increasing. CONCLUSION: The present study showed that better feeding practices were more important for children of lower socioeconomic status, The data available in CNHS data can be used effectively to create a composite child feeding index which could be targeted by nutrition education and behavior change interventions.

[Evaluation on glycine chelated iron (II) in improving nutritional anemia in rats].

OBJECTIVE: In order to evaluate the efficacy of glycine chelated iron (II) in improving nutritional anemia in rats. METHODS: After weaning wistar rats, weighing 50 - 60g, were fed the iron deficient diet for three weeks, whole blood was taken from rat's tail to measure Hb, then the rats were randomly divided into five groups by Hb, that is the control group fed with iron deficient diet, three groups fed the diets supplemented with different glycine chelated iron (II), and another group fed with the diet added with lactate iron. Each group was fed respective diets for four weeks and indicators related to iron-deficient nutritional anemia were evaluated. RESULTS: The addition of glycine chelated iron (II) did improve the growth and development of rats, increase the hemoglobin level and the iron retention in spleen, decrease free erythrocyte protoporphyrin (FEP) content in whole blood, and there was no significant difference between three supplemental groups with glycine chelated iron (II) and the group with lactate iron. CONCLUSION: glycine chelated iron (II) can be used as a reasonable iron supplement in improving iron-deficient nutritional anemia.

[Study on the effect of malnutrition and anemia identified among general population in 2002 to the future productivity in China].

OBJECTIVE: To measure the social productivity loss and negative effect to economic development due to malnutrition in view of quantitative analysis. METHODS: Using the data of childhood stunting and population anemia status, collected by 2002 National Nutrition and Health Survey to analyse the effect on present and future productivity. PROFILES model was used to estimate two kinds of productivity losses: "Future productivity loss" was figured out based on the data of stunting and anemia status in 0-5 year-old children while "Current productivity loss" was from anemia data of the adults. RESULTS: If current prevalence levels of malnutrition remained unchange over the next ten years (from 2002 to 2012), the total net present value of future productivity lost would be 281.7 billion Yuan (RMB), equivalent to 2.70 % of the Gross Domestice Product( GDP) in 2002, with the productivity losses due to stunting, anemia in adults and children were 0.15 % , 0.46 % and 2.09% of the 2002 GDP, respectively. All the results of calculation mentioned above was restricted with the same assumption - the ignorance of the real cost. CONCLUSION: The social economic development and the improvement of nutrition program would have a huge effect to population nutritional status. The social benefit and return on investment should be significant.

[The influence of maternal nutrition on children physical development].

OBJECTIVE: To study the effect of maternal nutrition status on child growth in China. METHODS: The study was performed using data from 2002 China Nutrition Health Survey in which data were collected through stratified multi-stage cluster samples in 31 provinces, autonomous regions, and municipalities. Accroding to the height of women aged 18-44 y was 156.4 cm, the data on mother and children' weight and height/length (n = 1380) were analyzed. RESULTS: The findings suggest child's length (age 2) were significantly correlated with maternal heights (P < 0.0001). The mean length in children born to mothers with a height below 156.4 cm was 2.4 cm less than those in children born to mothers with a height above 156.4 cm. The prevalence of stunting in children at age 2 born to mothers with a height below 156 cm was 2.07 times of that in children born to mothers with a height above 156 cm. Therefore, the risk for stunting in children at 2 is lower in children born to mothers with greater height. CONCLUSION: The maternal nutrition status could have a significant influence on children physical development.