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Objective To analyze the incidence of gestational diabetes mellitus (GDM) among Chinese pregnant women and the distributions of unhealthy lifestyles. Exploring the association between these behaviors and GDM to provide some suggestions to GDM prevention. Methods Women who were enrolled by the Chinese Pregnant Women Cohort Study and delivered before the 31st December, 2018 were enrolled by this study. The characters of physical activity, sedentary lifestyle, tobacco exposure, alcohol consumption, unhealthy diet and low sleep level were assessed by questionnaire and also the pregnancy complications. Binary Logistic regression model was adopted to analyzed the relationship between the dependent and independent variables. Results A total of 3 162 women were enrolled in this study and 372 of them were diagnosed GDM. Single variable analysis showed that lack of leisure time physical activity (RR=1.015,95% CI=1.005-1.279，P=0.046) and low sleep quality (RR=1.019, 95% CI: 1.004-1.196，P=0.047) were two risk factors of GDM. Compared with women who showed none of these unhealthy lifestyle, those who showed all six unhealthy behaviors had higher risk of GDM (RR=1.530, 95% CI: 1.263-8.880，P=0.036). Conclusions The incidence of GDM among Chinese women was 11.76%. Lack of physical activity and poor sleep quality could increase the risk of GDM and the cluster of unhealthy lifestyles is associated with higher GDM risk. Adequate physical activity, no smoking and drinking, balanced diet and other healthy behaviors are important to GDM prevention.
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@#Objective To explore the influence of reproduction history on depression during pregnancy． Methods Data on 3 792 pregnant women from the Chinese pregnant women cohort study with complete information on reproduction history and depression were used in the present study． The Edinburgh postnatal depression scale was used to assess depression status among pregnant women． A chi-square test was used for univariate analysis，and a Log－binomial regression was used for multivariate analysis． The adjusted relative risks ( ＲＲs) with 95% confidence intervals ( 95% CIs) were calculated，and were presented in a forest plot． Ｒesults The results of Log－binomial regression showed that a history of delivery could increase the risk of depression during the second trimester ( ＲＲ: 1. 04，95% CI: 1. 01 － 1. 08，P= 0. 042) and the third trimester ( ＲＲ: 1. 05，95% CI: 1. 01－1. 10，P= 0. 020) ． There was a 6% increase of risk on depression in women with a history of cesarean delivery compared with women without that during the third trimester ( ＲＲ: 1. 06，95% CI: 1. 01－1. 11，P = 0. 041) ． Conclusions There is asignificant influence of reproduction history on gestational depression． Maternal and child health personnel should focus on these pregnant women，and conduct targeted health education and mental nursing． In addition，medical personnel should also pay attention to the emotional changes of these women and provide them with several adjustment strategies．
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@#Objective To explore the associations between cesarean section with different types and intensity of physical activity in the second trimester pregnant women． Methods Six hundred and seventy－two participants from the Chinese pregnant women cohort study ( CPWCS) were analyzed． The pregnancy physical activity questionnaire ( PPAQ) was used to collect the status of physical activities in pregnant women． The participants were followed up and the data of delivery way was collected． Logistic regression model was conducted to analyze the associations． Ｒesults A total of 273 pregnant women ( 40. 63%) were delivered by cesarean section． After adjusting age，pre-pregnancy BMI and history of childbirth，results of Logistic regression model showed that pregnant women with higher levels of exercise had a lower risk of cesarean section than those who did not participate in exercise ( OＲ= 0. 564，95% CI: 0. 338－0. 941) . In terms of physical activity intensity，pregnant women who participated in the higher level of moderate to vigorous physical activity had a lower risk of cesarean section than those who partici- pated in the lower level ( OＲ= 0．642，95% CI: 0．437－0．972) ． Conclusions Exercise and moderate to vigorous physical activity are protective factors for cesarean section． Health education should be further strengthened to encourage pregnant women to carry out appropriate physical activity during pregnancy．
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@#Objective To analyze the relationship between pre － pregnancy body mass index ( BMI) ，gestational weight gain ( GWG) and the birth weight of infants，and explore the effect of weight change before and during pregnancy on low birth weight ( LBW) and macrosomia． Methods Women were enrolled by the Chinese Pregnant Women Cohort Study during first trimester． Each respondent＇s weight before and during pregnancy and the birth weight of infant were collected after fellow up． Prepregnancy BMI was divided into underweight，normal and overweight /obesity groups and GWG was divided into suitable， insufficient and excessive groups． Multivariate Logistic regression was adopted to explore the relationship be- tween pre－pregnancy BMI，GWG and newborn＇s birth weight． Ｒesults Women＇s prepregnancy BMI and GWG were associated with neonatal birth weight ( all P＜0. 05) ． Prepregnancy overweight or obesity ( OＲ=2. 339，95% CI: 1. 674－2. 282，P＜0. 001) and excessive GWG ( OＲ= 1. 398，95% CI: 1. 188－1. 978，P= 0. 048) were shown as risk factors for macrosomia． Insufficient GWG increased LBW risk ( OＲ = 1. 479， 95% CI: 1. 461－1. 679，P= 0. 035) while excessive GWG declined LBW risk ( OＲ= 0. 428，95% CI: 0. 225 －0. 817，P= 0. 010) ． Under weight－insufficient GWG was risk factor of LBW ( OＲ= 1. 335，95% CI: 1. 048 －2. 319，P= 0. 048) while normal BMI－excessive GWG ( OＲ= 1. 088，95% CI: 1. 016－1. 675，P= 0. 038) and overweight /obesity－excessive GWG ( OＲ= 1. 498，95% CI: 1. 244－2. 017，P= 0. 046) were associated with higher risk of delivering macrosomia． Conclusions Prepregnancy BMI and GWG were associated with infant＇s birth weight and women were suggested to maintain their weight in recommended range before and during pregnancy．
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Objective To explore the association between unhealthy diets and depression in early pregnancy. Methods 7 976 women in early pregnancy were recruited and analyzed in this study from the Chinese Pregnant Women Cohort Study (CPWCS) from July 25th, 2017 to July 24th, 2018. Differences of baseline characteristics between the two groups were conducted by a chi-square test. The qualitative food frequency questionnaire and the edinburgh postnatal depression scale were used to assess depression status and food intake frequency during the first trimester respectively. Log-binomial regression was used to analyze the relationship between unhealthy diets and depression in early pregnancy. Prevalence ratio (PR) and its 95% confidence interval (95% CI) were calculated. Results Eating regularly (PR=0.45, 95% CI:0.38-0.54，P<0.001) and eating breakfast frequently (PR=0.80, 95% CI:0.72-0.90, P<0.001) were related to the low incidence of depression while frequent consumption of fried food (PR=1.25, 95% CI:1.03-1.53, P=0.027), Western-style fast food (PR=1.36, 95% CI:1.06-1.74, P=0.015) and puffed food (PR=1.37, 95% CI:1.11-1.70, P=0.003) as well as drinking sugar-sweetened beverage (PR=1.37, 95% CI:1.17-1.61, P<0.001),wine (PR=1.60, 95% CI:1.26-2.01, P<0.001) and liqueur (PR=1.26, 95% CI:1.00-1.59, P=0.047) were linked with the high incidence of depression. Conclusions There might be an association between unhealthy diets and depression in early pregnancy. Pregnant women should take the initiative to better understand what are healthy diets and reduce the frequency of unhealthy diets consumption to decrease the incidence of depression during pregnancy.