文章摘要
赵枫,杜文琼,申嘉欣,郭玲玲,王颖,王科科,张萍,冯永亮,杨海澜,王素萍,邬惟为,Zhang Yawei.孕期膳食与小于胎龄儿的关系[J].中华流行病学杂志,2019,40(6):697-701
孕期膳食与小于胎龄儿的关系
Association between maternal dietary intake and the incidence of babies with small for gestational age
投稿时间:2018-11-14  
DOI:10.3760/cma.j.issn.0254-6450.2019.06.018
中文关键词: 膳食摄入;小于胎龄儿;体质指数
英文关键词: Dietary intake;Small for gestational age;Body mass index
基金项目:国家自然科学基金(81473061,81703314);山西省青年科技研究基金(2013021033-2);山西省普通高校特色重点学科建设项目;山西医科大学十人计划项目
作者单位E-mail
赵枫 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
杜文琼 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
申嘉欣 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
郭玲玲 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
王颖 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
王科科 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
张萍 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
冯永亮 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
杨海澜 山西医科大学第一医院妇产科, 太原 030001  
王素萍 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
邬惟为 山西医科大学公共卫生学院流行病学教研室, 太原 030001 wuweiwei2008@sina.com 
Zhang Yawei 耶鲁大学公共卫生学院环境健康科学系, 美国康涅狄格州纽黑文市 06520 yawei.zhang@yale.edu 
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中文摘要:
      目的 研究孕妇不同孕期膳食摄入对小于胎龄儿(SGA)发生风险的影响。方法 收集2012年3月至2016年9月在山西医科大学第一医院产科住院分娩孕妇的一般人口学特征、孕早、中、晚期膳食摄入能量、蛋白质、脂肪、碳水化合物以及新生儿基本信息。纳入研究对象8 102例,SGA组961例,适于胎龄儿(AGA)组7 141例。按照中国食物成分表将摄入食物转化为每日膳食营养素摄入量,以AGA组膳食营养素摄入量的三分位数划分为高摄入量组、中等摄入量组及低摄入量组。通过非条件logistic回归分析孕早、中、晚期膳食摄入营养素对SGA的影响。结果 相对于中等摄入量组,孕早期(<51.60 g/d)、孕中期(<52.69 g/d)及孕晚期蛋白质摄入量低(<52.65 g/d)是SGA的危险因素(OR=1.534,95% CI:1.217~1.934;OR=1.268,95% CI:1.005~1.599;OR=1.310,95% CI:1.036~1.655)。按孕前BMI分层后,孕前BMI<18.5 kg/m2的孕妇早期蛋白质摄入量低(<51.60 g/d)及总能量摄入低(<1 146.22 kcal/d)是SGA的危险因素(OR=1.872,95% CI:1.033~3.395;OR=1.754,95% CI:1.125~2.734);孕前18.5≤BMI<24.0 kg/m2的孕妇,孕早期膳食蛋白质摄入量低(<51.60 g/d)是SGA的危险因素(OR=1.465,95% CI:1.089~1.972);在孕前BMI≥24.0 kg/m2的孕妇中未发现膳食摄入与SGA有关联。结论 孕期膳食摄入影响SGA的发生风险,且不同孕前BMI人群膳食摄入对SGA的影响有差异,孕早期是膳食摄入对SGA作用的关键期。
英文摘要:
      Objective To investigate the relations between dietary intake during pregnancy and the incidence of their babies with small for gestational age (SGA). Methods Data on demographics, dietary intake of protein, fat, and carbohydrates of the pregnant mothers during the first, second and third trimester, were collected. Information related to birth weight and gestational age of the infants were also gathered. A total of 8 102 women, who delivered their babies at the First Affiliated Hospital of Shanxi Medical University from March 2012 to September 2016, were enrolled in this project. Among them, 961 mothers had infants with SGA but the other 7 141 of them having normal infants. Unconditional logistic regression model was used to analyze the effect of dietary nutrient intake on SGA the first, second and third trimester. Results We found that low dietary intake of protein during the first trimester and following trimesters during pregnancy were positively associated with higher risk of SGA (OR=1.534, 95%CI:1.217-1.934; OR=1.268, 95%CI:1.005-1.599; OR=1.310, 95%CI:1.036-1.655). When adjusting for maternal pre-pregnancy BMI, we found that when mothers were with a pre-pregnancy BMI less than 18.5 or with low maternal intake of protein during the first trimester, positive association with higher risk of SGA (OR=1.872, 95%CI:1.033-3.395; OR=1.754, 95%CI:1.125-2.734), was noticed. However, for mothers with a pre-pregnancy BMI between 18.5 and 24.0 or with low protein intake during the first trimester, significant association with higher risk of SGA (OR=1.465, 95%CI:1.089-1.972) was found. Conclusions Through our observation, maternal dietary intake during pregnancy seemed to be associated with the risk of SGA but the effects of dietary intake were different, according to the BMI of pre-pregnancy population. Early pregnancy appeares as the key period for dietary intake which may influence the SGA.
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