孕期妇女膳食指南依从性指数与子代先天性心脏病的关系

常倩倩; 党少农; 颜虹; 曾令霞; 杨姣梅

文章摘要

常倩倩,党少农,颜虹,曾令霞,杨姣梅.孕期妇女膳食指南依从性指数与子代先天性心脏病的关系[J].中华流行病学杂志,2022,43(12):1979-1985

孕期妇女膳食指南依从性指数与子代先天性心脏病的关系

Relationship between Chinese dietary guidelines compliance index for pregnant women and congenital heart disease in offspring

收稿日期:2022-04-29 出版日期:2022-12-17

DOI：10.3760/cma.j.cn112338-20220429-00358

中文关键词: 先天性心脏病孕期妇女膳食指南依从性指数膳食质量

英文关键词: Congenital heart disease Chinese dietary guidelines compliance index for pregnant women Diet quality

基金项目:国家自然科学基金（82103852，81230016）；中国博士后科学基金（2019M663751）；陕西省卫生和计划生育委员会基金（Sxwsjswzfcght2016-013）

作者	单位	E-mail
常倩倩	西安交通大学医学部公共卫生学院流行病与卫生统计学教研室, 西安 710061
党少农	西安交通大学医学部公共卫生学院流行病与卫生统计学教研室, 西安 710061
颜虹	西安交通大学医学部公共卫生学院流行病与卫生统计学教研室, 西安 710061
曾令霞	西安交通大学医学部公共卫生学院流行病与卫生统计学教研室, 西安 710061
杨姣梅	西安交通大学医学部公共卫生学院流行病与卫生统计学教研室, 西安 710061	violetyjm18@xjtu.edu.cn

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中文摘要:

目的研究孕期妇女膳食指南依从性指数（CDGCI_PW）与子代先天性心脏病（先心病）的关系。方法在陕西省西安市开展以医院为基础的病例对照研究，采用半定量食物频率问卷调查孕妇整个孕期的饮食情况。应用修订的CDGCI_PW评分评估孕期膳食质量，运用logistic回归分析其与子代先心病的关系，采用受试者工作特征曲线（ROC）构建CDGCI_PW对子代先心病患病的预测模型。结果共纳入1 422名研究对象，病例组474名，对照组948名。病例组CDGCI_PW评分M（Q₁，Q₃）为46.0（26.0，65.0）分低于对照组60.0（40.0，77.0）分，两组间差异有统计学意义（P<0.001）。与CDGCI_PW评分Q₁组相比，CDGCI_PW评分Q₂、Q₃和Q₄组的子代总先心病发生风险均降低（OR=0.60，95%CI：0.43~0.83；OR=0.64，95%CI：0.45~0.89；OR=0.29，95%CI：0.19~0.44）（趋势检验P<0.001）。CDGCI_PW评分每增加10分，子代总先心病的发生风险降低17%（OR=0.83，95%CI：0.79~0.88）。构建ROC预测的曲线下面积为0.793（95%CI：0.768~0.818），约登指数最大处的灵敏度为0.740、特异度为0.725。结论本研究提示改善妇女孕期膳食质量可降低子代先心病的发生风险。

英文摘要:

Objective To study the relationship between the Chinese dietary guidelines compliance index for pregnant women (CDGCI_PW) and congenital heart disease (CHD) in offspring.Methods In a hospital-based case-control study conducted in Xi'an, Shaanxi province, semi-quantitative food frequency questionnaires were used to investigate the diets of pregnant women throughout pregnancy. The modified CDGCI_PW score was used to evaluate dietary quality during pregnancy, logistic regression was applied to analyze the relationship between CDGCI_PW score and offspring CHD, and the ROC curve was adopted to construct the prediction model of CDGCI_PW for offspring CHD. Results A total of 1 422 subjects were enrolled, including 474 in the case group and 948 in the control group. The CDGCI_PW score in the case group M (Q₁, Q₃) was 46.0 (26.0, 65.0) lower than that in the control group, which was 60.0 (40.0, 77.0). The difference between the two groups was significant (P<0.001). Compared with those in the Q₁ of CDGCI_PW, the offspring in the Q₂, Q_3, and Q₄ of CDGCI_PW had a lower risk of total CHD (OR=0.60, 95%CI: 0.43-0.83; OR=0.64, 95%CI: 0.45-0.89; OR=0.29, 95%CI: 0.19-0.44), with the trend test P<0.001. The risk of total CHD was reduced by 17% (OR=0.83, 95%CI: 0.79-0.88) when 10 points increased the CDGCI_PW score. The area under curve predicted by constructing the ROC curve was 0.793 (95%CI: 0.768-0.818), and at the maximum of the Youden index, the sensitivity was 0.740, and the specificity was 0.725. Conclusion This study suggests that improving dietary quality during pregnancy may reduce the risk of CHD in offspring.

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