Abstract
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].Chinese journal of Epidemiology,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
Received:April 29, 2022  
DOI:10.3760/cma.j.cn112338-20220429-00358
KeyWord: 先天性心脏病  孕期妇女膳食指南依从性指数  膳食质量
English Key Word: Congenital heart disease  Chinese dietary guidelines compliance index for pregnant women  Diet quality
FundProject: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)
Author NameAffiliationE-mail
Chang Qianqian Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China  
Dang Shaonong Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China  
Yan Hong Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China  
Zeng Lingxia Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China  
Yang Jiaomei Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China violetyjm18@xjtu.edu.cn 
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Abstract:
      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MQ1Q3)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Q2Q3Q4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。
English Abstract:
      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, Q3, 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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