孕期奶类摄入与新生儿出生体质量关系的前瞻性研究

庞欣欣; 白丹; 蔡聪捷; 董洪利; 张亦奇; 兰茜; 吴成; 郝丽鑫; 杨梦圆; 王芃鹏; 曾果

doi:10.12182/20200960105

孕期奶类摄入与新生儿出生体质量关系的前瞻性研究

Associations of Dairy Consumption during Pregnancy and Neonatal Birth Body Mass: a Prospective Study

摘要

摘要:
目的了解西南地区孕妇孕期奶类摄入现况，探讨孕期奶类摄入量与新生儿出生体质量的关系。
方法采用前瞻性研究，选取成都市某三甲妇幼医疗机构产前门诊孕8～14周单胎健康妇女为研究对象。通过3 d 24小时膳食回顾法分别于孕8～14周、孕24～28周及孕32～36周收集孕早、中、晚期奶及奶制品的摄入信息，计算总奶类摄入量和饮奶率；参照《中国孕期妇女膳食指南（2016）》的奶类推荐量（300 g/d）为标准计算达标率，同时将研究对象分为不饮奶组、饮奶不足组和饮奶适宜组。利用医院信息系统收集分娩孕周、新生儿出生体质量等资料。应用多因素非条件logistic回归模型分析孕期奶类摄入量与新生儿出生体质量的关系。
结果最终纳入962例有效样本。孕早、中、晚期平均奶类摄入量〔中位数（P₂₅，P₇₅）〕分别为125.0（0，236.1） g/d、208.3（0，284.7） g/d、250.0（150.0，416.7） g/d，达标率分别为12.6%、33.2%和48.4%。平均新生儿出生体质量为（3 225.0±399.8） g，小于胎龄儿发生率为8.3%，大于胎龄儿发生率为3.9%。孕中期饮奶适宜组发生小于胎龄儿的风险较不饮奶组降低〔相对危险度（odds ratio, OR）=0.786，95%置信区间（confidence interval, CI）：0.385～0.976〕。孕晚期饮奶不足组和饮奶适宜组发生小于胎龄儿的风险较不饮奶组降低（分别为OR=0.672，95%CI：0.477～0.821和OR=0.497，95%CI：0.116～0.807）。未观察到孕早期奶类摄入量与新生儿出生体质量和孕中、晚期奶类摄入量与大于胎龄儿发生风险有关。
结论西南地区孕妇各孕期奶类摄入不足问题突出，亟待改善。孕期奶类摄入与新生儿出生体质量有关，孕中、晚期奶类摄入量增加可能降低小于胎龄儿发生的风险。

Abstract:
Objective To investigate the dairy product intake during pregnancy in Southwest China and to explore its relationship with neonatal birth body mass.
Methods A prospective study was conducted to select healthy singleton pregnant women at 8-14 weeks of gestation in a maternal and fetal health care institution in Chengdu City. Dairy product consumption during the first, second, third trimester of pregnancy were collected by 24-hour dietary recalls at 8-14 weeks, 24-28 weeks and 32-36 weeks of pregnancy, respectively, and the total milk intake and milk consumption rate were calculated. According to the dietary guidelines for Chinese pregnant women (2016), the recommended amount of milk (300 g/d) was used as the standard to calculate the compliance rate. The respondents were divided into three groups: no dairy consumption group, insufficient dairy consumption group and suitable dairy consumption group. The gestational age at delivery and neonatal birth body mass were collected by the hospital information system. Logistic regression model was used to analyze the association between milk intake during pregnancy and neonatal birth body mass.
Results A total of 962 pregnant women were included. The average milk intake in the first, second and third trimester of pregnancy were 125.0 (0, 236.1) g/d, 208.3 (0, 284.7) g/d and 250.0 (150.0, 416.7) g/d, respectively, with the compliance rates of 12.6%, 33.2% and 48.4%, respectively. The average neonatal birth body mass was (3 225.0±399.8) g. The incidence of small for gestational age (SGA) and large for gestational age (LGA) was 8.3% and 3.9%, respectively. Compared with no dairy consumption group in the second trimester of pregnancy, the risk of SGA was lower in suitable dairy consumption group (odds ratio (OR)=0.786, 95% confidence interval (CI): 0.385-0.976). Compared with no dairy consumption group in the third trimester of pregnancy, the risk of SGA was lower in insufficient dairy consumption group and suitable dairy consumption group (OR=0.672, 95%CI: 0.477-0.821 and OR=0.497, 95%CI: 0.116-0.807, respectively). No association was observed between milk intake in the first trimester and neonatal birth body mass, and milk intake in the second and third trimester of pregnancy was not associated with the risk of LGA.
Conclusion Insufficient milk intake of pregnant women is a significant problem in southwest China and needs to be improved. Milk intake during pregnancy is associated with neonatal birth body mass, and increased milk intake in the second and third trimester of pregnancy may reduce the risk of SGA.

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