孕中期膳食模式与孕期增重关系的前瞻性研究

蔡聪捷; 董洪利; 庞欣欣; 白丹; 张亦奇; 兰茜; 李润; 杨柳青; 孙鸿; 杨梦圆; 曾果

doi:10.12182/20201160105

孕中期膳食模式与孕期增重关系的前瞻性研究

A Prospective Study of the Relationship Between Dietary Patterns during the Second Trimester of Pregnancy and Gestational Weight Gain

摘要

摘要:
目的研究孕中期膳食模式，探讨膳食模式与孕期增重的关系。
方法采用前瞻性队列研究，选取成都市某三甲妇幼医疗机构产前门诊孕8～14周单胎健康孕妇为研究对象，分别于孕8～14周、孕24～28周、孕32～36周采用3天24 小时膳食回顾法收集孕妇摄入的所有食物种类及数量并计算能量摄入量，通过因子分析建立孕中期膳食模式并计算因子得分。分别在孕8～14周、孕24～28周及分娩前1周测量孕妇体质量，计算孕期总增重、孕中期和孕晚期增重速率。采用多重线性回归方法分析孕中期膳食模式与孕期增重的关系。
结果最终纳入有效样本1 004例，获得3种孕中期膳食模式：奶蛋全谷物型膳食模式、饮料甜点型膳食模式和传统型膳食模式。平均孕期总增重为（13.2±4.5） kg，平均孕中期增重速率为（0.4±0.2） kg/周，平均孕晚期增重速率为（0.5±0.3） kg/周。调整孕妇年龄、孕前体质量指数、膳食能量摄入量及体力活动水平等混杂因素后，多重线性回归分析结果显示，饮料甜点型膳食模式因子得分与孕期总增重和孕晚期增重速率之间均呈正相关关系〔分别为β=0.370，95%置信区间（confidence interval, CI）：（0.103，0.636），P=0.007；β=0.014，95%CI：（0.000，0.027），P=0.049〕，传统型膳食模式因子得分与孕期总增重呈负相关关系〔β=−0.285，95%CI：（−0.555，−0.015），P=0.039〕。未发现奶蛋全谷物型膳食模式与孕期增重相关。
结论孕中期膳食模式与孕期增重有关，饮料甜点型膳食模式可增加孕期总增重及孕晚期增重速率，传统型膳食模式有利于控制孕期总增重。

Abstract:
Objective To study dietary patterns during the second trimester of pregnancy and to investigate the relationship between dietary patterns and gestational weight gain (GWG).
Methods A prospective cohort study was conducted to select healthy singleton pregnant women at 8-14 weeks of gestation in a maternal and child health care institution in Chengdu city. Food items and quantities were collected at 8-14, 24-28, 32-36 weeks of gestation by using the 3-day 24-hour dietary recall and energy intakes were calculated. Dietary patterns during the second trimester were established by factor analysis and factor scores were calculated. The weight of pregnant women was measured at 8-14, 24-28 weeks of gestation and 1 week before delivery, and the total GWG and the GWG rates in the second and third trimesters were calculated. Multiple linear regression analyses were used to analyze the association between dietary patterns and GWG.
Results A total of 1 004 samples were included. Three dietary patterns were identified: Milk-egg-whole grain pattern, Beverage-dessert pattern and Traditional pattern. The average total GWG was (13.2±4.5) kg. The average weight gain rate was (0.4±0.2) kg/week in the second trimester. The average weight gain rate was (0.5±0.3) kg/week in the third trimester. After adjusting for confounding factors including maternal age, body mass index before pregnancy, dietary energy intake, physical activity, multiple linear regression analysis showed that the factor score of Beverage-dessert pattern was positively associated with the total GWG and the weight gain rate in the third trimester (β=0.370, 95% confidence interval (CI): (0.103, 0.636), P=0.007; β=0.014, 95%CI: (0.000, 0.027), P=0.049, respectively), and the factor score of Traditional pattern was negatively associated with the total GWG (β=−0.285, 95%CI: (−0.555, −0.015), P=0.039). There was no association between the Milk-egg-whole grain pattern and GWG.
Conclusion Dietary patterns during the second trimester of pregnancy are associated with GWG. The Beverage-dessert pattern may increase the total GWG and weight gain rate in the third trimester. The traditional pattern may help control the total GWG.

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