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孕期进餐频率与孕期过度增重及新生儿出生体质量关系的队列研究

Eating Frequency and Gestational Weight Gain and Its Association with Birth Body Mass of Neonates: a Birth Cohort Study

  • 摘要: 目的探讨孕期进餐频率与孕期过度增重及新生儿出生体质量的关系。 方法采用前瞻性队列研究,选取2015年4~10月就诊于四川大学华西第二医院的578例健康孕早期孕妇作为调查对象,并追踪随访至分娩。分别于孕早、中、晚期通过问卷调查收集孕妇的膳食摄入和体力活动资料,孕妇增重情况和新生儿胎龄、体质量等信息。采用多因素logistic回归模型分析孕期孕妇进餐频率与孕期过度增重及适龄胎龄儿的关系,采用多重线性回归模型分析孕期孕妇进餐频率与新生儿出生体质量的关系。 结果最终纳入503例孕妇。在调整年龄、教育年限、家庭人均月收入、体力活动、怀孕次数、生产次数和膳食摄入(蛋白质、脂肪、碳水化合物)后,与孕早期进餐总次数和加餐次数低值相比,孕早期进餐总次数和加餐次数高值可增加孕期过度增重的发生风险(进餐总次数:OR=2.03;95%CI:1.18~3.47;加餐次数:OR=1.84;95%CI:1.08~3.15);与孕早期正餐次数为3次相比,孕早期正餐次数多于或少于3次可增加不适龄胎龄儿(小于胎龄儿和大于胎龄儿)的发生风险(多于3次:OR=2.83;95%CI:1.07~4.58;少于3次:OR=1.92;95%CI:1.08~3.61)。孕早期正餐次数与新生儿出生体质量呈正相关(β=236.17;P<0.001)。孕中期、孕晚期均未发现相关性。结论孕早期孕妇进餐频率与孕期过度增重和新生儿出生体质量有关,孕早期每日3次正餐有利于正常新生儿体质量。

     

    Abstract: Objective To determine the association of eating frequency (EF) and gestational weight gain (GWG) with birth body mass of neonates. Methods A prospective cohort study was conducted on 578 healthy pregnant women from April to October 2015. Dietary intake and physical activity data per trimester were collected using a questionnaire. Data in relation to gestational body mass, gestational stage and birth body mass of neonates were obtained from clinical records. Multiple logistic regression models were established to test the impacts of EF and GWG on appropriate for gestational age (AGA). Multiple linear regression analyses were performed to determine the association between EF and birth body mass of neonates. Results A final sample of 503 eligible pregnant women (87.02%) was included in data analyses. Higher EF 〔odds ratio (OR)=2.03; 95% confidence interval (CI): 1.18-3.47〕 and snacks (OR=1.84; 95%CI: 1.08-3.15) in the first trimester were associated with increased risk of excessive GWG, after controlling for maternal age, education, average household income, physicalactivity, numbers of pregnancy, numbers of delivery, and dietary intake (protein, fat, carbohydrate). A meal frequency greater (OR=2.83; 95%CI: 1.07-4.58) or less (OR=1.92; 95%CI: 1.08-3.61) than three in the first trimester was also associated with increased risk of large or small for gestational age. Meal frequency in the first trimester was positively correlated with birth body mass of neonates (β=236.17; P<0.01). Conclusion Frequent eating and snacks in the first trimester are associated with increased risks of excessive GWG. Meal frequency in the first trimester is also positively correlated with birth body mass of neonates: three meals per day is a protective factor of AGA.

     

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