Rifas-Shiman Sheryl L, Rich-Edwards Janet W, Willett Walter C, Kleinman Ken P, Oken Emily, Gillman Matthew W
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA.
Paediatr Perinat Epidemiol. 2006 Jan;20(1):35-42. doi: 10.1111/j.1365-3016.2006.00691.x.
Maternal diet may influence outcomes of pregnancy and childhood. Diet in the first trimester may be more important to development and differentiation of various organs, whereas diet later in pregnancy may be important for overall fetal growth as well as for brain development. To our knowledge, no studies have examined individual-level changes in food and nutrient intake from the 1st to 2nd trimester of pregnancy. The objective of this study was to examine changes in dietary intake from the 1st to 2nd trimester of pregnancy. As part of the ongoing US prospective cohort study, Project Viva, we studied 1543 women who completed food-frequency questionnaires that assessed dietary intakes during the 1st and 2nd trimester of pregnancy. For both foods and energy-adjusted nutrients, we examined changes in dietary intake from 1st to 2nd trimester. Reported mean energy intake was similar for the 1st (2046 kcal) and 2nd (2137 kcal) trimesters. Foods and energy-adjusted nutrients from foods whose overall mean intakes increased more than 5% from 1st to 2nd trimester were skim or 1% dairy foods (22%), whole-fat dairy foods (15%), red and processed meat (11%), saturated fat (6%) and vitamin D (7%). Intake of caffeinated beverages (-30%) and alcoholic beverages (-88%) decreased more than 5%. Because mean multivitamin intake increased by 35% from the 1st to 2nd trimester, total micronutrient intake increased appreciably more than micronutrient intake from foods only. Correlations across trimesters ranged from 0.32 for vitamin B12 to 0.68 for fruit and vegetables. In conclusion, for many outcomes of pregnancy and childhood, the incremental information obtained from assessing complete diet in both early and late pregnancy may not outweigh the burden to participants and investigators. However, investigators should assess caffeine, alcohol, and vitamin and supplement use in both the 1st and 2nd trimester, and consider doing so for foods and nutrients for which trimester-specific hypotheses are well substantiated.
孕妇饮食可能会影响妊娠及儿童期的结局。孕早期的饮食对各器官的发育和分化可能更为重要，而孕期后期的饮食对胎儿的整体生长以及大脑发育可能很重要。据我们所知，尚无研究考察过妊娠第1期到第2期食物和营养摄入的个体水平变化。本研究的目的是考察妊娠第1期到第2期饮食摄入的变化。作为正在进行的美国前瞻性队列研究“活力计划”的一部分，我们对1543名完成了食物频率问卷调查的女性进行了研究，这些问卷评估了她们在妊娠第1期和第2期的饮食摄入情况。对于食物及能量调整后的营养素，我们考察了妊娠第1期到第2期饮食摄入的变化。报告的第1期（2046千卡）和第2期（2137千卡）的平均能量摄入量相似。从第1期到第2期总体平均摄入量增加超过5%的食物及能量调整后的营养素包括脱脂或1%脂肪的乳制品（22%）、全脂乳制品（15%）、红肉和加工肉类（11%）、饱和脂肪（6%）和维生素D（7%）。含咖啡因饮料（-30%）和酒精饮料（-88%）的摄入量减少超过5%。由于从第1期到第2期复合维生素的平均摄入量增加了35%，总的微量营养素摄入量的增加明显超过仅从食物中摄入的微量营养素摄入量。各孕期之间的相关性范围从维生素B12的0.32到水果和蔬菜的0.68。总之，对于许多妊娠和儿童期结局而言，从评估孕早期和孕晚期的完整饮食中获得的增量信息可能并不超过参与者和研究者的负担。然而，研究者应在妊娠第1期和第2期评估咖啡因、酒精以及维生素和补充剂的使用情况，并考虑对那些有充分确凿的孕期特异性假设的食物和营养素进行评估。
