Pinto Elisabete, Barros Henrique, dos Santos Silva Isabel
Department of Hygiene and Epidemiology, University of Porto Medical School, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
Public Health Nutr. 2009 Jul;12(7):922-31. doi: 10.1017/S1368980008003595. Epub 2008 Aug 27.
To assess maternal diet and nutritional adequacy prior to conception and during pregnancy.
Follow-up of a cohort of pregnant women with collection of questionnaire data throughout pregnancy and after delivery.
Antenatal clinics at two public hospitals in Porto, Portugal.
Two hundred and forty-nine pregnant women who reported a gestational age below 13 weeks at the time they attended their first antenatal visit.
Intakes of energy and macronutrients were within recommended levels for most women. Pregnancy was accompanied by increases in the dietary intake of vitamins A and E, riboflavin, folate, Ca and Mg, but declines in the intake of alcohol and caffeine. The micronutrients with higher inadequacy prevalences prior to pregnancy were vitamin E (83%), folate (58%) and Mg (19%). These three micronutrients, together with Fe, were also those with the highest inadequacy prevalences during pregnancy (91%, 88%, 73% and 21%, respectively, for folate, Fe, vitamin E and Mg). Ninety-seven per cent of the women reported taking supplements of folic acid during the first trimester, but the median gestational age at initiation was 6.5 (interquartile range 5, 9) weeks. Self-reported prevalences of Fe and Mg supplementation were high, and increased throughout pregnancy.
The study identified low dietary intakes of vitamin E, folate and Mg both in the preconceptional period and during pregnancy, and low intake of Fe during pregnancy only. The low dietary intake of folate and the late initiation of supplementation indicate that current national guidelines are unlikely to be effective in preventing neural tube defects.
评估孕前及孕期母亲的饮食和营养充足情况。
对一组孕妇进行随访，在整个孕期及产后收集问卷数据。
葡萄牙波尔图两家公立医院的产前诊所。
249名孕妇，她们在首次产前检查时报告孕周小于13周。
大多数女性的能量和常量营养素摄入量在推荐水平内。孕期维生素A、维生素E、核黄素、叶酸、钙和镁的膳食摄入量增加，但酒精和咖啡因的摄入量下降。孕前不足发生率较高的微量营养素是维生素E（83%）、叶酸（58%）和镁（19%）。这三种微量营养素以及铁也是孕期不足发生率最高的（叶酸、铁、维生素E和镁的不足发生率分别为91%、88%、73%和21%）。97%的女性报告在孕早期服用叶酸补充剂，但开始服用的中位孕周为6.5（四分位间距5，9）周。自我报告的铁和镁补充剂使用率较高，且在整个孕期都有所增加。
该研究发现孕前及孕期维生素E、叶酸和镁的膳食摄入量较低，仅孕期铁摄入量较低。叶酸的低膳食摄入量和补充剂的延迟开始表明，当前的国家指南不太可能有效预防神经管缺陷。
