Watson Patricia E, McDonald Barry W
Institute of Food Nutrition and Human Health, Massey University, Private Bag 102-904, NSMC, Auckland, New Zealand.
Matern Child Health J. 2009 Sep;13(5):695-706. doi: 10.1007/s10995-008-0405-6. Epub 2008 Sep 3.
To investigate factors associated with maternal diet during pregnancy and rank these in order of influence using data from a prospective cohort of 196 pregnant women, aged between 18 and 35 years of mostly European origin.
Anthropometric measurements were taken, questionnaires administered and 16 days of weighed diet intakes recorded, eight in the fourth and eight in the seventh month of pregnancy. Twenty four hours activity records were kept for 3 days at these times. Factors investigated were education, age, occupational status, welfare dependence, smoking, number of children, morning sickness, activity level, height, weight, body mass index, and sum of skinfolds.
Univariate analyses showed median weight of food and nutrient intakes were significantly lower in the less educated, the young, welfare dependants, smokers, and those who vomited during pregnancy. Almost all subjects had intakes of Vitamin D, folate, iron, and selenium below the estimated average requirement. Multivariate analyses of each nutrient against all predictors showed that in decreasing order of importance, education, maternal height, welfare dependence, smoking, and morning sickness had the greatest overall effect on the women's diets, mostly through their influence on energy intake. Age and number of children had less association with nutrient intake but along with education had a strong association with energy adjusted quality of diet. Weight and activity had weak associations with the quantity and quality of intake. After adjusting for energy intake, morning sickness ceased to be relevant.
To maximize effectiveness, education, welfare dependence, smoking, morning sickness, age, and parity are important factors to consider when attempting to change maternal diet during pregnancy.
利用来自196名年龄在18至35岁之间、大多为欧洲裔的孕妇前瞻性队列的数据，调查孕期母亲饮食的相关因素，并按影响程度对这些因素进行排序。
进行人体测量，发放问卷，并记录16天的称重饮食摄入量，孕期第四个月记录8天，第七个月记录8天。在这些时间段内，连续3天记录24小时的活动情况。调查的因素包括教育程度、年龄、职业状况、福利依赖情况、吸烟情况、子女数量、孕吐情况、活动水平、身高、体重、体重指数和皮褶厚度总和。
单因素分析显示，受教育程度较低者、年轻人、依赖福利者、吸烟者以及孕期呕吐者的食物和营养摄入量中位数显著较低。几乎所有受试者的维生素D、叶酸、铁和硒摄入量均低于估计平均需求量。对每种营养素与所有预测因素进行多因素分析表明，按重要性递减顺序，教育程度、母亲身高、福利依赖情况、吸烟情况和孕吐情况对女性饮食的总体影响最大，主要是通过对能量摄入的影响。年龄和子女数量与营养摄入量的关联较小，但与教育程度一起与能量调整后的饮食质量有很强的关联。体重和活动与摄入量的数量和质量的关联较弱。在调整能量摄入后，孕吐不再具有相关性。
为了使效果最大化，在试图改变孕期母亲饮食时，教育程度、福利依赖情况、吸烟情况、孕吐情况、年龄和胎次是需要考虑的重要因素。
