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一项观察性研究表明,为孕妇定制营养强化措施似乎能降低某些常见的母婴并发症的发生率。

Customized nutritional enhancement for pregnant women appears to lower incidence of certain common maternal and neonatal complications: an observational study.

作者信息

Stone Leslie P, Stone P Michael, Rydbom Emily A, Stone Lucas A, Stone T Elliot, Wilkens Lindsey E, Reynolds Kathryn

机构信息

Stone Medical PC, Ashland, Oregon (Dr Stone), United States.

Stone Medical PC, Ashland, Oregon (Ms E. Rydbom), United States.

出版信息

Glob Adv Health Med. 2014 Nov;3(6):50-5. doi: 10.7453/gahmj.2014.053.

Abstract

A retrospective chart review analyzed the effect of customized nutrition on the incidence of pregnancy-induced hypertension (PIH), gestational diabetes (GDM), and small- and large-for-gestational-age (SGA, LGA) neonates, examining consecutive deliveries between January 1, 2011, and Decem ber 31, 2012, at a low-risk community hospital. The population was divided into 3 groups: (1) study group (SG), (2) private practice (PP), and (3) community healthcare clinic (CHCC). All groups received standard perinatal management, but additionally the study group was analyzed for serum zinc, carnitine, total 25-hydroxy cholecalciferol (25 OH-D), methylene tetrahydrofolate reductase, and catechol-O-methyl transferase polymorphisms in the first trimester prior to intervention, with subsequent second trimester and postpartum assessment of zinc, carnitine, and 25 OH-D after intervention. Intervention consisted of trimesterby-trimester nutrition and lifestyle education, supplementation of L-methyl folate, magnesium, essential fatty acids, and probiotics for all SG patients, with targeted supplementation of zinc, carnitine, and 25 OH-D. Because of small case occurrence rates of individual conditions in the study group, unreportable reductions were found, except GDM (SG vs CHCC, P value .046 with 95.38% confidence interval [CI]), and PIH (SG vs PP, P value .0505 with 94.95% CIl). The aggregated occurrence rate of the four conditions, however, was significantly lower in the study population than in either comparison population (PP P value .0154 with 98.46% CI, and CHCC P value .0265 with 97.35% CI). Customized nutritional intervention appears to have significantly reduced adverse perinatal outcomes. Prospective study within larger, at-risk populations is needed to determine whether customized nutrition improves conditions individually.

摘要

一项回顾性病历审查分析了定制营养对妊娠高血压(PIH)、妊娠期糖尿病(GDM)以及小于胎龄儿和大于胎龄儿(SGA、LGA)新生儿发病率的影响,该审查针对2011年1月1日至2012年12月31日期间在一家低风险社区医院的连续分娩病例展开。研究对象被分为三组:(1)研究组(SG),(2)私人诊所组(PP),以及(3)社区医疗诊所组(CHCC)。所有组均接受标准围产期管理,但研究组还在干预前的孕早期对血清锌、肉碱、总25-羟基胆钙化醇(25 OH-D)、亚甲基四氢叶酸还原酶和儿茶酚-O-甲基转移酶多态性进行了分析,随后在干预后的孕中期和产后对锌、肉碱和25 OH-D进行了评估。干预措施包括逐 trimester 进行营养和生活方式教育,为所有SG患者补充L-甲基叶酸、镁、必需脂肪酸和益生菌,并针对性地补充锌、肉碱和25 OH-D。由于研究组中个别情况的病例发生率较低,除GDM(SG与CHCC相比,P值为0.046,95.38%置信区间[CI])和PIH(SG与PP相比,P值为0.0505,94.95% CIl)外,未发现可报告的降低情况。然而,研究人群中这四种情况的总发生率显著低于两个对照组人群(PP组P值为0.0154,98.46% CI;CHCC组P值为0.0265,97.35% CI)。定制营养干预似乎显著降低了不良围产期结局。需要在更大的高危人群中进行前瞻性研究,以确定定制营养是否能分别改善各种情况。

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