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孕前母亲的饮食质量与儿童白血病风险

Maternal diet quality before pregnancy and risk of childhood leukaemia.

作者信息

Singer Amanda W, Carmichael Suzan L, Selvin Steve, Fu Cecilia, Block Gladys, Metayer Catherine

机构信息

1Division of Epidemiology,University of California,Berkeley,CA 94720,USA.

2Department of Pediatrics,Division of Neonatology and Developmental Medicine,Stanford University School of Medicine,Stanford,CA 94305,USA.

出版信息

Br J Nutr. 2016 Oct;116(8):1469-1478. doi: 10.1017/S0007114516003469. Epub 2016 Oct 11.

Abstract

Previous studies on maternal nutrition and childhood leukaemia risk have focused on the role of specific nutrients such as folate and have not considered broader measures of diet quality, which may better capture intake of diverse nutrients known to impact fetal development. We examined the relationship between maternal diet quality before pregnancy, as summarised by a diet quality index, and risk of childhood acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in a case-control study in California. Dietary intake in the year before pregnancy was assessed using FFQ in 681 ALL cases, 103 AML cases and 1076 matched controls. Conditional logistic regression was used to estimate OR and 95 % CI for diet quality continuous score and quartiles (Q1-Q4). Higher maternal diet quality score was associated with reduced risk of ALL (OR 0·66; 95 % CI 0·47, 0·93 for Q4 v. Q1) and possibly AML (OR 0·42; 95 % CI 0·15, 1·15 for Q4 v. Q1). No single index component appeared to account for the association. The association of maternal diet quality with risk of ALL was stronger in children diagnosed under the age of 5 years and in children of women who did not report using vitamin supplements before pregnancy. These findings suggest that the joint effects of many dietary components may be important in influencing childhood leukaemia risk.

摘要

先前关于孕产妇营养与儿童白血病风险的研究主要聚焦于特定营养素(如叶酸)的作用,而未考虑更广泛的饮食质量衡量指标,这些指标可能更能全面反映已知会影响胎儿发育的多种营养素的摄入量。在加利福尼亚州的一项病例对照研究中,我们考察了用饮食质量指数概括的孕前孕产妇饮食质量与儿童急性淋巴细胞白血病(ALL)和急性髓细胞白血病(AML)风险之间的关系。通过食物频率问卷(FFQ)评估了681例ALL病例、103例AML病例和1076例匹配对照在孕前一年的饮食摄入量。采用条件逻辑回归来估计饮食质量连续评分和四分位数(Q1 - Q4)的比值比(OR)及95%置信区间(CI)。孕产妇饮食质量得分较高与ALL风险降低相关(Q4与Q1相比,OR为0·66;95%CI为0·47, 0·93),与AML风险可能降低也相关(Q4与Q1相比,OR为0·42;95%CI为0·15, 1·15)。似乎没有单一的指数成分能解释这种关联。孕产妇饮食质量与ALL风险之间的关联在5岁前确诊的儿童以及孕前未报告使用维生素补充剂的女性所生儿童中更强。这些发现表明,许多饮食成分的联合作用可能对影响儿童白血病风险很重要。

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