Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
San-ikukai Hospital, Tokyo, Japan.
Matern Child Nutr. 2017 Oct;13(4). doi: 10.1111/mcn.12391. Epub 2016 Nov 29.
This double cohort study aimed to evaluate the effect of tailored dietary guidance for pregnant women on dietary intake, nutritional status, and infant birth weight. Healthy pregnant women were recruited at an antenatal clinic during two phases over 2 years. The historical controls were analyzed a year prior to the intervention group. In both groups, data were collected at 19-26 gestational weeks (baseline) and at 34-37 gestational weeks (outcome measurement). The intervention included the following: (a) assessments of maternal dietary nutritional intake using the brief self-administered diet history questionnaire, (b) individual feedback based on the assessments of maternal nutritional status, (c) tailored guidance for a healthy diet, (d) original cooking recipes, and (e) goal sharing. Mann-Whitney U test was used to compare the outcome data between the groups. Of the 378 eligible women, 309 women had follow-up questionnaire data. Blood samples were obtained from 202 women. Despite a lack of improvement in reported dietary intake, plasma eicosapentaenoic acid (p = .002), docosahexaenoic acid (p < .001), arachidonic acid (p < .001), and dihomo-gamma-linolenic acid (p < .001) concentrations as well as maternal weight gain (p = .019) were significantly higher in the intervention group. However, serum folate (p = .031) concentration was significantly lower in the intervention group, and there were no significant differences between the groups in 25-hydroxy vitamin D levels, blood count, average birth weight, and rate of low birth weight infants. Assessment-based tailored guidance individualized to maternal dietary intake might partially contribute to improved nutrition in pregnant women.
本双队列研究旨在评估针对孕妇的个性化膳食指导对膳食摄入、营养状况和婴儿出生体重的影响。健康孕妇在两年内的两个阶段于产前门诊招募。历史对照组在干预组前一年进行分析。在两组中,数据均在妊娠 19-26 周(基线)和妊娠 34-37 周(结果测量)收集。干预措施包括:(a)使用简短的自我管理饮食历史问卷评估孕妇的膳食营养摄入,(b)根据孕妇营养状况评估进行个体反馈,(c)提供健康饮食的个性化指导,(d)原始烹饪食谱,以及(e)目标共享。采用 Mann-Whitney U 检验比较两组的结果数据。在 378 名符合条件的女性中,有 309 名女性有随访问卷数据。202 名女性获得了血液样本。尽管报告的膳食摄入没有改善,但血浆二十碳五烯酸(p = 0.002)、二十二碳六烯酸(p < 0.001)、花生四烯酸(p < 0.001)和二高-γ-亚麻酸(p < 0.001)浓度以及产妇体重增加(p = 0.019)在干预组中显著升高。然而,干预组血清叶酸(p = 0.031)浓度显著降低,25-羟维生素 D 水平、血常规、平均出生体重和低出生体重儿发生率在两组间无显著差异。基于评估的个性化指导,针对孕妇的膳食摄入,可能部分有助于改善孕妇的营养状况。