Uno Kaoru, Takemi Yukari, Hayashi Fumi, Hosokawa Momo
Graduate School of Kagawa Nutrition University.
Nihon Koshu Eisei Zasshi. 2016;63(12):738-749. doi: 10.11236/jph.63.12_738.
Objective The present study examined nutritional status and dietary intake of pregnant women in Japan in relation to pre-pregnancy body mass index (BMI).Methods Participants included 141 Japanese women with singleton pregnancies, from the outpatient department of the S hospital, Gunma prefecture, Japan. Two-day food records, dietary assessment questionnaires, and clinical records were obtained at 20 weeks gestation. Nine patients were excluded from the study due to morning sickness. The remaining 132 participants were divided into 3 groups according to pre-pregnancy BMI: underweight, normal weight, and overweight. Nutritional status and dietary intake were analyzed in relation to BMI using the chi-square test, Fisher's exact test, Kruskal-Wallis test, one-way analysis of variance, and analysis of covariance with adjustment for age, employment status, and total energy intake.Results Women who were underweight before pregnancy were more frequently working full-time than normal weight and overweight women. Underweight women were also more frequently anemic (P=0.038, underweight 39.3%, normal weight 24.7%, overweight 0%) and had lower mean hemoglobin (Hb) (P=0.021, underweight 11.3 g/dL, normal weight 11.6 g/dL, overweight 12.1 g/dL) and hematocrit (Hct) levels (P=0.025, underweight 33.7%, normal weight 34.3%, overweight 36.0%). Their dietary intake of protein, iron, magnesium, and folic acid was lower than that of normal weight and overweight women. Their meals tended to include fewer meat, fish, egg, and soybean dishes (underweight, mean of 4.7 servings per day; normal weight, 6.1 servings; overweight, 6.1 servings).Conclusion Pregnant women who were underweight before pregnancy had increased risk of anemia as well as reduced Hb and Hct levels. They had lower dietary intake of protein, iron and folic acid compared to women in the other BMI categories. Anemia and these nutrient deficiencies are known risk factors for low birth weight. Our findings suggest the importance of providing underweight pregnant women with support to improve dietary intake during their pregnancy, especially to increase intake of protein and iron through consumption of fish and meat dishes.
本研究调查了日本孕妇的营养状况和饮食摄入情况，并分析其与孕前体重指数（BMI）的关系。
研究对象为日本群马县S医院门诊的141名单胎妊娠日本女性。在妊娠20周时收集了她们的两日饮食记录、饮食评估问卷和临床记录。9名因晨吐而被排除在研究之外。其余132名参与者根据孕前BMI分为3组：体重过轻、体重正常和超重。使用卡方检验、Fisher精确检验、Kruskal-Wallis检验、单因素方差分析以及对年龄、就业状况和总能量摄入进行调整的协方差分析，分析营养状况和饮食摄入与BMI的关系。
孕前体重过轻的女性比体重正常和超重的女性更常全职工作。体重过轻的女性贫血发生率也更高（P = 0.038，体重过轻组为39.3%，体重正常组为24.7%，超重组为0%），平均血红蛋白（Hb）水平更低（P = 0.021，体重过轻组为11.3 g/dL，体重正常组为11.6 g/dL，超重组为12.1 g/dL），血细胞比容（Hct）水平也更低（P = 0.025，体重过轻组为33.7%，体重正常组为34.3%，超重组为36.0%）。她们蛋白质、铁、镁和叶酸摄入量低于体重正常和超重的女性。她们的饮食中肉类、鱼类、蛋类和大豆类菜肴往往较少（体重过轻组平均每天4.7份；体重正常组6.1份；超重组6.1份）。
孕前体重过轻的孕妇贫血风险增加，Hb和Hct水平降低。与其他BMI类别的女性相比，她们蛋白质、铁和叶酸的饮食摄入量较低。贫血和这些营养素缺乏是低出生体重的已知风险因素。我们的研究结果表明，为体重过轻的孕妇提供支持以改善其孕期饮食摄入非常重要，特别是通过食用鱼肉菜肴增加蛋白质和铁的摄入量。
