Englund-Ögge Linda, Birgisdottir Bryndis Eva, Sengpiel Verena, Brantsæter Anne Lise, Haugen Margareta, Myhre Ronny, Meltzer Helle Margrete, Jacobsson Bo
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Environmental Exposure and Epidemiology, Domain of Infection Control and Environmental Health, Oslo, Norway.
PLoS One. 2017 Mar 1;12(3):e0172896. doi: 10.1371/journal.pone.0172896. eCollection 2017.
Dietary habits are linked to high maternal glucose levels, associated with preterm delivery. The aim of this study was to examine the associations between meal frequency and glycemic properties of maternal diet in relation to preterm delivery.
This prospective cohort study included 66,000 women from the Norwegian Mother and Child Cohort Study (MoBa). Meal frequency and food intake data were obtained from a validated food frequency questionnaire during mid-pregnancy. Principal component factor analysis was used with a data-driven approach, and three meal frequency patterns were identified: "snack meal", "main meal", and "evening meal". Pattern scores were ranked in quartiles. Glycemic index and glycemic load were estimated from table values. Intakes of carbohydrates, added sugar, and fiber were reported in grams per day and divided into quartiles. Gestational age was obtained from the Medical Birth Registry of Norway. Preterm delivery was defined as birth at <37 gestational weeks. A Cox regression model was used to assess associations with preterm delivery.
After adjustments, the "main meal" pattern was associated with a reduced risk of preterm delivery, with hazard ratios (HRs) of 0.89 (95% confidence interval (CI): 0.80, 0.98) and 0.90 (95% CI: 0.81, 0.99) for the third and fourth quartiles, respectively, and p for trend of 0.028. This was mainly attributed to the group of women with BMI ≥25 kg/m2, with HRs of 0.87 (95% CI: 0.79, 0.96) and 0.89 (95% CI: 0.80, 0.98) for the third and fourth quartiles, respectively, and p for trend of 0.010. There was no association between glycemic index, glycemic load, carbohydrates, added sugar, fiber, or the remaining meal frequency patterns and preterm delivery.
Regular consumption of main meals (breakfast, lunch, dinner) was associated with a lower risk of preterm delivery. Diet should be further studied as potential contributing factors for preterm delivery.
饮食习惯与孕妇高血糖水平有关，而高血糖与早产相关。本研究的目的是探讨进餐频率与孕妇饮食的血糖特性之间的关联以及与早产的关系。
这项前瞻性队列研究纳入了挪威母婴队列研究（MoBa）中的66000名女性。在孕中期通过一份经过验证的食物频率问卷获取进餐频率和食物摄入数据。采用数据驱动的方法进行主成分因子分析，确定了三种进餐频率模式：“零食餐”、“正餐”和“晚餐”。模式得分按四分位数排名。根据表格数据估算血糖指数和血糖负荷。碳水化合物、添加糖和纤维的摄入量以每天克数报告，并分为四分位数。孕周数据来自挪威医疗出生登记处。早产定义为孕周<37周分娩。采用Cox回归模型评估与早产的关联。
调整后，“正餐”模式与早产风险降低相关，第三和第四四分位数的风险比（HR）分别为0.89（95%置信区间（CI）：0.80，0.98）和0.90（95%CI：0.81，0.99），趋势p值为0.028。这主要归因于体重指数（BMI）≥25kg/m²的女性群体，第三和第四四分位数的HR分别为0.87（95%CI：0.79，0.96）和0.89（95%CI：0.80，0.98），趋势p值为0.010。血糖指数、血糖负荷、碳水化合物、添加糖、纤维或其他进餐频率模式与早产之间均无关联。
规律食用正餐（早餐、午餐、晚餐）与较低的早产风险相关。饮食作为早产的潜在促成因素应进一步研究。
