Shrestha Shikhar, Jimenez Elizabeth, Garrison Laura, Pribis Peter, Raisch Dennis W, Stephen Julia M, Bakhireva Ludmila N
a Department of Pharmacy Practice and Administrative Sciences , University of New Mexico College of Pharmacy , Albuquerque , New Mexico , USA.
b Center for Education Policy Research , University of New Mexico , Albuquerque , New Mexico , USA.
Subst Use Misuse. 2018 Jan 28;53(2):260-269. doi: 10.1080/10826084.2016.1265563. Epub 2017 Feb 22.
Substance abuse in nonpregnant adults has been associated with increased intake in calories and decreased intake of nutrient-dense foods; however, studies examining dietary intake in opioid-using and alcohol-using pregnant women are lacking.
The objective of this study was to evaluate dietary intake in opioid-using pregnant women with or without concurrent light-to-moderate alcohol use as compared to abstaining controls.
This prospective birth cohort included 102 pregnant women classified into four study groups: controls (n = 27), medication-assisted treatment (MAT; n = 26), alcohol (ALC; n = 22), and concurrent use of both substances (MAT + ALC; n = 27). Percentage differences in macro- and micronutrient intake were estimated from the food frequency questionnaire and compared among the study groups. Proportions of participants with intakes below the estimated average requirements (EAR) based on diet and diet with supplements were estimated.
Three exposed groups had lower prevalence of multivitamin use in periconceptional period (11.5-31.8%) than controls (44.4%). Unadjusted mean energy intake was significantly higher in the MAT + ALC group compared to controls, while micronutrient intake per 1000 kcal was the highest in the control group for almost all of the micronutrients analyzed. After adjustment for energy intake and sociodemographic characteristics, MAT group had lower estimated dietary intake of iron (-15.0%, p = 0.04) and folate (-16.8%, p = 0.04) compared to controls. A high proportion of participants in all study groups had dietary intake below the EAR for vitamin E, iron, and folate.
Results highlight the need for targeted dietary interventions for opioid-using pregnant women.
非孕期成年人的药物滥用与热量摄入增加及营养丰富食物摄入减少有关；然而，关于使用阿片类药物和酒精的孕妇饮食摄入情况的研究却很缺乏。
本研究的目的是评估使用阿片类药物的孕妇（无论是否同时有轻度至中度饮酒）与戒酒对照组相比的饮食摄入情况。
这项前瞻性出生队列研究纳入了102名孕妇，分为四个研究组：对照组（n = 27）、药物辅助治疗组（MAT；n = 26）、酒精组（ALC；n = 22）以及两种物质同时使用组（MAT + ALC；n = 27）。通过食物频率问卷估计宏量营养素和微量营养素摄入的百分比差异，并在各研究组之间进行比较。估计了基于饮食和补充剂饮食的摄入量低于估计平均需求量（EAR）的参与者比例。
三个暴露组在受孕前阶段使用多种维生素的患病率（11.5 - 31.8%）低于对照组（44.4%）。与对照组相比，MAT + ALC组未调整的平均能量摄入量显著更高，而在几乎所有分析的微量营养素中，对照组每1000千卡的微量营养素摄入量最高。在对能量摄入和社会人口学特征进行调整后，MAT组与对照组相比，估计的铁（-15.0%，p = 0.04）和叶酸（-16.8%，p = 0.04）饮食摄入量较低。所有研究组中很大一部分参与者维生素E、铁和叶酸的饮食摄入量低于EAR。
结果凸显了对使用阿片类药物的孕妇进行有针对性饮食干预的必要性。
