Departments of Biomedical Data Science, Pediatrics, and Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH.
Departments of Pediatrics, and Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH.
J Nutr. 2018 Jan 1;148(1):22-30. doi: 10.1093/jn/nxx005.
Birth weight has a U-shaped relation with chronic disease. Diet quality during pregnancy may impact fetal growth and infant birth weight, yet findings are inconclusive.
We examined the relation between maternal diet quality during pregnancy and infant birth size among women enrolled in a prospective birth cohort.
Women 18-45 y old with a singleton pregnancy were recruited at 24-28 wk of gestation from prenatal clinics in New Hampshire. Women completed a validated food frequency questionnaire at enrollment. Diet quality was computed as adherence to the Alternative Healthy Eating Index. Infant birth outcomes (sex, head circumference, weight, and length) were extracted from medical records. Weight-for-length z scores, low birth weight, macrosomia, and size for gestational age [small for gestational age (SGA) or large for gestational age (LGA)] were computed. Multivariable regression models fit each outcome on quartiles of diet quality, adjusted for covariates. Models were computed overall and stratified by smoking status.
Analyses included 862 women and infants with complete data. Lower diet quality was associated with lower maternal education, being a smoker, prepregnancy obesity status, and lack of exercise during pregnancy. Overall, 3.4% of infants were born with a low birth weight, 12.1% with macrosomia, 4.6% were SGA, and 8.7% were LGA. In an adjusted model, increased diet quality appeared linearly associated with a reduced likelihood of SGA (P-trend = 0.03), although each quartile comparison did not reach statistical significance. Specifically, ORs for SGA were 0.89 (95% CI: 0.37, 2.15), 0.73 (95% CI: 0.28, 1.89), and 0.35 (95% CI: 0.11, 1.08) for each increasing quartile of diet quality compared to the lowest quartile. Similar trends for SGA were observed among non-smokers (n = 756; P-trend = 0.07). Also among non-smokers, increased diet quality was associated with lower infant birth weight (P-trend = 0.03) and a suggested reduction in macrosomia (P-trend = 0.07).
Increased diet quality during pregnancy was related to a reduced risk of SGA in this cohort of pregnant women from New Hampshire. Additional studies are needed to elucidate the relation between maternal diet quality and macrosomia.
出生体重与慢性病呈 U 型关系。孕期饮食质量可能会影响胎儿生长和婴儿出生体重，但结果尚无定论。
我们研究了在新罕布什尔州产前诊所招募的前瞻性出生队列中，孕妇孕期饮食质量与婴儿出生体重的关系。
招募年龄在 18-45 岁之间、单胎妊娠的孕妇，在妊娠 24-28 周时进行。孕妇在入组时完成了一份经过验证的食物频率问卷。饮食质量作为对替代健康饮食指数的依从性来计算。婴儿出生结局（性别、头围、体重和身长）从病历中提取。体重-身长 z 评分、低出生体重、巨大儿和胎儿生长发育迟缓[小于胎龄儿（SGA）或大于胎龄儿（LGA）]。多元回归模型根据饮食质量四分位数调整协变量后拟合每个结局。根据吸烟状况进行了总体模型和分层模型计算。
分析包括 862 名有完整数据的孕妇和婴儿。较低的饮食质量与较低的母亲教育程度、吸烟、孕前肥胖状况以及怀孕期间缺乏运动有关。总的来说，3.4%的婴儿出生体重低，12.1%的婴儿巨大儿，4.6%的婴儿 SGA，8.7%的婴儿 LGA。在调整后的模型中，饮食质量的提高与 SGA 的可能性降低呈线性相关（P 趋势=0.03），但每个四分位组比较均未达到统计学意义。具体而言，与最低四分位组相比，SGA 的 OR 分别为 0.89（95%CI：0.37，2.15）、0.73（95%CI：0.28，1.89）和 0.35（95%CI：0.11，1.08）。在非吸烟者（n=756；P 趋势=0.07）中也观察到了类似的 SGA 趋势。此外，在非吸烟者中，饮食质量的提高与婴儿出生体重较低（P 趋势=0.03）和巨大儿的减少（P 趋势=0.07）有关。
在新罕布什尔州的这组孕妇中，孕期饮食质量的提高与 SGA 风险的降低有关。需要进一步的研究来阐明母体饮食质量与巨大儿之间的关系。
