Smid Marcela C, Stuebe Alison M, Manuck Tracy A, Sen Sarbattama
a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of Utah School of Medicine , Salt Lake City , UT , USA.
b Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of North Carolina School of Medicine , Chapel Hill , NC , USA.
J Matern Fetal Neonatal Med. 2019 Aug;32(15):2486-2492. doi: 10.1080/14767058.2018.1439008. Epub 2018 Feb 21.
Moderate fish intake in early pregnancy is associated with decreased risk of preterm birth (PTB). Obesity during pregnancy is characterized by inflammation and insufficiency of essential fatty acids. The objective of this study was to measure the association between fish intake during pregnancy and risk of recurrent spontaneous (s) PTB among lean, overweight, and obese women.
This is secondary analysis of a randomized controlled trial of omega-3 fatty acid supplementation for recurrent PTB prevention, 2005-2006. The primary exposure was fish intake at time of enrollment (16-22.9-week gestation). The primary outcomes were sPTB <37 weeks and sPTB <35 weeks. Maternal prepregnancy body mass index was treated as an effect modifier.
Eight hundred and fifty-two women were included, 47% were lean, 25% overweight, and 28% obese.
In this cohort, among lean, but not overweight or obese women, ≥1 serving of fish per week was associated with decreased frequency of sPTB <37 weeks compared with <1 serving of fish per week (45.1% versus 27.5%, p = .001) and spontaneous PTB <35 (21.4% versus 11.6%, p = .01). In adjusted models, as fish intake increased, the predicted probability of sPTB decreased in lean women but increased in overweight and obese women (p for interaction < .10).
Fish intake was associated with lower probability of sPTB in lean women and higher probability in obese women. These findings warrant further investigation to understand the dietary or metabolic factors associated with obesity that may modulate benefit of fish intake during pregnancy.
孕早期适量摄入鱼类与早产风险降低有关。孕期肥胖的特征是炎症和必需脂肪酸不足。本研究的目的是测量孕期鱼类摄入量与体重正常、超重和肥胖女性复发性自发性早产风险之间的关联。
这是一项2005 - 2006年进行的关于补充ω-3脂肪酸预防复发性早产的随机对照试验的二次分析。主要暴露因素是入组时（妊娠16 - 22.9周）的鱼类摄入量。主要结局是孕37周前的自发性早产和孕35周前的自发性早产。孕妇孕前体重指数被视为效应修饰因素。
纳入852名女性，其中47%体重正常，25%超重，28%肥胖。
在该队列中，体重正常而非超重或肥胖的女性中，每周摄入≥1份鱼类与每周摄入<1份鱼类相比，孕37周前自发性早产的发生率降低（45.1%对27.5%，p = 0.001），孕35周前自发性早产的发生率也降低（21.4%对11.6%，p = 0.01）。在调整模型中，随着鱼类摄入量的增加，体重正常女性自发性早产的预测概率降低，而超重和肥胖女性的预测概率增加（交互作用p<0.10）。
鱼类摄入量与体重正常女性自发性早产概率较低以及肥胖女性自发性早产概率较高有关。这些发现值得进一步研究，以了解与肥胖相关的饮食或代谢因素，这些因素可能会调节孕期鱼类摄入的益处。
