Paknahad Zamzam, Fallah Atefeh, Moravejolahkami Amir Reza
Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
Clin Nutr Res. 2019 Jan 25;8(1):64-73. doi: 10.7762/cnr.2019.8.1.64. eCollection 2019 Jan.
Maternal nutritional status during pregnancy will affect the outcomes for the mother and the newborn. Maternal diet was assessed in 150 pregnant women during the first trimester of pregnancy by a 168-item food frequency questionnaire. Dietary patterns were explored by Factor analysis, and association of patterns with maternal and neonatal outcomes such as gestational diabetes mellitus (GDM), anemia and anthropometric indices were determined by analysis of variance and linear regression analysis. Three major dietary patterns were identified: 1) High Carbohydrate-Lower Fat (mean age, 27.67 ± 6.1; n = 34), 2) High Carbohydrate-Higher Fat (27.70 ± 4.1; n = 55), and 3) High Fiber (29.27 ± 5.8; n = 61). A significant difference was observed between maternal dietary patterns (p < 0.01) for GDM, while it was not significant for anemia. Also, the number of preterm and low birth weight (LBM) infants as well as mean weight, height and head circumference of the infants did not differ significantly between patterns, but there was a significant difference between the maternal dietary patterns about the number of macrosomic babies, which was higher in the second (n = 9) and third (n = 9) dietary patterns (p < 0.01). After adjusting for mothers' age, disease history, disease status, and energy intake, High Carbohydrate-Lower Fat dietary pattern was more associated with GDM than crude model (p = 0.01 vs. p = 0.02). The present study indicated a significant relationship between maternal dietary patterns before pregnancy and GDM and fetal macrosomia.
孕期母亲的营养状况会影响母亲和新生儿的结局。在妊娠早期,通过一份包含168个项目的食物频率问卷对150名孕妇的饮食情况进行了评估。采用因子分析探究饮食模式,并通过方差分析和线性回归分析确定这些模式与母亲和新生儿结局(如妊娠期糖尿病(GDM)、贫血和人体测量指标)之间的关联。确定了三种主要饮食模式:1)高碳水化合物-低脂肪(平均年龄27.67±6.1;n = 34),2)高碳水化合物-高脂肪(27.70±4.1;n = 55),3)高纤维(29.27±5.8;n = 61)。GDM在母亲饮食模式之间存在显著差异(p < 0.01),而贫血方面差异不显著。此外,早产和低出生体重(LBM)婴儿的数量以及婴儿的平均体重、身高和头围在不同模式之间没有显著差异,但母亲饮食模式在巨大儿数量方面存在显著差异,在第二种(n = 9)和第三种(n = 9)饮食模式中更高(p < 0.01)。在调整母亲年龄、病史、疾病状态和能量摄入后,高碳水化合物-低脂肪饮食模式与GDM的关联比原始模型更强(p = 0.01对p = 0.02)。本研究表明孕前母亲饮食模式与GDM和胎儿巨大儿之间存在显著关系。