Panum Group, Bethesda, MD.
Food and Nutrition Service, USDA, Alexandria, VA.
Am J Clin Nutr. 2019 Mar 1;109(Suppl_7):729S-756S. doi: 10.1093/ajcn/nqy353.
Maternal diet before and during pregnancy could influence fetal growth and birth outcomes.
Two systematic reviews aimed to assess the relationships between dietary patterns before and during pregnancy and 1) gestational age at birth and 2) gestational age- and sex-specific birth weight.
Literature was searched from January, 1980 to January, 2017 in 9 databases including PubMed, Embase, and Cochrane. Two analysts independently screened articles using predetermined inclusion and exclusion criteria. Data were extracted from included articles and risk of bias was assessed. Data were synthesized qualitatively, a conclusion statement was drafted for each question, and evidence supporting each conclusion was graded.
Of the 9103 studies identified, 11 [representing 7 cohorts and 1 randomized controlled trial (RCT)] were included for gestational age and 21 (representing 19 cohorts and 2 RCTs) were included for birth weight. Limited but consistent evidence suggests that certain dietary patterns during pregnancy are associated with a lower risk of preterm birth and spontaneous preterm birth. These protective dietary patterns are higher in vegetables; fruits; whole grains; nuts, legumes, and seeds; and seafood (preterm birth, only), and lower in red and processed meats, and fried foods. Most of the research was conducted in healthy Caucasian women with access to health care. No conclusion can be drawn on the association between dietary patterns during pregnancy and birth weight outcomes. Although research is available, the ability to draw a conclusion is restricted by inconsistency in study findings, inadequate adjustment of birth weight for gestational age and sex, and variation in study design, dietary assessment methodology, and adjustment for key confounding factors. Insufficient evidence exists regarding dietary patterns before pregnancy for both outcomes.
Maternal dietary patterns may be associated with a lower preterm and spontaneous preterm birth risk. The association is unclear for birth weight outcomes.
孕妇在妊娠前后的饮食可能会影响胎儿的生长和出生结局。
两篇系统综述旨在评估妊娠前后的饮食模式与 1）出生时的胎龄和 2）胎龄和性别特异性出生体重之间的关系。
从 1980 年 1 月至 2017 年 1 月，在 9 个数据库（包括 PubMed、Embase 和 Cochrane）中搜索文献。两名分析员使用预定的纳入和排除标准独立筛选文章。从纳入的文章中提取数据，并评估偏倚风险。对数据进行定性综合，为每个问题起草结论陈述，并对支持每个结论的证据进行分级。
在 9103 项研究中，有 11 项[代表 7 项队列研究和 1 项随机对照试验（RCT）]纳入胎龄研究，21 项[代表 19 项队列研究和 2 项 RCT）]纳入出生体重研究。有限但一致的证据表明，妊娠期间某些饮食模式与早产和自发性早产的风险降低有关。这些保护性饮食模式中蔬菜、水果、全谷物、坚果、豆类和种子、海鲜（仅早产）的含量较高，而红色和加工肉类以及油炸食品的含量较低。大多数研究都是在有条件获得医疗保健的健康白种女性中进行的。由于研究结果不一致、出生体重对胎龄和性别调整不足以及研究设计、饮食评估方法和关键混杂因素调整的差异，无法得出妊娠期间饮食模式与出生体重结局之间的关联结论。关于这两个结局，在妊娠前的饮食模式方面，研究证据不足。
孕妇的饮食模式可能与较低的早产和自发性早产风险有关。对于出生体重结局，其关联尚不清楚。
