J Acad Nutr Diet. 2019 Sep;119(9):1439-1451. doi: 10.1016/j.jand.2019.02.016. Epub 2019 Apr 30.
Dietary intake may be associated with neonatal outcomes, yet little is known about the influence of prepregnancy dietary pattern (DP).
To evaluate the association between prepregnancy DPs and perinatal outcomes.
Prospective cohort study during pregnancy (baseline between 5 and 13 gestational week and three follow-up visits: 20 to 26 gestational weeks, 30 to 36 gestational weeks, and 30 to 40 days postpartum, respectively). Diet was assessed in the first trimester using a food frequency questionnaire and having prepregnancy as the time frame.
PARTICIPANTS/SETTING: Two hundred fifty-three pregnant women met the following eligibility criteria (20 to 40 years of age, 5 to 13 weeks of gestation at baseline, free of chronic [except obesity] or infectious diseases, and with a singleton pregnancy). The final sample was composed of 193 pregnant women attending a public health care center in Rio de Janeiro, Brazil, from 2009 to 2012.
Type of delivery, large for gestational age (LGA), birth length (BL)>90th percentile, Apgar score<7 at 1 minute, and preterm birth.
Reduced rank regression was used to identify prepregnancy DPs that explain the following response variables: fiber density (daily dietary fiber intake in grams, divided by total daily energy intake in kilocalories), dietary energy density, and percent energy from saturated fat. Statistical analyses included multiple logistic regression models. The following covariates were defined as confounders based on a unique Direct Acyclic Graph for each outcome: maternal age, current smoker, alcohol consumption, years of education, and first-trimester leisure physical activity.
The prevalence of normal delivery was 56.7%. LGA occurred in 16%, BL>90th percentile in 24.3%, Apgar score<7 at 1 minute in 14.2%, and preterm birth in 9.5% of the study population. Three DPs were identified: "fast food and candies" was associated with higher odds of LGA (odds ratio [OR]=4.38, 95% CI: 1.32 to 14.48) and BL>90th percentile (OR=4.81, 95% CI: 1.77 to 13.07); "beans, bread, and fat" was inversely associated with Apgar score<7 at 1 minute (OR=0.14, 95% CI: 0.03 to 0.70); and "vegetables and dairy" was inversely associated with preterm birth (OR=0.24, 95% CI: 0.06 to 0.97). There was no association between adherence to DPs and type of delivery.
Higher adherence to fast food and candies prepregnancy DP increased the odds of LGA birth, while a higher adherence to vegetables and dairy DP decreased the odds of preterm birth.
饮食摄入可能与新生儿结局有关，但关于孕前饮食模式（DP）的影响知之甚少。
评估孕前 DP 与围产期结局的关系。
在怀孕期间进行的前瞻性队列研究（基线在 5 至 13 孕周，有 3 次随访：20 至 26 孕周、30 至 36 孕周和产后 30 至 40 天）。在孕早期使用食物频率问卷评估饮食，以孕前作为时间框架。
参与者/设置：253 名符合以下入选标准的孕妇（年龄 20 至 40 岁，基线时孕周 5 至 13 周，无慢性（除肥胖外）或传染病，单胎妊娠）。最终样本由 193 名在巴西里约热内卢的一家公共医疗保健中心就诊的孕妇组成，时间为 2009 年至 2012 年。
分娩方式、巨大儿（LGA）、出生长度（BL）>第 90 百分位数、1 分钟时 Apgar 评分<7、早产。
降秩回归用于识别孕前 DP，这些 DP 可解释以下反应变量：纤维密度（每日膳食纤维摄入量除以每日总能量摄入的克数）、饮食能量密度和饱和脂肪提供的能量百分比。统计分析包括多变量逻辑回归模型。根据每个结局的独特直接无环图，将以下协变量定义为混杂因素：母亲年龄、当前吸烟者、饮酒、受教育年限和孕早期休闲体力活动。
正常分娩的发生率为 56.7%。LGA 发生率为 16%，BL>第 90 百分位数为 24.3%，1 分钟时 Apgar 评分<7为 14.2%，早产发生率为 9.5%。确定了 3 种 DP：“快餐和糖果”与更高的 LGA（比值比[OR]=4.38，95%置信区间：1.32 至 14.48）和 BL>第 90 百分位数（OR=4.81，95%置信区间：1.77 至 13.07）相关；“豆类、面包和脂肪”与 1 分钟时 Apgar 评分<7呈负相关（OR=0.14，95%置信区间：0.03 至 0.70）；“蔬菜和乳制品”与早产呈负相关（OR=0.24，95%置信区间：0.06 至 0.97）。DP 与分娩方式之间没有关联。
孕前更多地食用快餐和糖果 DP 会增加 LGA 出生的几率，而孕前更多地食用蔬菜和乳制品 DP 会降低早产的几率。
