妊娠期间体重增加轨迹及其与母体饮食质量的关系：PRINCESA 队列研究结果。
Gestational weight gain trajectories over pregnancy and their association with maternal diet quality: Results from the PRINCESA cohort.
机构信息
Health Department, Universidad Iberoamericana, Mexico City, Mexico; UNAM, School of Medicine Branch at Instituto Nacional de Medicina Genómica, México City, México; National Institute of Public Health, Cuernavaca, Morelos, Mexico.
UNAM, School of Medicine Branch at Instituto Nacional de Medicina Genómica, México City, México.
出版信息
Nutrition. 2019 Sep;65:158-166. doi: 10.1016/j.nut.2019.02.002. Epub 2019 Mar 9.
OBJECTIVE
The aims of this study were to characterize, among pregnant Mexican women, gestational weight gain (GWG) trajectories; assess associations of maternal dietary quality score (MDQS) with GWG during early-mid pregnancy, middle pregnancy, late pregnancy, and prolonged pregnancy; and evaluate the association between MDQS and adequacy of GWG, throughout pregnancy. We hypothesized that higher MDQS adherence is protective against insufficient or excessive GWG across pregnancy and that the association between MDQS adherence and GWG would vary by prepregnancy body mass index (BMI) category.
METHODS
We analyzed data from 660 pregnant women participating in the PRINCESA (Pregnancy Research on Inflammation, Nutrition and City Environments: Systematic Analyses) cohort in Mexico City, 2009 to 2014. Repeated measures of dietary intake and mother's weight were obtained during pregnancy. Individual GWG trajectories were modeled in a multilevel regression framework. Associations between MDQS (low, medium, and high adherence) and GWG were investigated using mixed-effect regression models with linear splines.
RESULTS
Women with prepregnancy BMI of ≥30 kg/m had a slower rate of GWG (RGWG) compared with other categories. A higher adherence to MDQS was protective against an insufficient (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.42-0.95; P = 0.03) and an excessive RGWG (OR, 0.62; 95% CI, 0.41-0.94; P = 0.03) throughout pregnancy, adjusting for prepregnancy BMI, energy intake, maternal age, educational level, parity, fetal sex, marital status, and physical activity. Associations between diet and RGWG differed by gestational period.
CONCLUSION
A better quality diet, as measured by MDQS, was associated with appropriate GWG during pregnancy in the PRINCESA cohort.
目的
本研究旨在描述墨西哥孕妇的妊娠体重增加（GWG）轨迹；评估孕期早期-中期、中期、晚期和延长孕期的母体膳食质量评分（MDQS）与 GWG 的相关性；评估 MDQS 与整个孕期 GWG 充足性的相关性。我们假设，更高的 MDQS 依从性可以预防整个孕期 GWG 不足或过多，而 MDQS 依从性与 GWG 的相关性将因孕前体重指数（BMI）类别而异。
方法
我们分析了 2009 年至 2014 年在墨西哥城参加 PRINCESA（妊娠炎症、营养与城市环境研究：系统分析）队列的 660 名孕妇的数据。在妊娠期间，对膳食摄入和母亲体重进行了多次重复测量。在多水平回归框架内对个体 GWG 轨迹进行建模。使用具有线性样条的混合效应回归模型研究 MDQS（低、中、高依从性）与 GWG 之间的关系。
结果
孕前 BMI≥30kg/m2 的女性与其他类别相比，GWG 增加速度较慢。较高的 MDQS 依从性可以预防整个孕期 GWG 不足（比值比[OR]，0.63；95%置信区间[CI]，0.42-0.95；P=0.03）和 GWG 过多（OR，0.62；95%CI，0.41-0.94；P=0.03），调整了孕前 BMI、能量摄入、母亲年龄、教育程度、产次、胎儿性别、婚姻状况和体力活动。饮食与 GWG 之间的关系因孕产期而异。
结论
PRINCESA 队列中，MDQS 衡量的饮食质量越好，与孕期 GWG 增加越适当相关。
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