Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA.
BMJ Open. 2019 Sep 6;9(9):e030186. doi: 10.1136/bmjopen-2019-030186.
To assess associations between maternal prenatal diet quality and infant adiposity.
The design was a prospective birth cohort.
We used data from the Nurture study, a cohort of women and their infants residing in the southeastern USA.
Between 2013 and 2015, we enrolled 860 women between 20 and 36 weeks' gestation. After reconsenting at delivery and excluding women with implausible calorie intakes, we measured dietary intake using the Block food frequency questionnaire, and assessed diet quality using a modified Alternate Healthy Eating Index 2010 (AHEI-2010), which assessed intake of 10 food categories, including fruits, vegetables, whole grains, nuts/legumes, fats, meats, beverages and sodium (excluding alcohol).
We assessed birth weight for gestational age z-score, small and large for gestational age, low birth weight and macrosomia. Outcomes at 6 and 12 months were weight-for-length z-score, sum of subscapular and triceps skinfold thickness (SS+TR) and subscapular-to-triceps skinfold ratio (SS:TR).
Among mothers, 70.2% were black and 20.9% were white; less than half (45.2%) reported having a high school diploma or less. Among infants, 8.7% were low birth weight and 8.6% were small for gestational age. Unadjusted estimates showed that a higher AHEI-2010 score, was associated with a higher birth weight for gestational z-score (β=0.01; 95% CI 0.002 to 0.02; p=0.02) and a greater likelihood of macrosomia (OR=1.04; 95% CI 1.004 to 1.09; p=0.03). After adjustment, maternal diet quality was not associated with infant adiposity at birth, 6 or 12 months.
Although poor maternal diet quality during pregnancy was not associated with infant adiposity in our study, maternal diet during pregnancy may still be an important and modifiable factor of public health importance.
评估孕妇产前饮食质量与婴儿肥胖的关系。
前瞻性出生队列研究。
我们使用了美国东南部 Nurture 研究的数据,该研究是一项针对女性及其婴儿的队列研究。
2013 年至 2015 年,我们招募了 860 名 20 至 36 周妊娠的女性。在分娩时重新同意并排除了摄入热量不合理的女性后,我们使用 Block 食物频率问卷测量饮食摄入情况,并使用改良后的替代健康饮食指数 2010(AHEI-2010)评估饮食质量,该指数评估了 10 种食物类别的摄入量,包括水果、蔬菜、全谷物、坚果/豆类、脂肪、肉类、饮料和钠(不包括酒精)。
我们评估了胎龄体重 z 评分、小于胎龄儿和大于胎龄儿、低出生体重儿和巨大儿。6 个月和 12 个月的结果为体重身长 z 评分、肩胛下角和肱三头肌皮褶厚度总和(SS+TR)和肩胛下角与肱三头肌皮褶厚度比(SS:TR)。
虽然在我们的研究中,孕妇在怀孕期间的饮食质量差与婴儿肥胖无关,但孕妇在怀孕期间的饮食仍然是一个重要的、可改变的公共卫生因素。