SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.
Matern Child Nutr. 2020 Apr;16(2):e12912. doi: 10.1111/mcn.12912. Epub 2019 Nov 27.
This study examined associations between a maternal "mixed, high sugar" dietary pattern during pregnancy and ultrasound-determined fetal growth in 495 urban African women and explored whether these associations were independent of maternal baseline body mass index (BMI) and gestational weight gain (GWG). Linear mixed effects modelling (LMM) was used to test the associations between maternal mixed, high sugar dietary pattern score, baseline BMI (kg/m ), and GWG (kg/week) and the following fetal growth outcomes: (a) biparietal diameter (cm), (b) head circumference (cm), (c) abdominal circumference (cm), and (d) femur length (cm). In the pooled LMM, a +1 standard deviation (SD) increase in the mixed, high sugar dietary pattern score was associated with higher biparietal diameter (0.03 cm/+1 SD; p = .007), head circumference (0.07 cm/+1 SD; p = .026), abdominal circumference (0.08 cm/+1 SD; p = .038), and femur length (0.02 cm/+1 SD; p = .015). Although these associations were independent of maternal BMI and GWG, higher baseline BMI was independently and positively associated with abdominal circumference (0.03 cm/+1 kg/m ; p = .011) and femur length (0.01 cm/+1 kg/m ; p = .007) and 1 kg/week greater GWG was associated with a 0.82 cm increase in abdominal circumference (p = .007). In urban African settings, where preconception maternal obesity prevalence is high and processed, high sugar diets are common, improving maternal dietary intake and BMI prior to conception should be prioritised for optimising pregnancy and birth outcomes as well as longer-term offspring health. In addition, dietary management strategies during pregnancy may be beneficial in facilitating healthy fetal growth.
本研究调查了妊娠期间母体“混合、高糖”饮食模式与 495 名城市非洲女性超声确定的胎儿生长之间的关联，并探讨了这些关联是否独立于母体基线体重指数（BMI）和妊娠体重增加（GWG）。线性混合效应模型（LMM）用于测试母体混合、高糖饮食模式评分、基线 BMI（kg/m ）和 GWG（kg/周）与以下胎儿生长结局之间的关联：（a）双顶径（cm），（b）头围（cm），（c）腹围（cm）和（d）股骨长（cm）。在汇总的 LMM 中，混合、高糖饮食模式评分增加 1 个标准差（SD）与双顶径（0.03cm/+1SD;p=0.007）、头围（0.07cm/+1SD;p=0.026）、腹围（0.08cm/+1SD;p=0.038）和股骨长（0.02cm/+1SD;p=0.015）增加相关。尽管这些关联独立于母体 BMI 和 GWG，但较高的基线 BMI 与腹围（0.03cm/+1kg/m;p=0.011）和股骨长（0.01cm/+1kg/m;p=0.007）呈独立正相关，而 GWG 每增加 1kg/周与腹围增加 0.82cm（p=0.007）相关。在非洲城市地区，孕前母体肥胖的患病率较高，加工、高糖饮食较为普遍，因此在怀孕前应优先改善母体饮食摄入和 BMI，以优化妊娠和分娩结局以及更长远的后代健康。此外，在怀孕期间进行饮食管理策略可能有助于促进胎儿健康生长。
