Siega-Riz Anna Maria, Constantoulakis Leeza
Department of Family, Community, and Mental Health Systems, School of Nursing, University of Virginia, Charlottesville, Virginia, USA,
Department of Public Health Sciences and Obstetrics and Gynecology, School of Medicine, University of Virginia, Charlottesville, Virginia, USA,
Nestle Nutr Inst Workshop Ser. 2019;92:31-40. doi: 10.1159/000499545. Epub 2019 Nov 28.
Maternal nutrition plays a critical role in the course of pregnancy and in the health of the mother and child at birth and beyond. While evidence in support of following specific dietary patterns during pregnancy for an optimal outcome is weak, due to the many methodological limitations of previous studies, there are other guidelines that women should follow. These guidelines include, the healthy dietary patterns included in the 2015-2020 Dietary Guidelines for Americans, and other global guidelines. Key characteristics of these patterns include higher intakes of fish and seafood, vegetables, fruits, whole grains, nuts and seeds, legumes, and vegetable oils. Additionally, maternal weight status, in particular a high BMI (≥30) prior to conception itself, is strongly associated with many adverse birth outcomes. Current gestational weight gain guidelines are dependent on a woman's starting weight, and intervention studies that have been successful in helping women gain within the target require frequent, high intensity diet counseling. Intervention studies conducted in overweight and obese women show greater heterogeneity in success, but it seems prudent to provide counseling to these women even through the inter-conceptional period to help mitigate pregnancy complications and child outcomes associated with a high BMI in future pregnancies.
孕期营养对孕期进程以及母婴出生时及出生后的健康起着至关重要的作用。尽管由于既往研究存在诸多方法学上的局限性，支持孕期遵循特定饮食模式以获得最佳结局的证据尚不充分，但女性仍应遵循其他一些指导原则。这些指导原则包括《2015 - 2020年美国膳食指南》中包含的健康饮食模式以及其他全球指南。这些模式的关键特征包括增加鱼类、海鲜、蔬菜、水果、全谷物、坚果和种子、豆类以及植物油的摄入量。此外，母亲的体重状况，尤其是受孕前BMI较高（≥30），与许多不良出生结局密切相关。目前的孕期体重增加指南取决于女性的起始体重，而那些成功帮助女性在目标范围内增加体重的干预研究需要频繁、高强度的饮食咨询。针对超重和肥胖女性进行的干预研究显示成功率的异质性更大，但即便在受孕间隔期为这些女性提供咨询，以帮助减轻未来妊娠中与高BMI相关的妊娠并发症和儿童结局问题，似乎也是谨慎之举。
