Department of Nursing, University of Jaen, Jaen, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Madrid, Spain.
CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, Madrid, Spain; Department of Preventive Medicine and Public Health. University of Granada, Granada, Spain; Biosanitary Research Institute Granada, Granada, Spain.
Nutrition. 2020 Apr;72:110665. doi: 10.1016/j.nut.2019.110665. Epub 2019 Dec 9.
The aim of this study was to assess whether diet variables can neutralize the risk produced by three well-known risk factors for being small for gestational age: smoking, body mass index (BMI) ˂20 kg/m, and having a previous preterm/low birth weight (LBW) newborn.
A matched case control study was conducted (518 cases and 518 controls of pregnant women) in Spain. We collected data on demographic characteristics, socioeconomic status, toxic habits, and diet. Dietary intake during pregnancy was assessed using a validated food frequency questionnaire, categorized into quintiles. Adjusted odds ratios (aORs) and their 95% confidence intervals (CI) were estimated by conditional regression logistic models.
Women who smoked during pregnancy had a 78% increased risk for having an SGA newborn (aOR, 1.78; 95% CI, 1.28-2.74). Lean women (BMI ˂ 20 kg/m before pregnancy) augmented the risk 139% (aOR, 2.39; 95% CI, 1.68-3.40), and those with a previous SGA-LBW an increase of 160% (aOR, 2.60; 95% CI, 1.53-4.37). Smoking in women with a fruit intake of ≥421 g/d was not associated with a higher risk for SGA versus non-smoking women with the same fruit intake (aOR, 0.98; 95% CI, 0.41-2.33). A BMI <20 kg/m with an intake of ≥33 g/d of legumes did not increase the risk for SGA versus women with a BMI ≥20 kg/m with the same legume intake (aOR, 1.35; 95% CI, 0.54-3.37). Diet did not modify the risk by having a previous SGA-LBW newborn.
Smoking and leanness increased the SGA risk; nevertheless foods such as fruit, fish, and legumes, as well as intake of vitamins D and B and ω-3 marine fatty acids, may "at" least partially counteract this increase.
本研究旨在评估饮食变量是否可以中和三个众所周知的胎儿生长受限风险因素（吸烟、体重指数（BMI）<20kg/m2 和有早产/低出生体重（LBW）新生儿史）带来的风险。
在西班牙进行了一项匹配病例对照研究（518 例病例和 518 例孕妇对照）。我们收集了人口统计学特征、社会经济地位、有毒习惯和饮食方面的数据。使用经过验证的食物频率问卷评估妊娠期间的饮食摄入，并分为五分位数。通过条件回归逻辑模型估计调整后的比值比（aOR）及其 95%置信区间（CI）。
怀孕期间吸烟的女性发生胎儿生长受限的风险增加了 78%（aOR，1.78；95%CI，1.28-2.74）。瘦女性（怀孕前 BMI<20kg/m2）的风险增加了 139%（aOR，2.39；95%CI，1.68-3.40），而有早产/低出生体重史的女性的风险增加了 160%（aOR，2.60；95%CI，1.53-4.37）。与摄入相同水果量的非吸烟女性相比，每天摄入≥421 克水果的吸烟女性发生胎儿生长受限的风险无显著增加（aOR，0.98；95%CI，0.41-2.33）。与摄入相同豆类的 BMI≥20kg/m2 的女性相比，每天摄入≥33 克豆类的 BMI<20kg/m2 的女性发生胎儿生长受限的风险并未增加（aOR，1.35；95%CI，0.54-3.37）。饮食并没有改变有早产/低出生体重史的新生儿的风险。
吸烟和消瘦增加了胎儿生长受限的风险；然而，水果、鱼和豆类等食物以及维生素 D、B 和 ω-3 海洋脂肪酸的摄入可能至少部分抵消了这种增加。
