Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi710061, People's Republic of China.
Department of Nutrition, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi710061, People's Republic of China.
Br J Nutr. 2020 May 28;123(10):1176-1186. doi: 10.1017/S0007114520000392. Epub 2020 Feb 5.
Few studies have investigated the association between maternal dietary patterns (DP) during pregnancy, derived from reduced-rank regression (RRR), and fetal growth. This study aims to identify DP during pregnancy associated with macro- and micronutrient intakes, using the RRR method, and to examine their relationship with birth weight (BW). We used data of 7194 women from a large-scale cross-sectional survey in Northwest China. Dietary protein, carbohydrate, haem Fe density and the ratio of PUFA and MUFA:SFA were used as the intermediate variables in the RRR model to extract DP. Generalised estimating equation models were applied to evaluate the associations between DP and BW and related outcomes (including BW z-score, low birth weight (LBW) and small for gestational age (SGA)). Four DP during pregnancy were identified. Socio-demographically disadvantaged pregnant women were more likely to have lower BW and lower adherence to DP1 (high legumes, soyabean products, vegetables and animal-source foods, with relative low wheat and oils). Women with medium and high adherence to DP1 had significantly increased BW (medium 28·6 (95 % CI 7·1, 50·1); high 25·2 (95 % CI 2·7, 47·6)) and BW z-score and had significantly reduced risks of LBW and SGA. The associations were stronger among women with babies <3100 g. There is no association between other DP and outcomes. Higher adherence to the DP that was high in legumes, soyabean products, vegetables and animal-source foods was associated with improved BW in the Chinese pregnant women, particularly among those with disadvantageous socio-demographic conditions.
很少有研究调查过孕期母体饮食模式（DP）与胎儿生长之间的关系，本研究旨在使用降秩回归（RRR）方法，确定与宏量和微量营养素摄入相关的孕期 DP，并探讨其与出生体重（BW）的关系。我们使用了来自中国西北地区一项大规模横断面调查的 7194 名女性的数据。将膳食蛋白质、碳水化合物、血红素 Fe 密度和多不饱和脂肪酸与单不饱和脂肪酸/饱和脂肪酸的比值作为 RRR 模型中的中间变量来提取 DP。广义估计方程模型用于评估 DP 与 BW 及相关结局（包括 BW z 评分、低出生体重（LBW）和小于胎龄儿（SGA））之间的关系。确定了孕期的 4 种 DP。社会人口地位不利的孕妇更有可能 BW 较低，且对 DP1 的依从性较低（豆类、大豆制品、蔬菜和动物源性食物的摄入量较高，而小麦和油的摄入量较低）。中、高 DP1 依从性的女性 BW 显著增加（中 DP1 为 28.6（95 % CI 7.1，50.1）；高 DP1 为 25.2（95 % CI 2.7，47.6）），BW z 评分显著增加，LBW 和 SGA 的风险显著降低。在 BW<3100g 的女性中，关联更强。其他 DP 与结局之间没有关联。较高的豆类、大豆制品、蔬菜和动物源性食物 DP1 依从性与中国孕妇 BW 的改善有关，特别是在社会人口地位不利的孕妇中。
