Department of Public Health, Faculty of Health Sciences, The S. Daniel Abraham International Center for Health and Nutrition, Ben-Gurion University of the Negev, 84105, Beer-Sheva, Israel.
Cardiovascular Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, 52621, Ramat Gan, Israel.
Eur J Nutr. 2021 Feb;60(1):65-77. doi: 10.1007/s00394-020-02221-4. Epub 2020 Mar 17.
Studies of the association between maternal nutrition and birth outcomes have investigated differing nutrients, maternal socioeconomic conditions, and timing within the reproductive cycle; and have produced inconsistent results. We evaluated the association of preconceptional maternal dietary intake with birth outcomes among low socioeconomic status ethnic minority women in a high-income country.
In this prospective cohort study, habitual preconceptional dietary intake was assessed among pregnant Bedouin Arab women in Israel (n = 384), using a short culturally specific, targeted food frequency questionnaire. Multiple nutrients (protein, lysine, calcium, iron, zinc, folate, omega-3 fatty acids) were evaluated simultaneously via a diet quality score derived from principal component analysis. Multivariable logistic regression was used to test associations between the diet quality score and a composite adverse birth outcomes variable, including preterm birth, low birth weight and small for gestational age.
Sixty-nine women (18%) had adverse birth outcomes. Women with low preconceptional diet quality scores had low intakes of nutrient-rich plant foods, bioavailable micronutrients, and complete proteins. In multivariable analysis, a woman at the 10th percentile of the diet quality score had a 2.97 higher odds (95% CI 1.28-6.86) of an adverse birth outcome than a woman at the 90th percentile.
Low diet quality during the preconceptional period was associated with adverse birth outcomes among low socioeconomic status minority women in a high-income country. The results have implications for the development of appropriate intervention strategies to prevent adverse birth outcomes, and the promotion of adequate nutrition throughout the child-bearing years.
研究母体营养与出生结局之间的关系时，已经调查了不同的营养素、母体社会经济状况以及生殖周期内的时间；并得出了不一致的结果。我们评估了在高收入国家中，社会经济地位较低的少数民族孕妇在受孕前的饮食摄入与出生结局之间的关系。
在这项前瞻性队列研究中，我们使用一种短的文化特异、有针对性的食物频率问卷，评估了以色列贝多因阿拉伯孕妇（n=384）在受孕前的习惯性饮食摄入情况。通过主成分分析得出的饮食质量评分，同时评估了多种营养素（蛋白质、赖氨酸、钙、铁、锌、叶酸、ω-3 脂肪酸）。多变量逻辑回归用于检验饮食质量评分与复合不良出生结局变量（包括早产、低出生体重和小于胎龄儿）之间的关联。
有 69 名妇女（18%）出现不良出生结局。受孕前饮食质量评分低的妇女摄入的营养丰富的植物性食物、生物可利用的微量营养素和完整蛋白质较少。在多变量分析中，饮食质量评分处于第 10 百分位数的妇女发生不良出生结局的几率比处于第 90 百分位数的妇女高 2.97 倍（95%CI 1.28-6.86）。
在受孕前期间，饮食质量低与高收入国家社会经济地位较低的少数民族妇女的不良出生结局有关。这些结果对于制定适当的干预策略以预防不良出生结局以及促进整个生育期的充足营养具有重要意义。
