Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
Eur J Clin Nutr. 2021 Feb;75(2):355-363. doi: 10.1038/s41430-020-0617-4. Epub 2020 Mar 31.
BACKGROUND/OBJECTIVES: Maternal diet is critical to fetal development. This study aimed to explore the association between maternal dietary diversity during pregnancy and congenital heart defects (CHD) in Chinese population.
A hospital-based case-control study was conducted including 474 cases and 948 controls in Northwest China. We recruited eligible women waiting for delivery in the hospital and gathered their diets during the whole pregnancy by a validated food frequency questionnaire. According to the FAO Minimum Dietary Diversity for Women (MDD-W) guideline, the participants were categorized into "inadequate dietary diversity score (DDS)" (DDS < 5) and "adequate DDS" (DDS ≥ 5) groups. The association between dietary diversity and CHD was estimated using the mixed logistic regression models.
Case mothers had a lower DDS during pregnancy than the controls (P < 0.001). The proportions of women consuming all the ten defined food groups were lower in the inadequate DDS group than in the adequate DDS group among both cases and controls (all P < 0.001). The prevalence of inadequate micronutrient intake was higher in the inadequate DDS group than in the adequate DDS group among both cases and controls (all P < 0.05). Women in the adequate DDS group had reduced risks of having fetuses with total CHD (OR = 0.62, 95% CI = 0.45-0.84) and ventricular septal defects (OR = 0.58, 95% CI = 0.38-0.88).
Adequate DDS during pregnancy might be associated with a lower risk of CHD in offspring. Efforts to promote dietary diversity during pregnancy need to be strengthened to reduce the prevalence of CHD in Chinese population.
背景/目的：母体饮食对胎儿发育至关重要。本研究旨在探讨中国人群中孕妇饮食多样性与先天性心脏病（CHD）之间的关系。
本研究采用医院为基础的病例对照研究，在西北地区纳入了 474 例病例和 948 例对照。我们招募了在医院等待分娩的合格孕妇，并通过经过验证的食物频率问卷收集了她们整个孕期的饮食情况。根据粮农组织女性最低饮食多样性（MDD-W）指南，将参与者分为“饮食多样性得分不足（DDS）”（DDS＜5）和“饮食多样性得分充足（DDS）”（DDS≥5）组。使用混合逻辑回归模型估计饮食多样性与 CHD 之间的关联。
病例组母亲在孕期的 DDS 低于对照组（P＜0.001）。在病例组和对照组中，饮食多样性不足组摄入所有 10 种定义食物组的比例均低于饮食多样性充足组（均 P＜0.001）。在病例组和对照组中，饮食多样性不足组微量营养素摄入不足的比例均高于饮食多样性充足组（均 P＜0.05）。饮食多样性充足组的总 CHD（OR=0.62，95%CI=0.45-0.84）和室间隔缺损（OR=0.58，95%CI=0.38-0.88）患儿的发生风险降低。
孕期饮食多样性充足可能与后代 CHD 风险降低有关。需要加强孕期饮食多样性的促进工作，以降低中国人群 CHD 的患病率。
