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[孕期晚期饮食偏好上的妊娠应激]

[Gestational stress on dietary preferences in late pregnancy].

作者信息

Shi Yuyang, Shi Huijing, Ma Xuemei, Tan Liwei, Zhang Yunhui, Wang Ling

机构信息

Department of Maternal, Child and Adolescent Health, Shanghai 200032, China.

Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China.

出版信息

Wei Sheng Yan Jiu. 2020 Jan;49(1):1-18. doi: 10.19813/j.cnki.weishengyanjiu.2020.01.001.

Abstract

OBJECTIVE

To prospectively analyze the effects of gestational stress around 3 months of conception and stress in the second and third trimesters of pregnancy on the dietary preferences in late pregnancy of women in Shanghai City.

METHODS

From April 2016 to April 2018, pregnant women who registered in 2 delivery hospitals in Shanghai were recruited as participants of Shanghai Maternal-Child Pair Cohort with informed consent. Life Events Scale for Pregnant Women was used to evaluate the gestational stress around 3 months of conception and stress during 32-36 weeks of pregnancy, respectively. Food Frequency Questionnaire and factor analysis were used to evaluate the dietary tendency in late pregnancy. Binary Logistic regression model was used to analyze the relationship between gestational stress and dietary tendency.

RESULTS

Among the 2634 pregnant women included in this study, factor analysis revealed six dietary preferences in the third trimester of pregnancy, which were 'balanced', 'meat and beans', 'richer in sugar or oil', 'pickled products and giblets', 'nutritional supplement' and 'caffeine', respectively. After controlling for potential confounding factors of age, education, occupation, annual family income, body mass index before pregnancy, parity, anxiety and depression in the second and third trimesters of pregnancy, higher total and subjective gestational stress around conception would make pregnant women less likely to have a "balanced" diet in late pregnancy(OR=0. 76, 95%CI 0. 61-0. 95). The higher level of gestational stress in the second and third trimesters of pregnancy was associated with a greater preference for a "balanced" diet(OR=1. 66, 95%CI 1. 22-2. 25), but it also increased the preference for a "pickled products and giblets" diet(OR=1. 32, 95%CI 0. 98-1. 78)and inhibited a preference for a "meat and beans" diet(OR=0. 72, 95%CI 0. 53-0. 96).

CONCLUSION

Lower level of gestational pressure during pregnancy is beneficial to the balance of diet in late pregnancy. Compared with that in the second and third trimesters of pregnancy, gestational stress around conception is more likely to negatively affect dietary preferences in late pregnancy.

摘要

目的

前瞻性分析受孕3个月左右的孕期应激以及妊娠中晚期的应激对上海市女性妊娠晚期饮食偏好的影响。

方法

2016年4月至2018年4月,选取在上海2家分娩医院登记的孕妇作为上海母婴配对队列研究的参与者,并获得其知情同意。分别采用孕妇生活事件量表评估受孕3个月左右的孕期应激以及妊娠32 - 36周期间的应激。采用食物频率问卷和因子分析评估妊娠晚期的饮食倾向。采用二元Logistic回归模型分析孕期应激与饮食倾向之间的关系。

结果

本研究纳入的2634名孕妇中,因子分析揭示了妊娠晚期的六种饮食偏好,分别为“均衡饮食”“肉类和豆类”“糖或油含量较高”“腌制食品和内脏”“营养补充剂”和“咖啡因”。在控制年龄、教育程度、职业、家庭年收入、孕前体重指数、产次、妊娠中晚期焦虑和抑郁等潜在混杂因素后,受孕时较高的总孕期应激和主观孕期应激会使孕妇在妊娠晚期选择“均衡饮食”的可能性降低(比值比[OR]=0.76,95%置信区间[CI]为0.61 - 0.95)。妊娠中晚期较高水平的孕期应激与对“均衡饮食”的偏好增加有关(OR = 1.66,95%CI为1.22 - 2.25),但也增加了对“腌制食品和内脏”饮食的偏好(OR = 1.32,95%CI为0.98 - 1.78),并抑制了对“肉类和豆类”饮食的偏好(OR = 0.72,CI为0.53 - 0.96)。

结论

孕期较低水平的妊娠压力有利于妊娠晚期饮食的均衡。与妊娠中晚期相比,受孕时的孕期应激更有可能对妊娠晚期的饮食偏好产生负面影响。

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