Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, 6997801, Tel Aviv, Israel.
The S. Daniel Abraham International Center for Health and Nutrition, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.
Arch Gynecol Obstet. 2020 Oct;302(4):887-898. doi: 10.1007/s00404-020-05689-x. Epub 2020 Aug 10.
We aimed to explore the association of vegetarian-vegan diets and pregnancy outcomes.
A retrospective, web-based study conducted in 2017. Women who delivered < 4 years prior to enrolment where eligible to participate. Participants were allocated to 3 groups based on their self-reported diet during pregnancy: omnivores, vegetarians or vegans. Outcomes of interest including birthweight centile, small for gestational age (SGA), large for gestational age (LGA), preterm birth (PTB), maternal excessive weight gain (EWG) and gestational diabetes (GDM) were compared between the groups.
Overall, 1419 women of which 234 vegans (16.5%), 133 vegetarian (9.4%) and 1052 omnivores (74.1%) were included in final analysis. Maternal vegan diet during pregnancy was associated with a lower birth weight centile as compared to omnivores (42.6 ± 25.9 vs. 52.5 ± 27.0 P < 0.001), a greater adjusted odds ratio (aOR) for SGA (aOR = 1.74; 95% CI 1.05, 2.86) but not with the risk of LGA (aOR = 0.55; 95% CI 0.30, 1.00). Further adjustment for BMI showed similar but nonsignificant associations for SGA and LGA as compared to the omnivore group. Vegan diet was associated with lower risk for maternal EWG (aOR = 0.61; 95% CI 0.44, 0.86) and modest nonsignificant association with GDM (aOR = 0.54 95% CI 0.28, 1.03) which was further attenuated by adjustment for pre-pregnancy BMI. Maternal diet group was not associated with the risk of PTB or low birth weight.
Maternal vegan diet is a protective factor from EWG but associated with a higher risk for SGA and lower birth weight centile. The association between vegan diet and fetal growth was mediated by maternal BMI.
本研究旨在探讨素食和纯素饮食与妊娠结局的关系。
这是一项 2017 年进行的回顾性、基于网络的研究。符合条件的研究对象为在入组前 4 年内分娩的女性。参与者根据其孕期自我报告的饮食分为 3 组：杂食者、素食者或纯素食者。比较了各组之间感兴趣的结局，包括出生体重百分位数、小于胎龄儿（SGA）、大于胎龄儿（LGA）、早产（PTB）、产妇体重过度增加（EWG）和妊娠期糖尿病（GDM）。
共有 1419 名女性入组，其中 234 名纯素食者（16.5%）、133 名素食者（9.4%）和 1052 名杂食者（74.1%）纳入最终分析。与杂食者相比，孕妇素食饮食与较低的出生体重百分位数相关（42.6±25.9 与 52.5±27.0，P<0.001），SGA 的调整后比值比（aOR）更高（aOR=1.74；95%CI 1.05，2.86），但 LGA 的风险无差异（aOR=0.55；95%CI 0.30，1.00）。进一步调整 BMI 后，与杂食组相比，SGA 和 LGA 也有类似但无统计学意义的关联。素食饮食与较低的产妇 EWG 风险相关（aOR=0.61；95%CI 0.44，0.86），与 GDM 有适度的无统计学意义的关联（aOR=0.54，95%CI 0.28，1.03），这种关联在调整孕前 BMI 后进一步减弱。孕妇饮食组与早产或低出生体重的风险无关。
孕妇素食饮食是 EWG 的保护因素，但与 SGA 风险增加和出生体重百分位数降低相关。素食饮食与胎儿生长之间的关联是通过产妇 BMI 介导的。
