孕妇素食饮食与母婴结局。
Vegetarian diets during pregnancy, and maternal and neonatal outcomes.
机构信息
Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
出版信息
Int J Epidemiol. 2021 Mar 3;50(1):165-178. doi: 10.1093/ije/dyaa200.
BACKGROUND
Vegetarian diets are becoming increasingly popular in the USA. Limited research has examined the health consequences of vegetarian diets during pregnancy. We comprehensively examined associations of vegetarianism during pregnancy with maternal and neonatal outcomes.
METHODS
We used data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Fetal Growth Studies-Singletons, a prospective multi-site cohort of 1948 low-risk pregnant women of four races/ethnicities (White, Black, Hispanic, Asian/Pacific Islander) in the USA (2009-2013). Vegetarianism was self-reported and also defined based on dietary patterns measured using a self-administered first-trimester food-frequency questionnaire (full [lacto-ovo and vegan], pesco-, semi- and non-vegetarians). Neonatal outcomes included birthweight and neonatal anthropometric measures, small for gestational age, small for gestational age with neonatal morbidity and preterm delivery. Maternal outcomes included gestational weight gain, gestational diabetes, hypertensive disorders of pregnancy and gestational anaemia.
RESULTS
Ninety-nine (6.2%) women self-reported being vegetarian. The diet-based definition identified 32 (2.0%) full vegetarians, 7 (0.6%) pesco-vegetarians and 301 (17.6%) semi-vegetarians. Neonates of diet-based full vegetarians had higher odds of being small for gestational age [adjusted odds ratio (ORadj) = 2.51, 95% confidence interval: 1.01, 6.21], but not of being small for gestational age with a postnatal morbidity. Full vegetarians had marginally increased the odds of inadequate second-trimester gestational weight gain (ORadj = 2.24, 95% confidence interval: 0.95, 5.27).
CONCLUSION
Vegetarian diets during pregnancy were associated with constitutionally smaller neonatal size, potentially via the mothers' reduced gestational weight gain. Notably, vegetarianism was not associated with small-for-gestational-age-related morbidities or other adverse maternal outcomes.
背景
素食在 美国越来越受欢迎。有限的研究调查了素食在怀孕期间对母婴健康的影响。我们全面研究了孕妇素食与母婴结局的关系。
方法
我们使用了 Eunice Kennedy Shriver 国家儿童健康与人类发展研究所胎儿生长研究-单胎的数据分析，这是一项前瞻性的多地点队列研究，纳入了来自美国四个种族/族裔（白种人、黑种人、西班牙裔、亚洲/太平洋岛民）的 1948 名低危孕妇（2009-2013 年）。素食是自我报告的，也可以根据在孕早期使用自我管理的食物频率问卷（完全素食[乳蛋素食和纯素食]、鱼素食、半素食和非素食]）测量的饮食模式来定义。新生儿结局包括出生体重和新生儿人体测量指标、小于胎龄儿、小于胎龄儿伴新生儿发病率和早产。产妇结局包括妊娠期体重增加、妊娠期糖尿病、妊娠高血压疾病和妊娠期贫血。
结果
99 名（6.2%）女性自我报告为素食者。基于饮食的定义方法识别出 32 名（2.0%）完全素食者、7 名（0.6%）鱼素食者和 301 名（17.6%）半素食者。基于饮食的完全素食者的新生儿发生小于胎龄儿的几率更高[调整后的比值比（ORadj）=2.51，95%置信区间：1.01，6.21]，但小于胎龄儿伴产后发病率的几率没有增加。完全素食者在妊娠中期体重增加不足的几率略有增加（ORadj=2.24，95%置信区间：0.95，5.27）。
结论
孕妇素食与新生儿体型较小有关，可能是由于母亲的妊娠期体重增加减少。值得注意的是，素食与小于胎龄儿相关的发病率或其他不良产妇结局无关。
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