妊娠高血压与正常血压孕妇产后六个月的宏量和微量营养素摄入：不良的饮食质量是否会增加未来心血管代谢疾病的风险？

Maternal macro- and micronutrient intake six months after hypertensive versus normotensive pregnancy: is poor diet quality contributing to future cardiometabolic disease risk?

机构信息

School of Women's and Children's Health, UNSW Medicine, Level 1 Royal Hospital for Women, Barker Street, NSW 2031, Australia.

School of Women's and Children's Health, UNSW Medicine, Level 1 Royal Hospital for Women, Barker Street, NSW 2031, Australia; Department of Women's and Children's Health, St George Hospital - Prichard Wing Level 1, Gray Street, Kogarah, NSW 2217, Australia; Global Women's Health Program, The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW 2042, Australia.

出版信息

Pregnancy Hypertens. 2021 Mar;23:196-204. doi: 10.1016/j.preghy.2020.11.002. Epub 2020 Nov 13.

DOI:10.1016/j.preghy.2020.11.002

PMID:33515976

Abstract

BACKGROUND

Hypertensive pregnancy is associated with increased long-term cardiometabolic disease risk. Assessing dietary intake patterns after hypertensive (HP) versus normotensive pregnancy (NP) may provide insights into the mechanism of this risk.

METHODS

This study was a prospective sub-study of the P4 (Postpartum, Physiology, Psychology and Paediatrics) cohort. Women were studied six months after NP versus HP (preeclampsia or gestational hypertension). Dietary energy, macronutrient and micronutrient intake were measured using a three-day food diary (FoodWorks™) and assessed against Australian and New Zealand Nutrient Reference Values to determine nutritional adequacy. Comparisons between breastfeeding and non-breastfeeding women were assessed, and linear regression modelling (using hypertensive status, breastfeeding status, and demographic/pregnancy variables) performed to assess predictors of energy intake.

RESULTS

Seventy-four women (60 NP, 14 HP) were included. HP women had higher mean body mass index (p = 0.02) and lower breastfeeding rates (29% HP versus 83% NP, p < 0.001) compared to NP women. Twenty-four-hour energy intake and total fat intake were 17% and 20% lower after HP respectively. Nutrient deficiencies were prevalent across all participants, however more HP women had inadequate magnesium, calcium and phosphorus intake. Breastfeeding women had significantly increased energy (17%), carbohydrate (15%) and total fat intake (21%), and increased vitamin A, vitamin E, riboflavin, magnesium and iron intake compared to non-breastfeeding women. HP and breastfeeding status were independent predictors of energy intake.

CONCLUSIONS

HP women had lower micronutrient intake and greater prevalence of nutritional inadequacy compared to NP women, reflecting poorer diet quality and potentially contributing to future increased cardiometabolic disease risk.

摘要

背景

高血压妊娠与长期心血管代谢疾病风险增加有关。评估高血压（HP）与正常血压（NP）妊娠后饮食摄入模式可能有助于深入了解这种风险的机制。

方法

本研究是 P4（产后、生理学、心理学和儿科学）队列的前瞻性子研究。在 NP 与 HP（子痫前期或妊娠高血压）后 6 个月对女性进行研究。使用三天食物日记（FoodWorks ™）测量膳食能量、宏量营养素和微量营养素的摄入量，并根据澳大利亚和新西兰营养素参考值评估其营养充足程度。评估母乳喂养和非母乳喂养女性之间的差异，并进行线性回归模型（使用高血压状况、母乳喂养状况和人口统计学/妊娠变量），以评估能量摄入的预测因素。

结果

共有 74 名女性（60 名 NP，14 名 HP）入选。与 NP 女性相比，HP 女性的平均体重指数更高（p=0.02），母乳喂养率更低（29% HP 与 83% NP，p<0.001）。HP 后 24 小时能量摄入和总脂肪摄入分别降低了 17%和 20%。所有参与者均存在普遍的营养素缺乏，但更多的 HP 女性存在镁、钙和磷摄入不足。母乳喂养女性的能量（17%）、碳水化合物（15%）和总脂肪摄入（21%）均显著增加，维生素 A、维生素 E、核黄素、镁和铁的摄入也增加，与非母乳喂养女性相比。HP 和母乳喂养状况是能量摄入的独立预测因素。