母体饮食影响胎儿生长但不影响澳大利亚土著妊娠队列胎儿肾脏体积。

Maternal Diet Influences Fetal Growth but Not Fetal Kidney Volume in an Australian Indigenous Pregnancy Cohort.

机构信息

Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore.

Pregnancy and Reproduction Program, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia.

出版信息

Nutrients. 2021 Feb 9;13(2):569. doi: 10.3390/nu13020569.

Abstract

Suboptimal nutrition during pregnancy is recognised as a significant modifiable determinant in the development of chronic disease in offspring in later life. The current study aimed: (i) to assess the dietary intakes of pregnant Indigenous Australian women against national recommendations and (ii) to investigate the associations between maternal nutrition during pregnancy and the growth of the offspring, including kidney development in late gestation in the cohort ( = 103). Maternal dietary intake in the third trimester was assessed using the Australian Eating Survey Food Frequency Questionnaire. Estimated fetal weight (EFW) and kidney size were obtained by ultrasound. Birth weight was retrieved from hospital birth records. Of the five key nutrients for optimal reproductive health (folate, iron, calcium, zinc and fibre), the nutrients with the highest percentage of pregnant women achieving the nutrient reference values (NRVs) were zinc (75.7%) and folate (57.3%), whereas iron was the lowest. Only four people achieved all NRVs (folate, iron, calcium, zinc and fibre) important in pregnancy. Sodium and saturated fat intake exceeded recommended levels and diet quality was low, with a median score of 28 out of 73 points. After adjusting for smoking and pre-pregnancy body mass index, only maternal intake of retinol equivalents and the proportion of energy from nutrient-dense or energy-dense, nutrient-poor (EDNP) foods were associated with fetal growth. EFW decreased by 0.13 g and birth weight decreased by 0.24 g for every µg increase in maternal dietary retinol intake. Interestingly, EFW, but not actual birth weight, was positively associated with percentage energy from nutrient dense foods and negatively associated with percentage energy from EDNP foods. Dietary supplement usage was associated with increased birthweight, most significantly iron and folate supplementation. Current dietary intakes of pregnant Australian women from this cohort do not align with national guidelines. Furthermore, current findings show that maternal retinol intake and diet composition during pregnancy can influence fetal growth, but not fetal kidney growth in late gestation. Strategies that aim to support and optimise nutrient intakes of Indigenous pregnant women are urgently needed. Future studies with long-term follow-up of the children in the current cohort to assess renal damage and blood pressure are imperative.

摘要

孕期营养摄入不足被认为是导致后代在以后生活中患上慢性疾病的一个重要可改变的因素。本研究旨在:(i)评估澳大利亚土著孕妇的饮食摄入情况是否符合国家建议;(ii)研究孕妇在孕期的营养状况与后代生长之间的关系,包括在妊娠晚期胎儿肾脏的生长情况。在妊娠晚期,使用澳大利亚饮食调查食物频率问卷评估了产妇的饮食摄入量。通过超声获得胎儿估计体重(EFW)和肾脏大小。从医院出生记录中获取出生体重。在对生殖健康至关重要的五种关键营养素(叶酸、铁、钙、锌和纤维)中,达到营养素参考值(NRV)的孕妇比例最高的营养素是锌(75.7%)和叶酸(57.3%),而铁则是最低的。只有 4 人达到了所有在孕期都很重要的 NRV(叶酸、铁、钙、锌和纤维)。钠和饱和脂肪的摄入量超过了推荐水平,饮食质量较低,中位数为 73 分中的 28 分。在校正吸烟和孕前体重指数后,只有母体摄入视黄醇当量和来自营养密集或能量密集、营养贫乏(EDNP)食物的能量比例与胎儿生长有关。母体膳食视黄醇摄入量每增加 1µg,EFW 就会减少 0.13g,出生体重就会减少 0.24g。有趣的是,EFW 而不是实际出生体重,与来自营养密集型食物的能量百分比呈正相关,与来自 EDNP 食物的能量百分比呈负相关。膳食补充剂的使用与出生体重的增加有关,其中铁和叶酸的补充作用最为显著。来自该队列的澳大利亚孕妇目前的饮食摄入量与国家指南不一致。此外,目前的研究结果表明,孕妇在孕期的视黄醇摄入量和饮食组成可以影响胎儿的生长,但不能影响胎儿在妊娠晚期的肾脏生长。迫切需要制定旨在支持和优化土著孕妇营养摄入的策略。未来需要对当前队列中的儿童进行长期随访研究,以评估肾脏损伤和血压情况。

相似文献

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索