Santos Izabela da Silva, Crivellenti Lívia Castro, Franco Laércio Joel, Sartorelli Daniela Saes
Graduate Program in Nutrition and Metabolism, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
Graduate Program in Public Health, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
Eur J Clin Nutr. 2021 Dec;75(12):1819-1828. doi: 10.1038/s41430-021-00894-6. Epub 2021 Mar 19.
Birth weight is a relevant predictor of childhood health outcomes. Studies investigating the association between modifiable risk factors, as the maternal diet quality, and birth weight are needed. We aimed to investigate the association between the Diet Quality Index Adapted for Pregnant Women (IQDAG) score and birth weight.
This is a prospective cohort that includes 547 Brazilian mother-child pairs. Dietary recalls and a food frequency questionnaire were obtained during pregnancy. Information on birth weight, sex, and gestation duration were obtained from the Live Birth Information System (SINASC).
On total, 3.8% of the newborns were classified as low birth weight (LBW), 6.0% with macrosomia, 10.2% small for gestational age (SGA), and 11.2% large for gestational age (LGA). The mean (SD) IQDAG score was 70.1 (11.8). Adjusted logistic regression models showed that women in the third tertile of the IQDAG score presented a lower risk of having LGA babies [OR 0.44 (95% CI 0.22, 0.90), p-trend = 0.02] compared to the first tertile. Women in the third tertile of omega-3 intake presented a lower risk of giving birth to LGA infants [OR 0.33 (95% CI 0.15, 0.69), p-trend = 0.00] and LBW infants [OR 0.18 (95% CI 0.04, 0.83), p-trend = 0.02] when compared to the first tertile. There was also a lower SGA trend among the children of women in the third tertile of omega-3 intake [OR 0.43 (95% CI 0.17, 1.07), p-trend = 0.03] compared to the first tertile.
A better diet quality and higher omega-3 intake are protective factors for LGA babies, and increased maternal omega-3 intake reduce the risk of LBW and LGA, and may be a protective factor against the birth of SGA infants.
出生体重是儿童健康结局的一个相关预测指标。需要开展研究来调查可改变的风险因素（如孕妇饮食质量）与出生体重之间的关联。我们旨在研究适用于孕妇的饮食质量指数（IQDAG）得分与出生体重之间的关联。
这是一项前瞻性队列研究，纳入了547对巴西母婴。在孕期收集了饮食回忆和食物频率问卷。出生体重、性别和孕周信息来自活产信息系统（SINASC）。
总体而言，3.8%的新生儿被归类为低出生体重（LBW），6.0%为巨大儿，10.2%为小于胎龄儿（SGA），11.2%为大于胎龄儿（LGA）。IQDAG得分的均值（标准差）为70.1（11.8）。调整后的逻辑回归模型显示，与第一三分位数相比，IQDAG得分处于第三三分位数的女性生出LGA婴儿的风险较低[比值比（OR）0.44（95%置信区间0.22，0.90），p趋势=0.02]。与第一三分位数相比，ω-3摄入量处于第三三分位数的女性生出LGA婴儿的风险较低[OR 0.33（95%置信区间0.15，0.69），p趋势=0.00]，生出LBW婴儿的风险也较低[OR 0.18（95%置信区间0.04，0.83），p趋势=0.02]。与第一三分位数相比，ω-3摄入量处于第三三分位数的女性的子女中SGA趋势也较低[OR 0.43（95%置信区间0.17，1.07），p趋势=0.03]。
更好的饮食质量和更高的ω-3摄入量是LGA婴儿的保护因素，孕妇ω-3摄入量的增加可降低LBW和LGA的风险，并且可能是防止生出SGA婴儿的保护因素。
