Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Nutrients. 2021 Mar 3;13(3):829. doi: 10.3390/nu13030829.
Compliance with dietary guidelines among pregnant women can positively influence not only their own health but also the health of their babies. Measuring the compliance requires professional skills in nutrition and dietary counseling. In China, few simple and effective techniques assess dietary quality among pregnant women, especially in rural areas. We aimed to establish a new simple and effective assessment technique, the "Chinese Dietary Guidelines Compliance Index for Pregnant Women (CDGCI-PW)" and assess the association between maternal dietary compliance and risks of pregnancy complications.
The CDGCI-PW consists of 13 main components which were based on the 2016 edition of the Chinese dietary guidelines for pregnant women. Each component was assigned a different score range, and the overall score ranged from 0 to 100 points. The Tongji Maternal and Child Health Cohort study (from September 2013 to May 2016) was a prospective cohort study designed to examine maternal dietary and lifestyle effects on the health of pregnant women and their offspring. The maternal diet during the second trimester was compared with the corresponding recommended intake of the Chinese balanced dietary pagoda for pregnant women to verify their compliance with dietary guidelines. The association between maternal dietary quality and risks of pregnancy complications was estimated by regression analysis. Receiver operating characteristic (ROC) curves were constructed to identify the optimal cut-off values of CDGCI-PW for gestational hypertension and gestational diabetes mellitus (GDM).
Among the 2708 pregnant women, 1489 were eventually followed up. The mean CDGCI-PW score was 74.1 (standard deviation (SD) 7.5) in the second trimester. The majority of foods showed the following trend: the higher the CDGCI-PW score, the higher the proportion of pregnant women who reported food intake within the recommended range. Moreover, a higher maternal CDGCI-PW score was significantly associated with lower risks of gestational hypertension [odds ratio (OR) (95% confidence interval [(CI): 0.30 (0.20, 0.37)] and GDM [OR (95% CI): 0.38 (0.31, 0.48)]. The optimal CDGCI-PW cut-off value for gestational hypertension was ≥68.5 (sensitivity 82%; specificity: 61%; area under the ROC curve, AUC = 0.743), and the optimal CDGCI-PW cut-off score for GDM was ≥75.5 (sensitivity 43%; specificity: 81%; area under the ROC curve, AUC = 0.714).
The CDGCI-PW is a simple and useful technique that assesses maternal diet quality during pregnancy, while adherence to the CDGCI-PW is associated with a lower risk of gestational hypertension and GDM.
孕妇遵守饮食指南不仅能积极影响自身健康，还能影响婴儿健康。衡量依从性需要营养和饮食咨询方面的专业技能。在中国，很少有简单有效的技术可以评估孕妇的饮食质量，尤其是在农村地区。我们旨在建立一种新的简单有效的评估技术，即“中国孕妇膳食指南依从性指数（CDGCI-PW）”，并评估孕妇饮食依从性与妊娠并发症风险之间的关系。
CDGCI-PW 由 13 个主要组成部分组成，这些组成部分基于 2016 年版中国孕妇膳食指南。每个组成部分都被赋予了不同的分数范围，总分范围为 0 至 100 分。同济母婴健康队列研究（2013 年 9 月至 2016 年 5 月）是一项前瞻性队列研究，旨在研究孕妇饮食和生活方式对孕妇及其后代健康的影响。比较了孕妇在孕中期的饮食与中国孕妇平衡膳食宝塔的相应推荐摄入量，以验证其对饮食指南的依从性。通过回归分析估计了孕妇饮食质量与妊娠并发症风险之间的关系。构建了受试者工作特征（ROC）曲线，以确定 CDGCI-PW 预测妊娠高血压和妊娠糖尿病（GDM）的最佳截断值。
在 2708 名孕妇中，最终有 1489 名孕妇被随访。孕中期 CDGCI-PW 评分的平均值为 74.1（标准差（SD）为 7.5）。大多数食物表现出以下趋势：CDGCI-PW 评分越高，报告摄入推荐范围内食物的孕妇比例越高。此外，较高的孕妇 CDGCI-PW 评分与较低的妊娠高血压风险显著相关[比值比（OR）（95%置信区间[CI]：0.30（0.20，0.37）]和 GDM[OR（95%CI）：0.38（0.31，0.48）]。预测妊娠高血压的最佳 CDGCI-PW 截断值为≥68.5（灵敏度 82%；特异性：61%；ROC 曲线下面积，AUC=0.743），预测 GDM 的最佳 CDGCI-PW 截断值为≥75.5（灵敏度 43%；特异性：81%；ROC 曲线下面积，AUC=0.714）。
CDGCI-PW 是一种简单有效的评估孕妇孕期饮食质量的方法，而遵守 CDGCI-PW 与较低的妊娠高血压和 GDM 风险相关。
