Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Eur J Nutr. 2022 Sep;61(6):3255-3265. doi: 10.1007/s00394-022-02886-z. Epub 2022 Apr 24.
Evidence on the influence of modifiable risk factors on spontaneous abortion (SAB) is scarce. We investigated associations for adherence to national dietary guidelines and a healthy Nordic diet with first-trimester (≤ 12 weeks' gestation) SAB in a Danish cohort of couples trying to conceive.
Participants completed a questionnaire on sociodemographics, lifestyle and reproductive history and a validated food frequency questionnaire (FFQ). We ascertained pregnancies from follow-up questionnaires and restricted analyses to 3,043 women who became pregnant. We assessed adherence to the Danish Dietary Guidelines Index (DDGI, range of 0-6, from low to high), covering intake of fruit, vegetables, fish, red and processed meat, whole grains, saturated fat and added sugar. The Healthy Nordic Food Index (HNFI, range 0-6) covered intake of fish, cabbage, rye bread, apples, pears, root vegetables and oatmeal. Pregnancy outcomes were identified through Danish medical registries or self-reported. We used Cox proportional hazards regression to compute hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for sociodemographics and lifestyle.
Fifteen percent of participants had a first-trimester SAB. Compared with a DDGI score < 3, adjusted HRs (95% CIs) for scores 3 to < 4, 4 to < 5 and ≥ 5 were 0.85 (0.59-1.23), 0.78 (0.54-1.12) and 0.71 (0.44-1.13), respectively. Compared with an HNFI score < 2, adjusted HRs (95% CIs) for scores 2 to < 3, 3 to < 4, 4 to < 5 and ≥ 5 were 0.84 (0.62-1.15), 0.88 (0.66-1.19), 0.94 (0.69-1.28) and 0.69 (0.49-0.96), respectively.
Greater pre-pregnancy adherence to Danish dietary guidelines or a healthy Nordic diet was associated with a lower rate of first-trimester SAB, although estimates were imprecise.
关于可改变的风险因素对自然流产（SAB）影响的证据很少。我们在丹麦的一个尝试怀孕的夫妇队列中，研究了遵守国家饮食指南和健康的北欧饮食与第一孕期（≤12 周妊娠）SAB 的关系。
参与者完成了一份关于社会人口统计学、生活方式和生殖史的问卷和一份经过验证的食物频率问卷（FFQ）。我们通过随访问卷确定了怀孕情况，并将分析仅限于 3043 名怀孕的女性。我们评估了对丹麦饮食指南指数（DDGI，范围为 0-6，从低到高）的依从性，涵盖了水果、蔬菜、鱼、红色和加工肉类、全谷物、饱和脂肪和添加糖的摄入量。健康的北欧食品指数（HNFI，范围为 0-6）涵盖了鱼、甘蓝、黑麦面包、苹果、梨、根茎类蔬菜和燕麦片的摄入量。通过丹麦医疗记录或自我报告确定妊娠结局。我们使用 Cox 比例风险回归计算危险比（HR）和 95%置信区间（CI），并根据社会人口统计学和生活方式进行调整。
15%的参与者在第一孕期发生了 SAB。与 DDGI 评分<3 相比，评分 3 至<4、4 至<5 和≥5 的调整后 HR（95%CI）分别为 0.85（0.59-1.23）、0.78（0.54-1.12）和 0.71（0.44-1.13）。与 HNFI 评分<2 相比，评分 2 至<3、3 至<4、4 至<5 和≥5 的调整后 HR（95%CI）分别为 0.84（0.62-1.15）、0.88（0.66-1.19）、0.94（0.69-1.28）和 0.69（0.49-0.96）。
在怀孕前更高的遵守丹麦饮食指南或健康的北欧饮食与较低的第一孕期 SAB 发生率相关，但估计值不太准确。
