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埃塞俄比亚西南部吉马地区公立医院接受产前和分娩护理的孕妇的饮食模式与高血压疾病

Dietary Patterns and Hypertensive Disorders Among Pregnant Women Attending Antenatal and Delivery Care in Public Hospitals of Jimma Zone, Southwest Ethiopia.

作者信息

Kidane Rediet, Eshete Tewodros, Sintayehu Tsion, Belachew Tefera

机构信息

Department of Human Nutrition and Dietetics, Institution of Public Health Sciences, Jimma University, Jimma, Ethiopia.

Department of Public Health, Debre Markos University, Debre Markos, Ethiopia.

出版信息

J Multidiscip Healthc. 2022 Jul 30;15:1645-1656. doi: 10.2147/JMDH.S373749. eCollection 2022.

Abstract

PURPOSE

Hypertensive disorders of pregnancy are a major contributor to maternal morbidity and mortality. Dietary pattern is one of the modifiable determinants of hypertension. However, there is a research gap on dietary patterns and hypertensive disorders among pregnant women in Ethiopia. Therefore, this study aimed to identify dietary pattern of hypertensive disorders of pregnant women attending antenatal and delivery care.

METHODS

Institution-based unmatched case control study was conducted among a total of 333 participants (111 cases and 222 controls). Data were collected using an interviewer administered questionnaire and analyzed using SPSS version 20. Principal component analysis was used to identify wealth tertile and cluster analysis was used to derive dietary pattern. Adjusted odds ratio with 95% confidence interval and variables with P-value <0.05 were declared as statistically significant. Model of fitness was tested using Hosmer-Lemeshow goodness-of-fit test.

RESULTS

On multivariable analysis, plant source food based dietary pattern [AOR=0.36 95% CI: 0.15-0.82], balanced type of dietary pattern [AOR=0.24 95% CI: 0.11-0.51] and folate intake [AOR=0.17 95% CI: 0.06-0.48] were found to be significant protective factors from hypertensive disorders of pregnancy. Previous history of pregnancy induced hypertension [AOR=3.76 95% CI: 1.67-8.37], twin pregnancy [AOR=3.69 95% CI: 1.52-8.96], history of abortion [AOR=2.37 95% CI: 1.10-5.12], presence of anemia at the first visit [AOR=7.12 95% CI:2.30-21.98], gestational diabetes [AOR=3.12 95% CI: 1.002-9.72] and highest wealth index [AOR=4.17 95% CI: 1.27-13.66] were found to be significant risk factors for hypertensive disorders during pregnancy.

CONCLUSION

Balanced food based dietary pattern and plant-based food pattern had direct protective relationship with development of hypertension during pregnancy. This implies the need for promoting consumption of balanced diets and plant source foods high in fruit and vegetables. Mothers with twin pregnancies, anemia at first visit, previous history of pregnancy induced hypertension, and advanced age groups should be prioritized.

摘要

目的

妊娠高血压疾病是孕产妇发病和死亡的主要原因之一。饮食模式是高血压可改变的决定因素之一。然而,埃塞俄比亚孕妇的饮食模式与妊娠高血压疾病之间存在研究空白。因此,本研究旨在确定接受产前和分娩护理的孕妇妊娠高血压疾病的饮食模式。

方法

在总共333名参与者(111例病例和222名对照)中进行了基于机构的非匹配病例对照研究。使用访谈员管理的问卷收集数据,并使用SPSS 20版进行分析。主成分分析用于确定财富三分位数,聚类分析用于得出饮食模式。调整后的比值比及其95%置信区间以及P值<0.05的变量被判定为具有统计学意义。使用Hosmer-Lemeshow拟合优度检验对拟合模型进行检验。

结果

在多变量分析中,发现以植物性食物为主的饮食模式[AOR=0.36,95%CI:0.15 - 0.82]、均衡饮食模式[AOR=0.24,95%CI:0.11 - 0.51]和叶酸摄入量[AOR=0.17,95%CI:0.06 - 0.48]是预防妊娠高血压疾病的重要保护因素。既往妊娠高血压病史[AOR=3.76,95%CI:1.67 - 8.37]、双胎妊娠[AOR=3.69,95%CI:1.52 - 8.96]、流产史[AOR=2.37,95%CI:1.10 - 5.12]、首次就诊时贫血[AOR=7.12,95%CI:2.30 - 21.98]、妊娠期糖尿病[AOR=3.12,95%CI:1.002 - 9.72]和最高财富指数[AOR=4.17,95%CI:1.27 - 13.66]被发现是妊娠期间发生高血压疾病的重要危险因素。

结论

基于均衡食物的饮食模式和基于植物性食物的模式与孕期高血压发展有直接的保护关系。这意味着需要促进食用均衡饮食以及富含水果和蔬菜的植物性食物。双胎妊娠、首次就诊时贫血、既往妊娠高血压病史的母亲以及高龄组应被优先考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ef8/9348132/8fc861b52eb9/JMDH-15-1645-g0001.jpg

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