Department of Population & Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Health Sciences, California State University, Northridge, Northridge, CA, USA.
J Nutr. 2023 Jan 14;152(12):2837-2846. doi: 10.1093/jn/nxac209.
Studies examining diet and its links to birth outcomes among socioeconomically disadvantaged populations in the United States are scarce.
We aimed to identify prenatal dietary patterns, examine their relationships with birth outcomes, and evaluate the variation of these associations by maternal diabetes status [no diabetes, gestational diabetes mellitus (GDM), preexisting diabetes].
Women in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) study (n = 465)-an ongoing, prospective pregnancy cohort of predominantly low-income Hispanic/Latina women in Los Angeles-completed up to two 24-hour dietary recalls in the third trimester of pregnancy. We identified prenatal dietary patterns via factor analysis and evaluated their associations with infant birth weight and gestational age at birth (GA) z-scores, separately, using linear regression, as well as the associations of the dietary patterns with premature births, having an infant that was small for gestational age (SGA), and having an infant that was large for gestational age, using logistic regression and adjusting for relevant covariates. We additionally tested interaction terms between prenatal dietary patterns and maternal diabetes status in separate models. We adjusted for multiple comparisons using the false discovery rate.
We identified 2 dietary patterns: 1) a dietary pattern of solid fats, refined grains, and cheese (SRC); and 2) a dietary pattern of vegetables, oils, and fruit (VOF). Comparing the highest to lowest quartiles, the VOF was significantly associated with a greater infant birth weight (β = 0.40; 95% CIs: 0.10, 0.70; Ptrend = 0.011), a greater GA (β = 0.32; 95% CIs: 0.03, 0.61; Ptrend = 0.036), lower odds of a premature birth (OR = 0.31; 95% CIs: 0.10, 0.95; Ptrend = 0.049), and lower odds of having an infant that was SGA (OR = 0.18; 95% CIs: 0.06, 0.58; Ptrend = 0.028). Only among women with GDM, a 1-SD score increase in the prenatal SRC was significantly associated with a lower infant birth weight (β = -0.20; 95% CIs -0.39, -0.02; Pinteraction = 0.040).
Among low-income Hispanic/Latina pregnant women, greater adherence to the prenatal VOF may lower the risk of a premature birth and having an infant that is SGA. Greater adherence to the SRC, however, may adversely affect newborn birth weight among mothers with GDM, but future research is needed to verify our findings.
在美国，针对社会经济地位处于不利地位的人群的饮食及其与生育结果的关联的研究很少。
我们旨在确定产前饮食模式，研究它们与生育结果的关系，并评估这些关联在产妇糖尿病状态（无糖尿病、妊娠期糖尿病、既往糖尿病）下的变化。
MADRES 研究（一项正在进行的、前瞻性的洛杉矶以低收入的西班牙裔/拉丁裔妇女为主要研究对象的妊娠队列研究）中的女性（n=465）在妊娠晚期完成了最多两次 24 小时饮食回忆。我们通过因子分析确定产前饮食模式，并使用线性回归分别评估它们与婴儿出生体重和胎龄（GA）Z 评分的关系，使用逻辑回归评估这些饮食模式与早产、婴儿出生体重不足（SGA）和婴儿出生体重过大（GA）的关系，并调整了相关协变量。我们还在单独的模型中测试了产前饮食模式和产妇糖尿病状态之间的交互项。我们使用错误发现率对多重比较进行了调整。
我们确定了 2 种饮食模式：1）富含固体脂肪、精制谷物和奶酪的饮食模式（SRC）；2）富含蔬菜、油和水果的饮食模式（VOF）。与最低四分位相比，最高四分位的 VOF 与更大的婴儿出生体重（β=0.40；95%置信区间：0.10，0.70；Ptrend=0.011）、更大的 GA（β=0.32；95%置信区间：0.03，0.61；Ptrend=0.036）、早产的可能性降低（OR=0.31；95%置信区间：0.10，0.95；Ptrend=0.049）和 SGA 婴儿的可能性降低（OR=0.18；95%置信区间：0.06，0.58；Ptrend=0.028）显著相关。只有在患有 GDM 的女性中，产前 SRC 的 1-SD 评分增加与婴儿出生体重降低显著相关（β=-0.20；95%置信区间：-0.39，-0.02；Pinteraction=0.040）。
在低收入的西班牙裔/拉丁裔孕妇中，更大程度地遵循产前 VOF 可能会降低早产和 SGA 婴儿的风险。然而，更大程度地遵循 SRC 可能会对患有 GDM 的母亲的新生儿出生体重产生不利影响，但需要进一步的研究来验证我们的发现。
