母体营养风险因素与子痫前期发病的相关性：一项叙述性范围综述的研究结果。
Maternal nutritional risk factors for pre-eclampsia incidence: findings from a narrative scoping review.
机构信息
Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada.
Department of Pediatrics, Rm170, BC Children's and Women's Hospital, University of British Columbia, 950 West 28th Avenue, Vancouver, Canada.
出版信息
Reprod Health. 2022 Sep 5;19(1):188. doi: 10.1186/s12978-022-01485-9.
BACKGROUND
Pre-eclampsia is a leading cause of maternal mortality and morbidity that involves pregnancy-related stressors on the maternal cardiovascular and metabolic systems. As nutrition is important to support optimal development of the placenta and for the developing fetus, maternal diets may play a role in preventing pre-eclampsia. The purpose of this scoping review is to map the maternal nutritional deficiencies and imbalances associated with pre-eclampsia incidence and discuss evidence consistency and linkages with current understandings of the etiology of pre-eclampsia.
METHODS
A narrative scoping review was conducted to provide a descriptive account of available research, summarize research findings and identify gaps in the evidence base. Relevant observational studies and reviews of observational studies were identified in an iterative two-stage process first involving electronic database searches then more sensitive searches as familiarity with the literature increased. Results were considered in terms of their consistency of evidence, effect sizes and biological plausibility.
RESULTS
The review found evidence for associations between nutritional inadequacies and a greater risk of pre-eclampsia. These associations were most likely mediated through oxidative stress, inflammation, maternal endothelial dysfunction and blood pressure in the pathophysiology of pre-eclampsia. Maternal nutritional risk factors for pre-eclampsia incidence with the strongest consistency, effect and biological plausibility include vitamin C and its potential relationship with iron status, vitamin D (both on its own and combined with calcium and magnesium), and healthy dietary patterns featuring high consumption of fruits, vegetables, whole grains, fish, seafood and monounsaturated vegetable oils. Foods high in added sugar, such as sugary drinks, were associated with increased risk of pre-eclampsia incidence.
CONCLUSION
A growing body of literature highlights the involvement of maternal dietary factors in the development of pre-eclampsia. Our review findings support the need for further investigation into potential interactions between dietary factors and consideration of nutritional homeostasis and healthy dietary patterns. Further research is recommended to explore gestational age, potential non-linear relationships, dietary diversity and social, cultural contexts of food and meals.
背景
子痫前期是孕产妇死亡和发病的主要原因之一，涉及妊娠对母体心血管和代谢系统的相关压力。由于营养对支持胎盘的最佳发育和胎儿的发育很重要，因此孕产妇的饮食可能在预防子痫前期方面发挥作用。本范围综述的目的是绘制与子痫前期发病率相关的孕产妇营养缺乏和失衡，并讨论与当前对子痫前期病因学理解的一致性和联系。
方法
进行了叙述性范围综述，以提供对现有研究的描述性说明，总结研究结果并确定证据基础中的差距。在迭代的两阶段过程中首先涉及电子数据库搜索，然后随着对文献的熟悉程度的提高进行更敏感的搜索，以确定相关的观察性研究和观察性研究综述。根据证据的一致性、效应大小和生物学合理性来考虑结果。
结果
综述发现营养不足与子痫前期风险增加之间存在关联。这些关联最有可能通过氧化应激、炎症、母体内皮功能障碍和血压在子痫前期的病理生理学中发生介导。与子痫前期发病率最强的一致性、效应和生物学合理性相关的孕产妇营养风险因素包括维生素 C 及其与铁状态的潜在关系、维生素 D（单独或与钙和镁结合）以及富含水果、蔬菜、全谷物、鱼、海鲜和单不饱和植物油的健康饮食模式。添加糖含量高的食物，如含糖饮料，与子痫前期发病率增加有关。
结论
越来越多的文献强调了母体饮食因素在子痫前期发展中的作用。我们的综述结果支持进一步研究饮食因素之间的潜在相互作用，并考虑营养平衡和健康的饮食模式。建议进一步研究以探索妊娠期、潜在的非线性关系、饮食多样性以及食物和膳食的社会文化背景。
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