南非中部孕妇的健康状况、社会支持、压力及与胆碱摄入量的关联：2018 - 2019年NuEMI研究
Reported health, social support, stress and associations with choline intake in pregnant women in central South Africa: the NuEMI study 2018-2019.
作者信息
Robb Liska, Jordaan Elizabeth Margaretha, Joubert Gina, Ngounda Jennifer, Walsh Corinna May
机构信息
Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, PO Box 339, internal box G24, 9300, Bloemfontein, Republic of South Africa.
Department of Biostatistics, School of Biomedical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa.
出版信息
Arch Public Health. 2023 Mar 30;81(1):48. doi: 10.1186/s13690-023-01061-y.
BACKGROUND
The health and well-being of pregnant women can influence pregnancy outcomes and are closely associated with social support and experiences of stress. Poor nutrition predisposes to poor health with choline intake affecting pregnancy outcome. This study determined reported health, social support, and stress and how these factors are associated with choline intake in pregnancy.
METHODS
A cross sectional study was performed. Pregnant women in their second and third trimesters attending a high-risk antenatal clinic at a regional hospital in Bloemfontein, South Africa, were included. Trained fieldworkers obtained information during structured interviews using standardised questionnaires. Logistic regression with backward selection (p < 0.05) was used to select significant independent factors associated with choline intake. Variables with a p-value < 0.15 in bivariate analysis were considered for inclusion in the model.
RESULTS
Median age and gestation in the sample (N = 682) were 31.8 years and 32.0 weeks, respectively. Most participants (84.7%) consumed less than the adequate intake (AI) of 450 mg of choline per day. Most participants (69.0%) were either overweight or obese. One in eight participants (12.6%) reported not having anyone that could help them in times of need, more than one third (36.0%) reported having unpayable debt and one in twelve (8.4%) reported experiencing physical abuse by their partners. Normotensive participants and those using anti-retroviral therapy (ART) (thus HIV-infected), were more likely to consume choline in amounts below the AI (p = 0.042 and p = 0.011, respectively). Logistic regression analysis showed that the odds of consuming choline in amounts below the AI were lower for participants that were not using ART versus those using ART, with an odds ratio of 0.53.
CONCLUSION
HIV-infected participants were more likely to consume choline in levels below the AI. This vulnerable group should be the focus of targeted efforts to improve choline intake.
背景
孕妇的健康与幸福会影响妊娠结局，且与社会支持和压力体验密切相关。营养不佳会导致健康状况不佳，胆碱摄入量会影响妊娠结局。本研究确定了所报告的健康状况、社会支持和压力，以及这些因素与孕期胆碱摄入量之间的关联。
方法
进行了一项横断面研究。纳入了在南非布隆方丹一家地区医院的高危产前诊所就诊的孕中期和孕晚期孕妇。经过培训的现场工作人员在结构化访谈期间使用标准化问卷获取信息。采用向后选择的逻辑回归（p < 0.05）来选择与胆碱摄入量相关的显著独立因素。在双变量分析中p值< 0.15的变量被考虑纳入模型。
结果
样本（N = 682）的中位年龄和孕周分别为31.8岁和32.0周。大多数参与者（84.7%）的胆碱摄入量低于每天450毫克的适宜摄入量（AI）。大多数参与者（69.0%）超重或肥胖。八分之一的参与者（12.6%）报告在需要时无人能提供帮助，超过三分之一（36.0%）报告有无法偿还的债务，十二分之一（8.4%）报告遭受伴侣的身体虐待。血压正常的参与者和使用抗逆转录病毒疗法（ART）（即感染了HIV）的参与者，更有可能摄入低于AI量的胆碱（分别为p = 0.042和p = 0.011）。逻辑回归分析表明，未使用ART的参与者与使用ART的参与者相比，摄入低于AI量胆碱的几率较低，比值比为0.53。
结论
感染HIV的参与者更有可能摄入低于AI水平的胆碱。这一弱势群体应成为提高胆碱摄入量的针对性努力的重点。
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