Darling Anne Marie, Yazdy Mahsa M, García Michelle Huezo, Carmichael Suzan L, Shaw Gary M, Nestoridi Eirini
Bureau of Family Health and Nutrition, Massachusetts Department of Public Health, Boston, Massachusetts, United States.
Bureau of Family Health and Nutrition, Massachusetts Department of Public Health, Boston, Massachusetts, United States.
Nutrition. 2024 Mar;119:112322. doi: 10.1016/j.nut.2023.112322. Epub 2023 Dec 4.
Diets with a high glycemic index (GI) leading to elevated postprandial glucose levels and hyperinsulinemia during pregnancy have been inconsistently linked to an increased risk for large-for-gestational-age (LGA) births. The effects of prepregnancy dietary GI on LGA risk are, to our knowledge, unknown. We examined the association of prepregnancy dietary GI with LGA births and joint associations of GI and maternal overweight/obesity and infant sex with LGA births among 10 188 infants born without congenital anomalies from 1997 to 2011, using data from the National Birth Defects Prevention Study (NBDPS). The aim of this study was to investigate this association among infants without major congenital anomalies (controls) who participated in the NBDPS and to evaluate how prepregnancy BMI and infant sex may modify this association on the additive scale.
Dietary intake was ascertained using a 58-item food frequency questionnaire. We dichotomized dietary GI into high and low categories using spline regression models. Infants with a birth weight at or above the 90th percentile for gestational age and sex, according to a U.S. population reference, were considered LGA. We used logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (CIs).
Of the infants, 859 (9%) had a high dietary GI (cut-point: 59), and 1244 infants (12%) were born LGA. Unadjusted analysis suggested an inverse association between high dietary GI and LGA (OR, 0.79; 95% CI, 0.62-0.99). No association was observed in multivariable models when comparing high dietary GI intake between LGA births and all other births (OR, 0.94; 95% CI, 0.74-1.20) or when excluding small-for-gestational-age (SGA) births (OR, 0.94; 95% CI, 0.73-1.19). No joint associations with maternal overweight/obesity or infant sex were observed.
High prepregnancy maternal GI was not associated with LGA births independently of or jointly with other factors.
血糖生成指数（GI）高的饮食会导致孕期餐后血糖水平升高和高胰岛素血症，这与大于胎龄儿（LGA）出生风险增加之间的联系并不一致。据我们所知，孕前饮食GI对LGA风险的影响尚不清楚。我们利用国家出生缺陷预防研究（NBDPS）的数据，在1997年至2011年出生且无先天性异常的10188名婴儿中，研究了孕前饮食GI与LGA出生之间的关联，以及GI与孕妇超重/肥胖和婴儿性别对LGA出生的联合关联。本研究的目的是调查参与NBDPS的无重大先天性异常婴儿（对照）中的这种关联，并评估孕前体重指数和婴儿性别如何在相加尺度上改变这种关联。
使用一份包含58个条目的食物频率问卷确定饮食摄入量。我们使用样条回归模型将饮食GI分为高和低两类。根据美国人群参考标准，出生体重处于胎龄和性别的第90百分位数及以上的婴儿被视为LGA。我们使用逻辑回归来获得比值比（OR）和95%置信区间（CI）。
在这些婴儿中，859名（9%）饮食GI高（切点：59），1244名婴儿（12%）为LGA出生。未调整分析表明高饮食GI与LGA之间存在负相关（OR，0.79；95%CI，0.62 - 0.99）。在比较LGA出生与所有其他出生的高饮食GI摄入量时，多变量模型中未观察到关联（OR，0.94；95%CI，0.74 - 1.20），排除小于胎龄儿（SGA）出生时也未观察到关联（OR，0.94；95%CI，0.73 - 1.19）。未观察到与孕妇超重/肥胖或婴儿性别的联合关联。
孕前孕妇高GI与LGA出生之间不存在独立关联，也不存在与其他因素的联合关联。
