State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Scientific Research and Education, Changzhou Medical Center, Changzhou Maternity and Child Health Care Hospital, Nanjing Medical University, Changzhou, Jiangsu, China.
J Nutr. 2024 Jun;154(6):1880-1889. doi: 10.1016/j.tjnut.2024.04.011. Epub 2024 Apr 9.
Cholesterol plays a vital role in fetal growth and development during pregnancy. There remains controversy over whether pregnant females should limit their cholesterol intake.
The objective of this study was to investigate the association between maternal dietary cholesterol intake during pregnancy and infant birth weight in a Chinese prospective cohort study.
A total of 4146 mother-child pairs were included based on the Jiangsu Birth Cohort study. Maternal dietary information was assessed with a semiquantitative food-frequency questionnaire. Birth weight z-scores and large-for-gestational-age (LGA) infants were converted by the INTERGROWTH-21st neonatal weight-for-gestational-age standard. Poisson regression and generalized estimating equations were employed to examine the relationships between LGA and maternal dietary cholesterol across the entire pregnancy and trimester-specific cholesterol intake, respectively.
The median intake of maternal total dietary cholesterol during the entire pregnancy was 671.06 mg/d, with eggs being the main source. Maternal total dietary cholesterol and egg-sourced cholesterol were associated with an increase in birth weight z-score, with per standard deviation increase in maternal total and egg-sourced dietary cholesterol being associated with an increase of 0.16 [95% confidence interval (CI): 0.07, 0.25] and 0.06 (95% CI: 0.03, 0.09) in birth weight z-score, respectively. Egg-derived cholesterol intake in the first and third trimesters was positively linked to LGA, with an adjusted relative risk of 1.11 (95% CI: 1.04, 1.18) and 1.09 (95% CI: 1.00, 1.18). Compared with mothers consuming ≤7 eggs/wk in the third trimester, the adjusted relative risk for having an LGA newborn was 1.37 (95% CI: 1.09, 1.72) for consuming 8-10 eggs/wk and 1.45 (95% CI: 1.12, 1.86) for consuming >10 eggs/wk (P-trend = 0.015).
Maternal total dietary cholesterol intake, as well as consuming over 7 eggs/wk during pregnancy, displayed significant positive relationships with the incidence of LGA, suggesting that mothers should avoid excessive cholesterol intake during pregnancy to prevent adverse birth outcomes.
胆固醇在孕期胎儿生长发育中起着至关重要的作用。目前仍存在争议，即孕妇是否应该限制胆固醇的摄入量。
本研究旨在通过中国前瞻性队列研究探讨孕妇孕期膳食胆固醇摄入量与婴儿出生体重的关系。
本研究基于江苏省出生队列研究，共纳入 4146 对母婴。采用半定量食物频率问卷评估孕妇膳食信息。通过 INTERGROWTH-21 新生儿胎龄体重标准，将出生体重 z 评分和大于胎龄儿（LGA）转换。采用泊松回归和广义估计方程分别检验整个孕期以及特定孕期胆固醇摄入量与 LGA 之间的关系。
整个孕期孕妇总膳食胆固醇的中位数摄入量为 671.06mg/d，鸡蛋是主要来源。孕妇总膳食胆固醇和鸡蛋来源胆固醇与出生体重 z 评分增加相关，母亲总膳食和鸡蛋来源膳食胆固醇每标准差增加，出生体重 z 评分分别增加 0.16[95%置信区间（CI）：0.07，0.25]和 0.06（95% CI：0.03，0.09）。第一和第三孕期摄入鸡蛋来源胆固醇与 LGA 呈正相关，调整后的相对风险分别为 1.11（95% CI：1.04，1.18）和 1.09（95% CI：1.00，1.18）。与第三孕期每周食用≤7 个鸡蛋的母亲相比，每周食用 8-10 个和>10 个鸡蛋的 LGA 新生儿的调整后相对风险分别为 1.37（95% CI：1.09，1.72）和 1.45（95% CI：1.12，1.86）（P 趋势=0.015）。
孕妇总膳食胆固醇摄入量以及孕期每周食用超过 7 个鸡蛋与 LGA 的发生率呈显著正相关，提示孕妇在孕期应避免过量摄入胆固醇，以预防不良出生结局。
