Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States.
Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States.
Am J Clin Nutr. 2024 Nov;120(5):1284-1293. doi: 10.1016/j.ajcnut.2024.09.016. Epub 2024 Sep 20.
Although diet quality during pregnancy and postpartum is important for multiple parent and child outcomes, within-person changes in diet quality throughout these periods have not been extensively examined.
This study investigated diet quality from early pregnancy through 1 y postpartum and examined differences by sociodemographic characteristics in participants receiving obstetric care in Chapel Hill, North Carolina, United States.
Participants completed 24-h dietary recalls at 6 study visits (each pregnancy trimester and 6 wk, 6 mo, and 1 y postpartum) (n = 383). Between-visit mean Healthy Eating Index-2015 (HEI) scores (min = 0, max = 100) were compared using the population ratio (PR) method. The NCI usual intakes method estimated the distribution of HEI scores in pregnancy and postpartum; unpaired t-tests compared usual mean HEI scores by covariates; paired t-tests compared differences between mean pregnancy and postpartum.
The total HEI mean ± standard error scores (NCI method) were 61.4 ± 0.8 in pregnancy and 61.7 ± 0.9 in postpartum. Mean HEI scores differed by sociodemographic characteristics, particularly education, marital status, and federal assistance participation. The highest scores were observed in participants with at least a bachelor's degree (64.1 ± 0.9 in pregnancy, 64.5 ± 1.0 in postpartum, n = 257) and those with other non-Hispanic White race/ethnicity (64.7 ± 1.8 in pregnancy, 66.4 ± 2.2 in postpartum). There were no between-visit differences in mean total HEI scores (PR). Although differences were observed in some mean HEI component scores between pregnancy and postpartum visits, they were small (mostly <1 point) in magnitude and in inconsistent directions.
Stable total HEI mean scores suggest that adherence to dietary guidelines was consistent throughout pregnancy and postpartum in this sample. Although some sociodemographic characteristics may identify individuals at greater risk of diet-related pregnancy complications, low diet quality was pervasive throughout all subgroups and reflects an urgent need for widespread improvement.
尽管孕期和产后的饮食质量对母婴双方都有重要影响，但目前尚未广泛研究这些时期内的个体饮食质量变化。
本研究调查了从怀孕早期到产后 1 年期间的饮食质量，并在美国北卡罗来纳州教堂山接受产科护理的参与者中，按社会人口学特征分析了饮食质量的差异。
参与者在 6 次研究访视时完成了 24 小时膳食回忆（每个孕期 trimester 和产后 6 周、6 个月和 1 年）（n=383）。使用人群比值（PR）法比较了访视间平均健康饮食指数-2015（HEI）评分（最小值=0，最大值=100）。NCI 常用摄入量法估计了孕期和产后 HEI 评分的分布；未配对 t 检验比较了协变量的常用平均 HEI 评分；配对 t 检验比较了孕期和产后平均 HEI 评分的差异。
总 HEI 平均±标准误差评分（NCI 方法）在孕期为 61.4±0.8，在产后为 61.7±0.9。平均 HEI 评分因社会人口学特征而异，尤其是教育程度、婚姻状况和联邦援助参与情况。评分最高的是至少拥有学士学位的参与者（孕期为 64.1±0.9，产后为 64.5±1.0，n=257）和其他非西班牙裔白人种族/民族的参与者（孕期为 64.7±1.8，产后为 66.4±2.2）。访视间的总 HEI 平均评分无差异（PR）。尽管在孕期和产后访视时，某些 HEI 成分评分存在差异，但差异较小（大多为 1 分以内）且方向不一致。
在该样本中，总 HEI 平均评分稳定，表明在整个孕期和产后期间，饮食指南的遵守情况一致。尽管某些社会人口学特征可能会识别出更容易发生与饮食相关的妊娠并发症的个体，但低饮食质量普遍存在于所有亚组中，迫切需要广泛改善。
