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一项关于 GDM 诊断前后孕妇饮食与妊娠结局的前瞻性观察性研究。 **说明**:该研究旨在评估 GDM 患者和非 GDM 患者的饮食与妊娠结局之间的关系。

A prospective observational study on maternal diet pre- and post-GDM diagnosis and pregnancy outcomes in individuals with/without GDM.

机构信息

Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, No.2699, West Gaoke Road, Pudong District, Shanghai, 201204, China.

出版信息

BMC Pregnancy Childbirth. 2024 Nov 14;24(1):754. doi: 10.1186/s12884-024-06961-7.

Abstract

AIMS

To investigate (1) the association between maternal dietary choices during the first and second trimesters and the diagnosis of gestational diabetes mellitus (GDM), (2) the association between a GDM diagnosis and dietary choices during pregnancy, and (3) the differences in pregnancy outcomes between individuals with and without GDM.

METHODS

A prospective cohort study. Pregnant individuals with singleton pregnancy aged 19 ∼ 44 years, without severe pregnancy complications were enrolled in the study. Dietary data were collected at three time points during routine antenatal appointments: 8 ∼ 12 weeks gestation(n = 993), 20 ∼ 24 weeks gestation(n = 732), and 32 ∼ 36 weeks gestation(n = 536). GDM diagnosis and pregnancy outcomes were collected during follow-up from the electronic medical record (EMR).

RESULTS

A total of 93 participants (12.9%) were diagnosed with GDM. Livestock and poultry meat intake during the second trimester were associated with an increased risk of developing GDM (aOR 1.371, 95%CI 1.070-1.756, P = 0.013), and a GDM diagnosis may lead to decreased intake of cereals and its products (P = 0.001), potatoes and its products (P < 0.001), and fruit (P = 0.002) and increased intake of fish, shrimp and shellfish (P = 0.001), eggs (P = 0.015), and milk and milk products (P = 0.011) in the third trimester. Individuals with GDM related to lower risk of excessive gestational weight gain (aOR 0.384, 95%CI 0.188-0.646, P = 0.001) but may increase the risk of fetal macrosomia (aOR 3.873, 95%CI 1.364-10.996, P = 0.011).

CONCLUSIONS

Understanding maternal dietary choices around GDM diagnosis is crucial for accurate nutritional assessment and effective education programs. While our findings suggest dietary changes may occur post-diagnosis, further research is needed to confirm these patterns and the potential benefits of early dietary counseling for individuals with GDM.

摘要

目的

(1)研究孕妇在第一和第二孕期的饮食选择与妊娠糖尿病(GDM)诊断之间的关系;(2)研究 GDM 诊断与孕期饮食选择之间的关系;(3)比较 GDM 患者与非 GDM 患者的妊娠结局差异。

方法

这是一项前瞻性队列研究。研究纳入了年龄在 19 至 44 岁之间、无严重妊娠并发症的单胎妊娠孕妇。在常规产前检查的三个时间点收集饮食数据:妊娠 8 至 12 周(n=993)、妊娠 20 至 24 周(n=732)和妊娠 32 至 36 周(n=536)。通过电子病历(EMR)随访收集 GDM 诊断和妊娠结局。

结果

共有 93 名参与者(12.9%)被诊断为 GDM。孕中期畜肉和禽肉的摄入量与 GDM 发病风险增加相关(aOR 1.371,95%CI 1.070-1.756,P=0.013),而 GDM 诊断可能导致孕期第 3 期摄入的谷物及其制品(P=0.001)、土豆及其制品(P<0.001)、水果(P=0.002)减少,鱼类、虾蟹贝类(P=0.001)、蛋类(P=0.015)和奶及奶制品(P=0.011)摄入增加。与 GDM 相关的个体发生妊娠体重过度增加的风险较低(aOR 0.384,95%CI 0.188-0.646,P=0.001),但可能增加巨大儿的风险(aOR 3.873,95%CI 1.364-10.996,P=0.011)。

结论

了解 GDM 诊断前后孕妇的饮食选择对于准确的营养评估和有效的教育计划至关重要。虽然我们的研究结果表明,诊断后可能会发生饮食变化,但需要进一步研究以证实这些模式以及对 GDM 患者进行早期饮食咨询的潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/342b/11566912/c3ca691a6f2b/12884_2024_6961_Fig1_HTML.jpg

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