Chung Yealin, Melo Pedro, Easter Christina, Price Malcolm J, Dhillon-Smith Rima, Quenby Siobhan, Devall Adam, Coomarasamy Arri
Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, UK.
CARE Fertility Birmingham, Edgbaston, UK.
BJOG. 2025 Mar;132(4):504-517. doi: 10.1111/1471-0528.18022. Epub 2024 Nov 26.
To examine the association between periconceptual maternal diet and miscarriage risk among women with recurrent miscarriages.
Prospective multicentre cohort study (Tommy's Net).
Three university hospital research centres in the United Kingdom.
1035 women with a baseline history of two or more miscarriages.
We analysed baseline dietary data from a 10-item Food Frequency Questionnaire (FFQ). For individual food category analyses, we used multivariable Poisson regression following adjustment for maternal confounders and paternal dietary patterns. For whole diet analyses, ordinal principal component analysis (PCA) was used to identify common dietary patterns. Results were presented as relative risks (RR) with 95% confidence intervals (CI) and accompanying p-values.
Miscarriage rate, defined as the rate of spontaneous pregnancy loss (< 24 weeks of gestation) relative to the total number of pregnancies (miscarriages and live births).
High consumption of fruit and nuts (almonds and walnuts) was associated with lower miscarriage risk (fruit 226/662 (34.1%) vs. 38/77 (49.4%), RR 0.66, 95% CI 0.51 to 0.85, p = 0.001; nuts 47/152 (30.9%) vs. 220/613 (35.9%), RR 0.73, 95% CI 0.54 to 0.98, p = 0.039). High red meat intake was associated with a possible increase in miscarriage risk (6/12 (50.0%) vs. 165/469 (35.2%), RR 1.86, 95% CI 1.10 to 3.16, p = 0.022). The association with miscarriage risk was unclear for other food groups, including fresh vegetables, white meat, fish, dairy, eggs, soya and chocolate, due to imprecise point estimates. Through PCA, we identified three data-derived dietary patterns. Yet, no distinct relationship emerged between these dietary patterns and miscarriage risk.
A maternal diet rich in fresh fruits and nuts is associated with a lower miscarriage risk among women with a history of recurrent miscarriage.
Tommy's Net (ISRCTN17732518) https://www.isrctn.com/ISRCTN17732518. Analysis plan (OSF zp7cs) https://osf.io/zp7cs.
探讨反复流产女性受孕前母亲饮食与流产风险之间的关联。
前瞻性多中心队列研究（汤米网络）。
英国的三个大学医院研究中心。
1035名有两次或更多次流产基线病史的女性。
我们分析了一份10项食物频率问卷（FFQ）中的基线饮食数据。对于个体食物类别分析，我们在对母亲混杂因素和父亲饮食模式进行调整后，使用多变量泊松回归分析。对于整体饮食分析，使用有序主成分分析（PCA）来识别常见的饮食模式。结果以相对风险（RR）及其95%置信区间（CI）和伴随的p值表示。
流产率，定义为自然妊娠丢失率（妊娠<24周）相对于妊娠总数（流产和活产）的比例。
水果和坚果（杏仁和核桃）摄入量高与流产风险较低相关（水果：226/662（34.1%）对38/77（49.4%），RR 0.66，95%CI 0.51至0.85，p = 0.001；坚果：47/152（30.9%）对220/613（35.9%），RR 0.73，95%CI 0.54至0.98，p = 0.039）。红肉摄入量高与流产风险可能增加相关（6/12（50.0%）对165/469（35.2%），RR 1.86，95%CI 1.10至3.16，p = 0.022）。由于点估计不精确，其他食物组（包括新鲜蔬菜、白肉、鱼类、乳制品、鸡蛋、大豆和巧克力）与流产风险之间的关联尚不清楚。通过PCA，我们确定了三种数据衍生的饮食模式。然而，这些饮食模式与流产风险之间未出现明显关系。
受孕前母亲饮食富含新鲜水果和坚果与有反复流产病史的女性流产风险较低相关。
汤米网络（ISRCTN17732518）https://www.isrctn.com/ISRCTN17732518。分析计划（OSF zp7cs）https://osf.io/zp7cs。
