Papadopoulou Theopisti, Sarantaki Antigoni, Metallinou Dimitra, Palaska Ermioni, Nanou Christina, Diamanti Athina
Department of Midwifery, Faculty of Health and Care Sciences, University of West Attica, Egaleo, Greece.
Metabol Open. 2024 Dec 10;25:100338. doi: 10.1016/j.metop.2024.100338. eCollection 2025 Mar.
The increasing adoption of strict vegetarian diets during pregnancy has raised concerns about their effects on maternal and neonatal outcomes. This systematic review and meta-analysis aimed to assess the impact of strict vegetarian diets on key pregnancy outcomes, including neonatal birth weight, small-for-gestational-age (SGA) infants, gestational diabetes mellitus (GDM), hypertensive disorders, and gestational weight gain (GWG).
A comprehensive literature search across multiple databases yielded eight studies from various countries, involving a total of 72,284 participants. Primary outcomes included neonatal birth weight, SGA, preterm birth, GDM, and maternal hypertensive disorders.
The meta-analysis found that strict vegetarian diets were significantly associated with an increased risk of delivering SGA infants, with a pooled odds ratio (OR) of 2.71 (95 % confidence interval [CI]: 1.24 to 5.95; = 0.01). Additionally, infants born to strict vegetarian mothers had lower birth weights, with some studies reporting a mean difference of 240g compared to omnivores. For GDM, no significant differences were found between strict vegetarians and omnivores, with a pooled OR of 0.64 (95 % CI: 0.37 to 1.11; = 0.11). While vegans showed lower gestational weight gain and reduced risk of excessive weight gain, there was considerable heterogeneity in results regarding hypertensive disorders and preterm birth.
Strict vegetarian diets during pregnancy are associated with an increased risk of SGA infants and lower birth weights. To mitigate these risks, specific dietary guidelines emphasizing adequate intake of critical nutrients such as vitamin B12, iron, omega-3 fatty acids, and iodine should be developed. Supplementation and tailored dietary counseling, incorporating fortified foods and plant-based sources like legumes, nuts, seeds, and algae-derived omega-3, are essential to ensure maternal and neonatal health. Further research is necessary to refine these guidelines and explore their impact on diverse populations.
孕期严格素食的采用日益增多，引发了人们对其对母婴结局影响的担忧。本系统评价和荟萃分析旨在评估严格素食对关键妊娠结局的影响，包括新生儿出生体重、小于胎龄儿（SGA）、妊娠期糖尿病（GDM）、高血压疾病和妊娠期体重增加（GWG）。
对多个数据库进行全面的文献检索，得到来自不同国家的8项研究，共涉及72284名参与者。主要结局包括新生儿出生体重、SGA、早产、GDM和母亲高血压疾病。
荟萃分析发现，严格素食与分娩SGA婴儿的风险显著增加相关，合并比值比（OR）为2.71（95%置信区间[CI]：1.24至5.95；P = 0.01）。此外，严格素食母亲所生婴儿的出生体重较低，一些研究报告称与杂食者相比平均差异为240克。对于GDM，严格素食者和杂食者之间未发现显著差异，合并OR为0.64（95% CI：0.37至1.11；P = 0.11）。虽然纯素食者的妊娠期体重增加较低且体重过度增加的风险降低，但在高血压疾病和早产方面的结果存在相当大的异质性。
孕期严格素食与SGA婴儿风险增加和出生体重较低有关。为降低这些风险，应制定强调充足摄入关键营养素（如维生素B12、铁、ω-3脂肪酸和碘）的特定饮食指南。补充和量身定制的饮食咨询，包括强化食品和植物性来源（如豆类、坚果、种子和藻类衍生的ω-3），对于确保母婴健康至关重要。需要进一步研究以完善这些指南并探索其对不同人群的影响。
