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孕期无麸质饮食与妊娠结局:一项回顾性队列研究。

Gluten-free diet during pregnancy and pregnancy outcome: A retrospective cohort study.

作者信息

Reijonen Johanna Kristiina, Tihtonen Kati Maaria Hannele, Luukkaala Tiina Hannele, Uotila Jukka Tapio

机构信息

Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research, Tampere University, Tampere, Finland.

Department of Obstetrics and Gynecology, Wellbeing Services County of Pirkanmaa, Tampere University Hospital, Tampere, Finland.

出版信息

Int J Gynaecol Obstet. 2025 Jun;169(3):1184-1190. doi: 10.1002/ijgo.16130. Epub 2025 Jan 10.

Abstract

OBJECTIVE

A gluten-free diet (GFD) is becoming increasingly popular, especially among young females, and including those without diagnosed celiac disease (CD). Whether a GFD is appropriate during pregnancy remains unclear. Our primary aim was to evaluate the association of a GFD and neonatal birthweight and incidence of large for gestational age (LGA) and small for gestational age (SGA). Secondarily, we sought associations with other obstetric outcomes.

METHODS

The data was collected retrospectively from the Tampere University Hospital database. The study period was from January 2015 to April 2021. The diet information was obtained from self-reported questionnaires. All women following a GFD were included. A total of 79 had CD and 291 followed a GFD without CD diagnosis. The latter are referred to here as people without CD avoiding gluten (PWAG). A total of 456 omnivores were randomly chosen to constitute a control group. Outcomes were analyzed by comparing gluten-free groups to a control group.

RESULTS

The median birth weight was higher in the GFD group compared to the controls (3533 vs. 3440 g, P < 0.003), but the incidences of SGA or LGA did not differ between the study groups. The incidence of pregnancy complications was comparable between the groups. Induction of labor was more frequent (aOR 1.52; 95% CI: 1.12-2.08), and the duration of labor was longer (aOR1.56; 95% CI: 1.18-2.06) in the GFD group, especially among PWAG. However, no difference in the cesarean section rate were found between the groups.

CONCLUSION

In the present retrospective cohort study, a GFD did not appear to be associated with adverse pregnancy or neonatal outcomes.

摘要

目的

无麸质饮食(GFD)越来越受欢迎,尤其是在年轻女性中,包括那些未被诊断为乳糜泻(CD)的女性。孕期是否适合采用无麸质饮食仍不明确。我们的主要目的是评估无麸质饮食与新生儿出生体重以及大于胎龄儿(LGA)和小于胎龄儿(SGA)发生率之间的关联。其次,我们探寻其与其他产科结局的关联。

方法

数据从坦佩雷大学医院数据库中回顾性收集。研究时间段为2015年1月至2021年4月。饮食信息通过自我报告问卷获取。所有遵循无麸质饮食的女性均被纳入。共有79人患有乳糜泻,291人遵循无麸质饮食但未被诊断为乳糜泻。后者在此被称为无乳糜泻但避免麸质的人群(PWAG)。随机选取456名杂食者组成对照组。通过将无麸质饮食组与对照组进行比较来分析结局。

结果

与对照组相比,无麸质饮食组的出生体重中位数更高(3533克对3440克,P<0.003),但研究组之间小于胎龄儿或大于胎龄儿的发生率并无差异。各组之间妊娠并发症的发生率相当。无麸质饮食组引产更为频繁(调整后比值比1.52;95%置信区间:1.12 - 2.08),产程更长(调整后比值比1.56;95%置信区间:1.18 - 2.06),尤其是在无乳糜泻但避免麸质的人群中。然而,各组之间剖宫产率没有差异。

结论

在本回顾性队列研究中,无麸质饮食似乎与不良妊娠或新生儿结局无关。

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本文引用的文献

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Coeliac disease and pregnancy outcomes.乳糜泻与妊娠结局
Obstet Med. 2011 Sep;4(3):95-8. doi: 10.1258/om.2011.110007. Epub 2011 Jun 22.
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Celiac disease and obstetric complications: a systematic review and metaanalysis.乳糜泻与产科并发症:系统评价和荟萃分析。
Am J Obstet Gynecol. 2016 Feb;214(2):225-234. doi: 10.1016/j.ajog.2015.09.080. Epub 2015 Oct 9.
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Maternal body mass index and duration of labor.产妇体重指数与产程时长。
Eur J Obstet Gynecol Reprod Biol. 2013 Nov;171(1):49-53. doi: 10.1016/j.ejogrb.2013.08.021. Epub 2013 Aug 29.
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Fetal and neonatal outcome in celiac disease.乳糜泻的胎儿及新生儿结局
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