Pathirathna Malshani Lakshika, Haruna Megumi, Sasaki Satoshi, Yonezawa Kaori, Usui Yuriko, Hagiwara Yasuhiro
Department of Midwifery and Women's Health, Graduate School of Medicine, Division of Health Sciences and Nursing, The University of Tokyo, Tokyo, Japan.
Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
J Hum Nutr Diet. 2025 Feb;38(1):e70020. doi: 10.1111/jhn.70020.
Maternal nutrition during pregnancy is crucial to ensure positive outcomes for both the mother and newborn. Despite its importance, maternal nutritional status remains poor, particularly in low- and middle-income countries, where social, cultural and economic factors play a pivotal role. This study assessed the adequacy of energy and dietary nutrient intake among Sri Lankan pregnant women compared to their dietary reference intakes.
This study was part of the Sri Lanka Mother and Newborn Growth study, a nationwide prospective cohort of 2000 pregnant women. We prospectively investigated maternal dietary intake using a validated food frequency questionnaire during the first, second and third trimesters.
We observed an imbalanced macronutrient distribution, with carbohydrates contributing over 67% of total median energy intake, while protein and fat contributed approximately 11% and 17%, respectively. Ethnic and socio-economic disparities in energy and macronutrient intake were notable. The Sinhalese ethnic group showed the highest median percentage of energy consumption derived from carbohydrates at 68.0% (IQR: 64.6%‒71.1%), significantly exceeding the intake of Tamil and Moor groups. Estate residents reported the lowest proportion of energy from protein (10.6%, IQR: 10.1%‒11.3%), which was significantly lower than the intakes of urban and rural residents. Additionally, women in the lowest income group had a lower total energy intake (1871 kcal/day, IQR: 1464-2392) than those in higher income groups, highlighting socio-economic influences on maternal nutrition. Micronutrient deficiencies were pervasive, particularly for vitamin B2 (88.6%-91.0%), folate (99.3%-99.8%), vitamin B12 (97.8%-99.5%), calcium (80.8%-91.4%) and iron (91.1%-96.5%). Sodium intake exceeded recommended levels for over 75% of women across all trimesters.
Imbalances in macronutrient intake and widespread micronutrient deficiencies among Sri Lankan pregnant women underscore the urgent need for interventions targeting maternal nutrition. Addressing socio-economic disparities is critical to improving maternal and neonatal health outcomes.
孕期的孕产妇营养对于确保母亲和新生儿都获得良好结局至关重要。尽管其很重要，但孕产妇营养状况仍然较差，尤其是在低收入和中等收入国家，其中社会、文化和经济因素起着关键作用。本研究评估了斯里兰卡孕妇的能量和膳食营养素摄入量与其膳食参考摄入量相比是否充足。
本研究是斯里兰卡母婴生长研究的一部分，这是一项针对2000名孕妇的全国性前瞻性队列研究。我们在孕早期、孕中期和孕晚期使用经过验证的食物频率问卷对孕产妇的膳食摄入量进行了前瞻性调查。
我们观察到宏量营养素分布不均衡，碳水化合物占总能量摄入中位数的比例超过67%，而蛋白质和脂肪分别约占11%和17%。能量和宏量营养素摄入量存在种族和社会经济差异。僧伽罗族碳水化合物能量消耗的中位数百分比最高，为68.0%（四分位间距：64.6% - 71.1%），显著超过泰米尔族和摩尔族的摄入量。种植园居民报告蛋白质能量占比最低（10.6%，四分位间距：10.1% - 11.3%），显著低于城市和农村居民的摄入量。此外，最低收入组的女性总能量摄入量（1871千卡/天，四分位间距：1464 - 2392）低于高收入组女性，这突出了社会经济对孕产妇营养的影响。微量营养素缺乏普遍存在，尤其是维生素B2（88.6% - 91.0%）、叶酸（99.3% - 99.8%）、维生素B12（97.8% - 99.5%）、钙（80.8% - 91.4%）和铁（91.1% - 96.5%）。在所有孕期中，超过75%的女性钠摄入量超过推荐水平。
斯里兰卡孕妇宏量营养素摄入不均衡以及广泛存在的微量营养素缺乏突出表明迫切需要针对孕产妇营养进行干预。解决社会经济差异对于改善孕产妇和新生儿健康结局至关重要。
