Lin Yuting, Li Yanhui, Nian Zhaoyang, Mao Limei
School of Public Health, Southern Medical University, Guangzhou 510515, China.
Wei Sheng Yan Jiu. 2025 May;54(3):349-357. doi: 10.19813/j.cnki.weishengyanjiu.2025.03.001.
To explore the relationship between dietary acid load during late pregnancy in pregnant women and body mass index for age Z score(BMIZ) trajectories in infants.
From September 2010 to November 2011, a total of 468 women in late pregnancy in Guangzhou were recruited as the study subjects, and their offspring were followed up to 1 year old after delivery. Pregnant women were required to complete a basic situation questionnaire and a 3-day 24-hour dietary review survey in late pregnancy. They were also asked to complete a questionnaire on delivery and fetal health status after delivery. The dietary acid load during late pregnancy was calculated using potential renal acid load(PRAL), net endogenous acid production(NEAP), and animal protein to potassium ratio(A∶K ratio). The subjects were then grouped according to the quartiles for each indicator. The weight and length of infants at birth, 1, 3, 6 and 12 months old were prospectively tracked. The BMIZ were calculated and the BMIZ trajectories of infants were analyzed by latent class growth model(LCGM). Multiple logistic regression was used to analyze the relationship between dietary acid load during late pregnancy and BMIZ trajectories of infants.
The median and quartiles of PRAL in late pregnancy were 28.02(21.88, 36.51) mEq/d, and the values of NEAP and A∶K ratio were (81.58±15.41) mEq/d and 22.62±6.80, respectively. A significant negative correlation was identified between dietary acid load and the intake of vegetables, fruits, and legumes(P<0.01). A significant positive correlation was identified between dietary acid lood with the intake of eggs, poultry, livestock, and seafood(P<0.01). According to the latent class growth model, three types of infant BMIZ trajectory groups were identified: the slower growth group(n=52), the appropriate growth group(n=307) and the faster growth group(n=54). Among the infants in the faster growth group, their mothers' late pregnancy NEAP was lower than that of the remaining two trajectory groups(P<0.05). Multiple Logistic regression analyses demonstrated that pregnant women in the highest quartile of late-pregnancy NEAP(OR=4.03, 95% CI 1.01-16.14) and A∶K ratio(OR=4.04, 95% CI 1.30-12.59) were more likely to have offspring with a slower growth trajectory compared with those in the lowest quartile.
Higher dietary acid loads in late pregnancy, particularly elevated levels of NEAP and A∶K ratio, have been associated with slower growth patterns in infants.
探讨孕妇妊娠晚期饮食酸负荷与婴儿年龄别体重指数Z评分（BMIZ）轨迹之间的关系。
2010年9月至2011年11月，招募了广州468名妊娠晚期妇女作为研究对象，并对其后代在出生后随访至1岁。要求孕妇在妊娠晚期完成一份基本情况问卷和一份为期3天的24小时饮食回顾调查。还要求她们在产后完成一份关于分娩和胎儿健康状况的问卷。采用潜在肾酸负荷（PRAL）、净内源性酸生成（NEAP）和动物蛋白与钾比值（A∶K比值）计算妊娠晚期的饮食酸负荷。然后根据每个指标的四分位数对受试者进行分组。前瞻性追踪婴儿出生时、1、3、6和12个月时的体重和身长。计算BMIZ，并通过潜在类别生长模型（LCGM）分析婴儿的BMIZ轨迹。采用多因素logistic回归分析妊娠晚期饮食酸负荷与婴儿BMIZ轨迹之间的关系。
妊娠晚期PRAL的中位数和四分位数分别为28.02（21.88，36.51）mEq/d，NEAP和A∶K比值分别为（81.58±15.41）mEq/d和22.62±6.80。饮食酸负荷与蔬菜、水果和豆类的摄入量呈显著负相关（P<0.01）。饮食酸负荷与蛋类、禽类、畜类和海鲜的摄入量呈显著正相关（P<0.01）。根据潜在类别生长模型，确定了三种类型的婴儿BMIZ轨迹组：生长较慢组（n=52）、生长适宜组（n=307）和生长较快组（n=54）。在生长较快组的婴儿中，其母亲妊娠晚期的NEAP低于其余两个轨迹组（P<0.05）。多因素logistic回归分析表明，妊娠晚期NEAP（OR=4.03，95%CI 1.01-16.14）和A∶K比值（OR=4.04，95%CI 1.30-12.59）最高四分位数的孕妇与最低四分位数的孕妇相比，其后代生长轨迹较慢的可能性更大。
妊娠晚期较高的饮食酸负荷，尤其是NEAP和A∶K比值升高，与婴儿生长模式较慢有关。
