Scholl T O, Hediger M L, Schall J I, Fischer R L, Khoo C S
Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey, Camden 08103-1505.
Am J Epidemiol. 1993 May 15;137(10):1115-24. doi: 10.1093/oxfordjournals.aje.a116615.
Zinc affects growth, development, and reproduction. However, the effect of poor maternal zinc nutriture, usually measured as plasma zinc, on poor pregnancy outcome has not been consistent. The influence of dietary zinc on pregnancy outcome was examined in a cohort of 818 pregnant girls and women from a poor urban community in Camden, New Jersey (1985-1990). Zinc intake in this sample was 11.1 mg/day, a level ascertained from averaged 24-hour dietary recalls during pregnancy. Gravidas with low zinc intake (< or = 6 mg/day, amounting to 40% of the recommended dietary allowance for pregnancy) had lower caloric intake and multivitamin usage as well as a higher incidence of inadequate weight gain during pregnancy and iron deficiency anemia at entry to prenatal care compared with those with higher intakes. A low zinc intake was associated with approximately a twofold increase in the risk of low birth weight (< 2,500 g) after controlling for calories and other confounding variables. The risk of preterm delivery (< 37 completed weeks) was also increased, particularly when rupture of the membranes preceded the onset of labor (adjusted odds ratio = 3.46, 95% confidence interval 1.04-11.47). A low intake of dietary zinc earlier in pregnancy was associated with a greater than threefold increase in the risk of very preterm delivery (< 33 completed weeks). In conjunction with iron deficiency anemia at entry to prenatal care, the adjusted odds ratio for very preterm delivery with low zinc intake was 5.44 (95% confidence interval 1.58-18.79). Among the urban poor, a marginal zinc intake during pregnancy may play an important role in the duration of gestation and is associated with increased risk of preterm and very preterm delivery.
锌会影响生长、发育和繁殖。然而，通常以血浆锌来衡量的孕产妇锌营养状况不佳对不良妊娠结局的影响并不一致。在新泽西州卡姆登一个贫困城市社区的818名怀孕女孩和妇女队列中，研究了膳食锌对妊娠结局的影响（1985 - 1990年）。该样本中的锌摄入量为11.1毫克/天，这一水平是根据孕期平均24小时饮食回忆确定的。与锌摄入量较高的孕妇相比，锌摄入量低（≤6毫克/天，相当于孕期推荐膳食摄入量的40%）的孕妇热量摄入和多种维生素的使用量较低，孕期体重增加不足以及在开始产前护理时缺铁性贫血的发生率较高。在控制热量和其他混杂变量后，低锌摄入量与低出生体重（<2500克）风险增加约两倍有关。早产（<37足周）的风险也增加，特别是当胎膜破裂先于临产时（调整后的优势比 = 3.46，95%置信区间1.04 - 11.47）。孕期早期膳食锌摄入量低与极早产（<33足周）风险增加超过三倍有关。与产前护理开始时的缺铁性贫血相结合，低锌摄入量导致极早产的调整后优势比为5.44（95%置信区间1.58 - 18.79）。在城市贫困人口中，孕期锌摄入量处于边缘水平可能在妊娠期时长方面发挥重要作用，并与早产和极早产风险增加有关。
