Better Diet Quality during Pregnancy Is Associated with a Reduced Likelihood of an Infant Born Small for Gestational Age: An Analysis of the Prospective New Hampshire Birth Cohort Study
Better Diet Quality during Pregnancy Is Associated with a Reduced Likelihood of an Infant Born Small for Gestational Age: An Analysis of the Prospective New Hampshire Birth Cohort Study
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DOI：
10.1093/jn/nxx005
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发表时间：
2018-01-01
影响因子：
4.2
通讯作者：
Gilbert-Diamond, Diane
中科院分区：
文献类型：
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作者：
Emond, Jennifer A.;Karagas, Margaret R.;Gilbert-Diamond, Diane
研究背景：出生体重与慢性病呈U型关系。妊娠期间的饮食质量可能会影响胎儿的生长和婴儿出生体重，但调查结果是inconclusive.Objective：我们研究了孕妇在怀孕期间的饮食质量和婴儿出生大小之间的关系，在一个前瞻性的birth coholt.Methods：妇女18-45岁，单胎妊娠，在24-28周的妊娠从产前诊所在新罕布什尔州招募。女性在入组时完成了一份经验证的食物频率问卷。饮食质量计算为遵守替代健康饮食指数。婴儿出生结果（性别、头围、体重和身长）从医疗记录中提取。计算身高体重z评分、低出生体重、巨大儿和胎龄尺寸[小于胎龄（SGA）或大于胎龄（LGA）]。多变量回归模型将每个结果拟合到饮食质量的四分位数上，并对协变量进行了调整。模型计算整体和分层吸烟status.Results：分析包括862名妇女和婴儿的完整数据。较低的饮食质量与母亲受教育程度较低、吸烟、孕前肥胖状态和怀孕期间缺乏锻炼有关。总体而言，3.4%的婴儿出生时体重不足，12.1%的婴儿患有巨大儿，4.6%为SGA，8.7%为LGA。在调整后的模型中，饮食质量的提高似乎与SGA可能性的降低呈线性相关（P趋势= 0.03），尽管每个四分位数比较均未达到统计学显著性。具体而言，与最低四分位数相比，对于饮食质量的每个增加的四分位数，SGA的OR分别为0.89（95% CI：0.37，2.15）、0.73（95% CI：0.28，1.89）和0.35（95% CI：0.11，1.08）。在非吸烟者中观察到了类似的SGA趋势（n = 756; P趋势= 0.07）。此外，在非吸烟者中，饮食质量的提高与婴儿出生体重较低（P趋势= 0.03），并建议减少巨大儿（P趋势= 0.07）。结论：在怀孕期间饮食质量的提高与SGA的风险降低在这个队列的孕妇从新罕布什尔州。需要进一步的研究来阐明母亲饮食质量和巨大儿之间的关系。
Background: Birth weight has a U-shaped relation with chronic disease. Diet quality during pregnancy may impact fetal growth and infant birth weight, yet findings are inconclusive.Objective: We examined the relation between maternal diet quality during pregnancy and infant birth size among women enrolled in a prospective birth cohort.Methods: Women 18-45 y old with a singleton pregnancy were recruited at 24-28 wk of gestation from prenatal clinics in New Hampshire. Women completed a validated food frequency questionnaire at enrollment. Diet quality was computed as adherence to the Alternative Healthy Eating Index. Infant birth outcomes (sex, head circumference, weight, and length) were extracted from medical records. Weight-for-length z scores, low birth weight, macrosomia, and size for gestational age [small for gestational age (SGA) or large for gestational age (LGA)] were computed. Multivariable regression models fit each outcome on quartiles of diet quality, adjusted for covariates. Models were computed overall and stratified by smoking status.Results: Analyses included 862 women and infants with complete data. Lower diet quality was associated with lower maternal education, being a smoker, prepregnancy obesity status, and lack of exercise during pregnancy. Overall, 3.4% of infants were born with a low birth weight, 12.1% with macrosomia, 4.6% were SGA, and 8.7% were LGA. In an adjusted model, increased diet quality appeared linearly associated with a reduced likelihood of SGA (P-trend = 0.03), although each quartile comparison did not reach statistical significance. Specifically, ORs for SGA were 0.89 (95% CI: 0.37, 2.15), 0.73 (95% CI: 0.28, 1.89), and 0.35 (95% CI: 0.11, 1.08) for each increasing quartile of diet quality compared to the lowest quartile. Similar trends for SGA were observed among non-smokers (n = 756; P-trend = 0.07). Also among non-smokers, increased diet quality was associated with lower infant birth weight (P-trend = 0.03) and a suggested reduction in macrosomia (P-trend = 0.07).Conclusions: Increased diet quality during pregnancy was related to a reduced risk of SGA in this cohort of pregnant women from New Hampshire. Additional studies are needed to elucidate the relation between maternal diet quality and macrosomia.