Association between pre-pregnancy calcium intake and hypertensive disorders during the first pregnancy: the Japan environment and children's study
Association between pre-pregnancy calcium intake and hypertensive disorders during the first pregnancy: the Japan environment and children's study
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DOI：
10.1186/s12884-020-03108-2
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发表时间：
2020-07-28
影响因子：
3.1
通讯作者：
Fujimori, Keiya
中科院分区：
文献类型：
--
作者：
Kyozuka, Hyo;Murata, Tsuyoshi;Fujimori, Keiya
确定适当的孕前保健以减少妊娠期高血压疾病（HDP）的发生仍然是现代产科的一个挑战。本研究的目的是检查妊娠前钙（Ca）摄入量与血压正常孕妇HDP之间的关系。方法我们使用日本环境儿童研究（JECS）的数据，这是最大的出生队列研究。在2011年1月至2014年3月期间，共招募了33，894名血压正常的日本人参加JECS。根据孕前钙摄入量五分位数将参与者分为五组（Q1和Q5分别为最低和最高钙摄入量组），以比较其基本背景和产科结局。使用500、550、650、700、1000、1500和1500 mg的钙摄入阈值，进行多重逻辑回归以确定孕前钙摄入对HDP、早发性HDP和晚发性HDP的影响。结果不同钙摄入量组的母亲背景存在显著差异，尤其是低钙摄入量组中社会经济地位较低的受试者（低教育水平和低家庭收入）和吸烟者较多。多因素Logistic回归分析显示，HDP、早发性HDP和迟发性HDP在各钙摄入阈值方面均无显著差异。结论尽管相当多的建议有关钙的摄入量为育龄妇女，本研究表明，孕前钙的摄入量是不相关的风险增加新发高血压的孕妇在怀孕期间。在制定早期预防产后出血的策略时，应考虑进一步研究其他怀孕前饮食因素对产科结局的影响。
Background Determining the appropriate preconception care to reduce the occurrence of hypertensive disorder of pregnancy (HDP) remains a challenge in modern obstetrics. This study aimed to examine the association between pre-pregnancy calcium (Ca) intake and HDP in normotensive primiparas. Methods We used data from the Japan Environment Children's study (JECS), which is the largest birth cohort study. A total of 33,894 normotensive Japanese primiparas were recruited for JECS between January 2011 and March 2014. Participants were categorized into five groups according to pre-pregnancy Ca intake quintiles (Q1 and Q5 were the lowest and highest Ca intake groups, respectively) to compare their basic background and obstetrics outcome. Multiple logistic regressions were performed to identify the effect of pre-pregnancy Ca intake on HDP, early onset HDP, and late-onset HDP, using Ca intake thresholds of 500, 550, 650, 700, 1000, 1500, and 1500 mg. Results We found significant differences in maternal background among the Ca intake groups; in particular, there were more participants with low socioeconomic status, indicated by low education level and low household income, and smokers in the lowest Ca intake group. Multiple logistic regression did not show any significant difference with regard to HDP, early onset HDP, and late-onset HDP in each Ca intake threshold. Conclusions Despite considerable recommendations concerning Ca intake for women of reproductive age, the present study indicates that pre-pregnancy Ca intake was not associated with an increased risk of new-onset hypertension among primiparas during pregnancy. Further studies examining the effect of other pre-pregnancy dietary factors on obstetric outcomes should be considered in the formulation of earlier preventive strategies for primiparas.