Adequately diversified dietary intake and iron and folic acid supplementation during pregnancy is associated with reduced occurrence of symptoms suggestive of pre-eclampsia or eclampsia in Indian women.
Adequately diversified dietary intake and iron and folic acid supplementation during pregnancy is associated with reduced occurrence of symptoms suggestive of pre-eclampsia or eclampsia in Indian women.
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DOI：
10.1371/journal.pone.0119120
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Stuckler D
中科院分区：
文献类型：
--
作者：
Agrawal S;Fledderjohann J;Vellakkal S;Stuckler D
先兆子痫或子痫（PE或E）占全世界孕产妇死亡病例的25%。有一些证据表明这与饮食因素有关，但很少有研究探讨发展中国家的这种联系，发展中国家的负担主要落在那里。我们研究了印度妇女妊娠期间充分多样化的饮食摄入、铁和叶酸补充与PE或E症状之间的关系。本研究使用了印度第三次全国家庭健康调查（nfhs - 3,2005 - 2006）的横断面数据。研究人员从39,657名年龄在15-49岁、在调查前五年内活产过一次的妇女中收集了怀孕期间提示PE或E的自我报告症状。采用多变量logistic回归分析，在调整了产妇、健康和生活方式因素以及母亲的社会人口统计学特征后，估计怀孕期间充分多样化的饮食摄入、铁和叶酸补充与提示PE或E症状之间的关系。在最近一次怀孕中，1.2% （n=456）的研究样本经历了提示PE或E的症状。饮食多样化的母亲报告PE或E症状的可能性比饮食多样化不充分的母亲低34% （or: 0.66; 95% CI: 0.51-0.87）。在上一次怀孕期间补充铁和叶酸至少90天的母亲中，报告PE或E症状的可能性也降低了36% （or: 0.64; 95% CI: 0.47-0.88）。作为敏感性分析，我们按教育、财富、产前检查、生育间隔和胎次顺序对模型进行分层。我们的结果基本保持不变：怀孕期间充分多样化的饮食摄入和铁和叶酸的补充与PE或E症状的发生减少有关。在印度妇女中，怀孕期间膳食摄入充分多样化并补充铁和叶酸可减少PE或E症状的发生。
Pre-eclampsia or Eclampsia (PE or E) accounts for 25% of cases of maternal mortality worldwide. There is some evidence of a link to dietary factors, but few studies have explored this association in developing countries, where the majority of the burden falls. We examined the association between adequately diversified dietary intake, iron and folic acid supplementation during pregnancy and symptoms suggestive of PE or E in Indian women. Cross-sectional data from India’s third National Family Health Survey (NFHS-3, 2005-06) was used for this study. Self-reported symptoms suggestive of PE or E during pregnancy were obtained from 39,657 women aged 15-49 years who had had a live birth in the five years preceding the survey. Multivariable logistic regression analysis was used to estimate the association between adequately diversified dietary intake, iron and folic acid supplementation during pregnancy and symptoms suggestive of PE or E after adjusting for maternal, health and lifestyle factors, and socio-demographic characteristics of the mother. In their most recent pregnancy, 1.2% (n=456) of the study sample experienced symptoms suggestive of PE or E. Mothers who consumed an adequately diversified diet were 34% less likely (OR: 0.66; 95% CI: 0.51-0.87) to report PE or E symptoms than mothers with inadequately diversified dietary intake. The likelihood of reporting PE or E symptoms was also 36% lower (OR: 0.64; 95% CI: 0.47-0.88) among those mothers who consumed iron and folic acid supplementation for at least 90 days during their last pregnancy. As a sensitivity analysis, we stratified our models sequentially by education, wealth, antenatal care visits, birth interval, and parity. Our results remained largely unchanged: both adequately diversified dietary intake and iron and folic acid supplementation during pregnancy were associated with a reduced occurrence of PE or E symptoms. Having a adequately diversified dietary intake and iron and folic acid supplementation in pregnancy was associated with a reduced occurrence of symptoms suggestive of PE or E in Indian women.
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