Maternal Dietary L-Arginine and Adverse Birth Outcomes in Dar es Salaam, Tanzania
Maternal Dietary L-Arginine and Adverse Birth Outcomes in Dar es Salaam, Tanzania
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DOI：
10.1093/aje/kwx080
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发表时间：
2017-09-01
影响因子：
5
通讯作者：
Fawzi, Wafaie W.
中科院分区：
文献类型：
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作者：
Darling, Anne Marie;McDonald, Chloe R.;Fawzi, Wafaie W.
精氨酸是一氧化氮的生理前体，一氧化氮是胚胎存活、胎儿生长和妊娠维持的关键介质。我们使用坦桑尼亚达累斯萨拉姆（2001-2004年）孕妇中的双盲、随机、安慰剂对照微量营养素补充试验的数据，评估了氨基酸精氨酸的消耗量与不良出生结局发生率之间的关系。精氨酸的饮食摄入量进行了评估，使用重复的24小时回忆，在整个怀孕期间管理。参与者（n = 7，591）在整个随访期间由研究助产士进行监测，以评估妊娠结局。三次限制样条和多变量log-Poisson回归与经验标准误被用来估计精氨酸摄入量和不良出生结局之间的连续和分类关联。与精氨酸摄入量最低五分位数的妇女相比，精氨酸摄入量最高五分位数的妇女在37周前早产的风险是0.79倍（95%置信区间：0.63，1.00; P = 0.03）。精氨酸摄入量与37周前早产和34周前早产的持续相关性的特征是随着摄入量的增加，风险最初迅速下降（非线性P < 0.01）。精氨酸摄入量与胎儿丢失或分娩小于胎龄儿无关。这些数据表明，膳食精氨酸摄入量和早产之间的关联值得进一步研究。
The amino acid arginine is a physiological precursor to nitric oxide, which is a key mediator of embryonic survival, fetal growth, and pregnancy maintenance. We evaluated the association between consumption of the amino acid arginine and the rate of adverse birth outcomes using data from a double-blind, randomized, placebo-controlled micronutrient supplementation trial among pregnant women in Dar es Salaam, Tanzania (2001-2004). Dietary intakes of arginine were assessed using repeated 24-hour recalls that were administered throughout pregnancy. Participants (n = 7,591) were monitored by research midwives throughout follow-up to assess pregnancy outcomes. Cubic-restricted splines and multivariable log-Poisson regression with empirical standard errors were used to estimate the continuous and categorical associations between arginine intake and adverse birth outcomes. Compared with women within the lowest quintile of arginine intake, those within the highest quintile had 0.79 times the risk of preterm birth before 37 weeks (95% confidence interval: 0.63, 1.00; P = 0.03). The continuous associations of arginine intake with preterm birth before 37 weeks and with preterm birth before 34 weeks were characterized by an initial rapid decrease in risk with increasing intake (P for nonlinearity < 0.01). Arginine intake was not associated with fetal loss or giving birth to infants who were born small for their gestational ages. This data suggest that the association between dietary arginine intake and preterm birth warrants further investigation.