Dietary diversity and diet quality with gestational weight gain and adverse birth outcomes, results from a prospective pregnancy cohort study in urban Tanzania.
Dietary diversity and diet quality with gestational weight gain and adverse birth outcomes, results from a prospective pregnancy cohort study in urban Tanzania.
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DOI：
10.1111/mcn.13300
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发表时间：
2022-04
影响因子：
3.4
通讯作者：
Fawzi WW
中科院分区：
文献类型：
--
作者：
Yang J;Wang M;Tobias DK;Rich-Edwards JW;Darling AM;Abioye AI;Noor RA;Madzorera I;Fawzi WW
孕期健康的孕产妇饮食是妊娠相关结局的重要保护因素，包括妊娠期体重增加（GWG）和分娩结局。在坦桑尼亚（n = 1190）的一项试验中，我们使用女性最低饮食多样性（MDD‐W）和主要饮食质量评分（PDQS），以及GWG和分娩结局，前瞻性地研究了产妇饮食多样性和饮食质量之间的关系。MDD - W和PDQS来源于基线食物频率问卷。每个月对妇女进行随访，直到分娩，期间测量体重。GWG是根据2009年医学研究所的指南分类的。不良出生结局分为低出生体重（LBW）、小于胎龄、大于胎龄和早产。46.2%的参与者MDD‐W≥5。PDQS平均评分为23.3分。母亲对坚果、家禽和鸡蛋的摄入量很低，而含糖饮料和精制谷物的摄入量很高。MDD‐W与GWG或出生结局无关。对于PDQS，与最低分位数相比，最高分位数的女性GWG不适当的风险较低（风险比[RR] = 0.93, 95%可信区间[CI]: 0.87-1.00）。PDQS中胎组的妇女早产风险较低（RR = 0.72, 95% CI: 0.51-1.00）。在排除有既往并发症的女性后，较高的PDQS与较低的LBW风险相关（中位数：RR = 0.55, 95% CI: 0.31-0.99，最高位数：RR = 0.52, 95% CI: 0.29-0.94；连续每SD: RR = 0.77, 95% CI: 0.60-0.99）。我们的研究结果支持在坦桑尼亚妇女中继续努力改善产妇饮食质量，以获得最佳的GWG和婴儿结局。产妇饮食是妊娠期体重增加（GWG）和分娩结局的关键可改变决定因素。我们观察到，在坦桑尼亚城市营养良好的孕妇中，健康蛋白质和脂肪的摄入量达不到最佳水平，而精制谷物和含糖食物的摄入量却很高。本研究发现，高质量的母亲饮食与不适当的GWG、低出生体重和早产的风险较低相关。这项研究支持了高产妇饮食质量的重要性，并继续努力促进均衡的产妇饮食，避免营养不足和营养过剩，以实现坦桑尼亚人口的最佳妊娠结局。
Healthy maternal diets during pregnancy are an important protective factor for pregnancy‐related outcomes, including gestational weight gain (GWG) and birth outcomes. We prospectively examined the associations of maternal dietary diversity and diet quality, using Minimum Dietary Diversity for Women (MDD‐W) and Prime Diet Quality Score (PDQS), with GWG and birth outcomes among women enrolled in a trial in Tanzania (n = 1190). MDD‐W and PDQS were derived from a baseline food frequency questionnaire. Women were monthly followed until delivery, during which weight was measured. GWG was classified based on the 2009 Institute of Medicine guidelines. Adverse birth outcomes were classified as low birth weight (LBW), small for gestational age, large for gestational age, and preterm birth. 46.2% participants had MDD‐W ≥ 5. Mean score of PDQS was 23.3. Maternal intakes of nuts, poultry, and eggs were low, whereas intakes of sugar‐sweetened beverages and refined grains were high. MDD‐W was not associated with GWG or birth outcomes. For PDQS, compared to the lowest tertile, women in the highest tertile had lower risk of inappropriate GWG (risk ratio [RR] = 0.93, 95% confidence interval [CI]: 0.87–1.00). Women in the middle tertile group of PDQS (RR = 0.72, 95% CI: 0.51–1.00) had lower risk of preterm birth. After excluding women with prior complications, higher PDQS was associated with lower risk of LBW (middle tertile: RR = 0.55, 95% CI: 0.31–0.99, highest tertile: RR = 0.52, 95% CI: 0.29–0.94; continuous per SD: RR = 0.77, 95% CI: 0.60–0.99). Our findings support continuing efforts to improve maternal diet quality for optimal GWG and infant outcomes among Tanzanian women. Maternal diets are a key modifiable determinant of gestational weight gain (GWG) and birth outcomes. We observed suboptimal intakes of healthy proteins and fats and high intakes of refined grains and sugar‐containing foods among well‐nourished pregnant women in urban Tanzania. This study found that higher‐quality maternal diets were associated with lower risks of inappropriate GWG, low birth weight, and preterm birth. This study supports the importance of high maternal diet quality and continuing efforts to promote well‐balanced maternal diets with avoiding both under‐ and over‐nutrition for optimal pregnancy outcomes among Tanzanian populations.
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影响因子：
1.8
作者：
Lukmanji, Zohra;Hertzmark, Ellen;Fawzi, Wafaie W.
通讯作者：
Fawzi, Wafaie W.
影响因子：
7.1
作者：
LAWRENCE, M;COWARD, WA;WHITEHEAD, RG
通讯作者：
WHITEHEAD, RG
影响因子：
2.8
作者：
Imdad, Aamer;Bhutta, Zulfiqar A.
通讯作者：
Bhutta, Zulfiqar A.
影响因子：
7.1
作者：
Fung, Teresa T.;Isanaka, Sheila;Willett, Walter C.
通讯作者：
Willett, Walter C.
影响因子：
158.5
作者：
Fawzi, Wafaie W.;Msamanga, Gernard I.;Spiegelman, Donna
通讯作者：
Spiegelman, Donna