孕晚期膳食摄入量对新生儿出生体重及胎盘系数的影响

The Association Between Dietary Intake in 3^(rd) Trimester Gestation and Infant Birthweight and Placenta Coefficient

目的:探讨孕妇孕晚期膳食摄入量对新生儿出生体重及胎盘系数的影响。方法:纳入241例在2017年10月—2018年1月于上海市新华医院产科分娩的健康产妇,在分娩后72h内进行回顾性孕晚期食物频率问卷调查,并收集孕妇身高、孕前体重、年龄、分娩方式,和新生儿性别、出生体重、胎龄、胎盘重量,计算胎盘系数(胎盘系数=胎盘重量/出生体重)。根据2013Fenton生长曲线新生儿胎龄别体重将新生儿分为小于胎龄儿组、适于胎龄儿组和大于胎龄儿组。结果:经多因素Logistic回归分析显示,对于体重大于胎龄儿,增加孕晚期能量(OR=0. 998,95%CI:0. 996～1. 000)和碳水化合物(OR=0. 027,95%CI:0. 975～0. 998)摄入量能够降低其发生率;对于新生儿体重小于胎龄,增加蛋白质摄入(OR=0. 977,95%CI:0. 956～1. 000)能够降低其发生率,而碳水化合物供能比增加(OR=1. 074,95%CI:1. 010～1. 142)则会增加其发生率。线性回归分析显示,增加孕晚期脂肪摄入量(β=0. 020,95%CI:0. 000～0. 039)和脂肪供能比(β=0. 059,95%CI:0. 001～0. 118)会增大胎盘系数,增加碳水化合物供能比(β=-0. 049,95%CI:-0. 097～-0. 001)会降低胎盘系数。结论:孕晚期膳食摄入量影响新生儿出生体重及胎盘系数。

Objective To investigate the relationship between dietary intake in 3 rd trimester gestation and infant birth weight and placenta coefficient.Method A retrospective food frequency questionnaire for 3 rd trimester gestation was conducted among 241 pregnant women who delivered in Xinhua Hospital within 72 hours after delivered.We collected the data such as maternal height,pre-pregnancy weight,age,mode of delivery,and infant sex,birthweight,gestational age,placenta.Placenta coefficient was calculated.Placenta coefficient=placenta weight/birthweight.According to infant birthweight for gestational age,women were divided into small for gestational age(SGA)group(n=22),appropriate for gestational age(AGA)group(n=208)and large for gestational age(LGA)group(n=11).Result Logistic regression analysis showed that higher intake of energy(OR=0.998,95%CI:0.996~1.000)and carbohydrate(OR=0.027,95%CI:0.975~0.998)were protective factors of LGA.Higher intake of protein(OR=0.977,95%CI:0.956~1.000)was protective factor of SGA.Higher energy ratio of carbohydrate(OR=1.074,95%CI:1.010~1.142)was risk factor of SGA.Linear regression analysis showed that higher intake of fat(β=0.020,95%CI:0.001~0.039)was associated with greater placental coefficient.Conclusion Dietary intake in 3 rd trimester gestation was associated with infant birthweight and placenta coefficient.