2010-2012年陕西省育龄妇女孕期膳食模式与不良妊娠结局关联研究

Study on the association of dietary patterns of Shaanxi women of childbearing age during pregnancy with adverse pregnancy outcomes from 2010 to 2012

目的分析陕西育龄妇女孕期膳食模式类型及其与不良妊娠结局的关联。方法研究对象来源于"陕西省出生缺陷现况及其危险因素调查",于2013年7-11月,采用多阶段分层随机抽样方法,从陕西省抽取符合纳入排除标准的育龄妇女15 980名。问卷调查获得妊娠结局和孕期的食物摄入量等信息。采用因子分析法确定膳食模式的类别,并根据因子得分将每种膳食模式的研究对象分为T1~T3组。采用非条件多因素logistic回归模型分析膳食模式与不良妊娠结局的关联。结果因子分析法得出了4种孕期的膳食模式:素食模式、均衡模式、传统模式和加工模式。多因素logistic回归模型的分析结果显示,与素食模式T2组相比,素食模式T1组有较低的子代低出生体重发生风险(OR=0.56,95%CI:0.41~0.83),素食模式T3组有较高的子代低出生体重发生的风险(OR=2.32,95%CI:1.59~3.89);与传统模式T2组相比,传统模式T3组有较高的子代早产发生风险(OR=2.62,95%CI:1.58~5.01);与均衡模式T2组相比,均衡模式T3组具有较低的自然流产发生风险(OR=0.73,95%CI:0.36~0.89);与加工模式T2组相比,加工模式T3组有较高的自然流产(OR=1.97,95%CI:1.36~3.34)、子代死胎死产(OR=2.96,95%CI:1.49~6.26)的发生风险,加工模式T1组有较低的子代死胎死产发生的风险(OR=0.52,95%CI:0.33~0.83)。结论陕西育龄妇女具有不同的膳食模式,膳食模式与不良妊娠结局可能存在关联性。

Objective To analyze the types of dietary patterns of women during pregnancy in Shaanxi and their association with adverse pregnancy outcomes. Methods Data were derived from a cross-sectional program named "The prevalence and risk factors of birth defects in Shaanxi Province" from July to November in 2013. A multi-stage stratified random sampling method was used to extract 15 980 women of childbearing age who met the inclusion exclusion criteria from Shaanxi Province. The questionnaire obtained information such as the pregnancy outcome and the food intake of the study subjects during pregnancy. The dietary pattern was extracted by factor analysis, and the each dietary pattern of subjects were divided into T1-T3 groups according to the factor score. The effects of each dietary pattern on major adverse pregnancy outcomes were estimated by unconditional logistic regression model. Results Four dietary patterns were established:vegetarian pattern, balanced pattern, traditional pattern, and processing pattern. The multivariate logistic regression model results showed that compared with the vegetarian pattern T2 group, the T1 group had lower risk of low birth weight (OR=0.56, 95%CI: 0.41-0.83), and the T3 group had higher risk of low birth weight in offspring (OR=2.32, 95%CI: 1.59-3.89);compared with the traditional pattern T2 group, the T3 group had higher risk of premature (OR=2.62, 95%CI: 1.58-5.01);compared with the balanced pattern T2 group, the T3 group had a lower risk of spontaneous abortion (OR=0.73, 95%CI: 0.36-0.89);compared with the processing pattern T2 group, the T3 group had a higher risk of spontaneous abortion (OR=1.97, 95%CI: 1.36-3.34) and higher risk of stillbirth (OR=2.96, 95%CI: 1.49-6.26), and the T1 group had a lower risk of stillbirths in offspring (OR=0.52, 95%CI: 0.33-0.83). Conclusion The women of childbearing age in Shaanxi have different dietary patterns, and there may be a correlation between dietary patterns and adverse pregnancy outcomes.