云南农村妇女不同孕期膳食模式及影响因素

Dietary patterns and their influencing factors of rural pregnant women in different trimesters in Yunnan

目的探讨云南农村妇女不同孕期膳食模式及其影响因素。方法在云南农村地区建立队列,于2015年1月至2018年12月共纳入816名孕妇,在孕早、中、晚期对孕妇进行食物频率调查,采用主成分分析判断膳食模式,应用多元线性回归分析其影响因素。结果孕早、中、晚期及合并孕中晚期均得到3种膳食模式类型,分别为动物蛋白型、腌制型和传统型。动物蛋白型与年龄(β=0.269,P<0.05)和初中及以上学历呈正相关(初中:β=0.452,P<0.05;高中及以上:β=0.557,P<0.05),与家庭年收入呈负相关(β=-0.654,P<0.05)。腌制型与孕晚期处于夏季(β=0.228,P<0.05)和孕晚期高感知压力呈正相关(β=0.168,P<0.05),与初中及以上学历、家庭年收入、孕前BMI≤18.5kg/m2和呕吐呈负相关(β值分别为-0.427、-0.416、-0.489、-0.406、-0.240,P<0.05)。传统型与家庭年收入(β=0.544,P<0.05)和呕吐呈正相关(β=0.121,P<0.05),与胎次(β=-0.159,P<0.05)、孕前BMI≥24.0kg/m2(β=-0.253,P<0.05)呈负相关。结论低学历、低龄、低收入、高感知压力、孕前BMI正常的孕妇更倾向选择不合理的膳食模式。应对孕妇开展有针对性的营养教育,帮助她们选择合理健康的膳食模式。

Objective To explore dietary patterns and influencing factors of pregnant women in different trimesters in Yunnan rural area.Methods A total of 816 pregnant women were included in the current study from a prospective birth cohort in rural, Yunnan, China from January 2015 to December 2018.A food-frequency questionnaire survey was conducted to collect food information in three trimesters.Principal components analysis was used to identify dietary patterns, and multiple linear regression analysis was used to explore the associated factors of dietary patterns.Results There were 3 types of diets in the early, middle, and late stages of pregnancy and the combined second and third trimesters, including the animal protein diet, the pickling diet and the traditional diet.The animal protein diet was positively associated with age(β=0.269,P<0.05) and education level(junior high school: β=0.452;high school and above: β=0.557,both P<0.05).The animal protein diet was negatively associated with the family′s annual income(β=-0.654,P<0.05).The pickling diet was positively associated with summer season(β=0.228,P<0.05) and high perceived pressure in the third trimester(β=0.168,P<0.05) and was negatively associated with junior high school degree or above education level, family′s annual income, pre-pregnancy BMI≤18.5 kg/m2 and pregnant vomiting(β=-0.427,-0.416,-0.489,-0.406 and-0.240,respectively, all P<0.05).The traditional diet was positively associated with family′s annual income and pregnant vomiting(β=0.544 and 0.121,respectively, both P<0.05) and was negatively associated with parity and pre-pregnancy BMI≥24 kg/m2(β=-0.159 and-0.253,respectively, both P<0.05).Conclusion Women with low education, young age, low income, high perceived stress level, normal pre-pregnancy BMI are more likely to choose unreasonable dietary patterns.It is necessary to strengthen nutrition education for pregnant women to help them to establish the concept of reasonable diet and balanced nutrition.