孕期膳食维生素C摄入与子痫前期及其临床亚型的关系

Association of dietary vitamin C intake during pregnancy with preeclampsia and its clinical subtypes

目的探讨孕期膳食维生素C摄入与子痫前期(preeclampsia,PE)及其临床亚型的关系。方法选取2012年3月1日―2016年9月30日于山西医科大学第一医院妇产科住院分娩的孕妇为研究对象,其中861例PE孕妇作为病例组,7987例非PE孕妇作为对照组,收集其一般人口学特征、疾病史、家族史及孕期膳食摄入情况等。采用非条件logistic回归分析模型分析孕期膳食维生素C摄入对PE及其临床亚型的发生风险的影响。结果调整孕妇年龄、文化程度等影响因素后,孕妇孕早期膳食维生素C摄入达到Q_(3)水平(OR=0.80,95%CI:0.64~0.99)、孕晚期达到Q_(3)水平(OR=0.78,95%CI:0.63~0.97)会降低PE的发生风险。按照孕前BMI进行分层后,孕前BMI<24.0 kg/m^(2)的孕妇孕早期膳食维生素C摄入达到Q_(3)水平(OR=0.73,95%CI:0.55~0.96)、孕中期达到Q_(3)水平(OR=0.71,95%CI:0.54~0.93)、孕晚期达到Q_(3)水平(OR=0.67,95%CI:0.51~0.88)是PE的保护因素。进一步探讨不同孕前BMI孕妇膳食维生素C摄入与PE临床亚型的关系后发现,孕前BMI<24.0 kg/m^(2)的孕妇孕晚期膳食维生素C摄入达到Q_(3)水平(OR=0.66,95%CI:0.47~0.93)会降低晚发型子痫前期(late-onset preeclampsia,LOPE)的发生风险。结论孕前BMI<24.0 kg/m^(2)的孕妇Q_(3)水平的膳食维生素C摄入可降低PE的发生风险,尤其是对于LOPE。

Objective To investigate the relationship between dietary vitamin C intake during pregnancy and preeclampsia(PE)and its clinical subtypes.Methods Pregnant women who were delivered in the Department of Obstetrics and Gynecology of the First Hospital of Shanxi Medical University from March 1,2012 to September 30,2016 were selected as the research subjects.Among them,861 PE pregnant women were used as the case group and 7987 non-PE pregnant women were used as the control group.Information on demographic characteristics,disease history,family history and dietary intake during pregnancy were collected.Unconditional logistic regression was used to analyze the influence of dietary vitamin C intake during pregnancy on the risk of PE and its clinical subtypes.Results After adjusting for maternity age,educational level and other influencing factors,the dietary vitamin C intake of pregnant women reached Q_(3) level in the first trimester(OR=0.80,95%CI:0.64-0.99)and the third trimester(OR=0.78,95%CI:0.63-0.97)were negatively related with the risk of PE.After stratifying according to the pre-pregnancy BMI,the dietary vitamin C intake of pregnant women with pre-pregnancy BMI<24.0 kg/m^(2) reached Q_(3) level in the first trimester(OR=0.73,95%CI:0.55-0.96),the second trimester(OR=0.71,95%CI:0.54-0.93)and the third trimester(OR=0.67,95%CI:0.51-0.88)were protective factors for PE.After further exploring the relationship between dietary vitamin C intake of pregnant women with different pre-pregnancy BMI and PE clinical subtypes,it was found that the dietary vitamin C intake of pregnant women with pre-pregnancy BMI<24.0 kg/m^(2) Q_(3) level in the third trimester(OR=0.66,95%CI:0.47-0.93)reduced risk of late-onset preeclampsia(LOPE).Conclusion Dietary vitamin C intake of pregnant women with Pre-pregnancy BMI<24.0 kg/m^(2) at Q_(3) level had reduced risk of PE,especially for LOPE.