辅助生殖女性孕早期膳食摄入频率与抑郁症状的关联研究

Association between frequency of dietary intake and depressive symptoms during early pregnancy of women receiving ART

目的 探索接受辅助生殖技术(assisted reproductive technology,ART)女性孕早期膳食摄入频率与抑郁症状的关联性,为ART女性的孕期保健提供参考依据。方法 以中国国家出生队列·辅助生殖技术子代胚胎源性疾病队列研究(China National Birth Cohort,CNBC)项目招募的1 211例ART孕早期女性为研究对象,使用流调中心用抑郁自评量表评估抑郁症状、食物摄入频率问卷评估膳食摄入情况,采用多因素logistic回归评估ART女性孕早期抑郁症状与膳食摄入频率的关联。结果 CNBC中ART女性孕早期抑郁症状患病率为32.62%。调整混杂因素后,logistic多因素分析结果显示,孕早期抑郁与蔬菜摄入频率低于7 d/周(a OR=1.97,95%CI=1.1.50~2.60),与新鲜水果摄入频率低于7 d/周(a OR=1.58,95%CI=1.15~2.17),与畜禽肉类摄入频率低于7 d/周(a OR=1.86,95%CI=1.42~2.45),与蛋类摄入频率低于7 d/周(a OR=1.48,95%CI=1.15~1.91),与奶类摄入频率低于7 d/周(a OR=1.55,95%CI=1.20~2.00)成正相关。进一步分析以上5个差异有统计学意义的膳食风险因素的协同作用,风险因素数量由低到高对应OR值分别为1.42、2.09、2.57、3.70、3.87,膳食风险因素数量越多,孕早抑郁症状发生的风险越高。结论 蔬菜类、新鲜水果类、畜禽肉类、蛋类、奶类摄入频率低于7 d/周与孕早期抑郁发生有显著关联,应加大对ART女性孕早期抑郁的关注,有针对性地开展孕期营养及心理保健,以促进母婴健康。

Objective To explore the association between frequency of dietary intake and depressive symptoms in early pregnancy of women receiving assisted reproductive technology(ART), to provide reference for pregnancy health care of ART women. Methods A subgroup of 1 211 pregnant women who received ART and were already enrolled in China National Birth Cohort(CNBC) project were selected in the survey, a self-rated depression scale provided by the Center for Epidemiological Studies was used to assess the depressive symptoms of the subjects. Food frequency questionnaire survey was also conducted to collect the information of dietary intake frequency. The association between depressive symptoms and frequency of dietary intake in early pregnancy of ART women were analyzed using multivariate logistic regression method. Results The prevalence of depressive symptoms was 32. 62% in early pregnancy of ART women. After adjusting confounding factors, the results of multivariate logistic regression analysis showed that the depressive symptoms of ART women in the first trimester of pregnancy were positively correlated with less than 7 d/week frequency of vegetable intake(a OR=1. 97, 95%CI:1. 1. 50-2. 60), fresh fruit intake(a OR=1. 58, 95%CI:1. 15-2. 17), livestock and meat intake(a OR=1. 86, 95%CI: 1. 42-2. 45), egg intake(a OR=1. 48,95%CI: 1. 15-1. 91), and with dairy intake(a OR=1. 55, 95%CI: 1. 20-2. 00). Further analysis of the synergistic effect of the above five significant dietary risk factors showed that the OR values corresponding to the number of risk factors from low to high were 1. 42, 2. 09, 2. 57, 3. 70, 3. 87, respectively. The risk of depression in early pregnancy of ART women increased with the increase number of dietary risk factors.Conclusions The frequencies of vegetables, fresh fruits, meat, eggs and milk intake of less than 7 days per week are significantly associated with early pregnancy depression. Therefore, nutritional and mental health education should be strengthened among ART women during early pregnancy to promote the health of mothers and infants.