孕中期膳食平衡指数与婴幼儿体重发育关系的队列研究

Relationship between dietary balance index during pregnancy and infant body weight development:a cohort study

目的前瞻性探究孕中期膳食平衡指数(diet balance index for pregnancy,DBI)与婴幼儿体重发育的纵向关联。方法基于出生队列,通过食物频率问卷收集孕中期妇女过去1个月内的摄入膳食情况,并采用经修订的孕妇膳食平衡指数(diet balance index for pregnancy,DBI-P)评价孕妇膳食质量,评分分值越高代表偏离推荐值程度越高。随访其子代至24月龄,分别在1、6、12、18、24月龄测量体重,并计算年龄别体重Z分值和0~24月龄年龄别体重Z分值变化值。分别采用混合线性模型和多重logistic回归分析模型进行关联性分析。结果共纳入543对母子对,13.45%的孕妇存在低度以上摄入过量,84.53%的孕妇存在低度以上的摄入不足,88.77%的孕妇存在低度以上膳食不均。孕期水果类摄入评分与婴幼儿0~24月龄年龄别体重呈正相关(β=0.065,P=0.002);孕期添加糖评分和DBI-P正端分(high bound score,HBS)与0~24月龄年龄别体重变化值呈正相关(β=0.091,P=0.032);孕期饮酒评分与0~24月龄年龄别体重变化值呈负相关(β=-0.282,P=0.032)。结论广州市孕中期妇女膳食摄入不均衡,应强调适宜摄入水果,减少孕期过量摄入水果及添加糖,避免酒类摄入。

Objective To prospectively explore the longitudinal association between dietary balance index during pregnancy and infant body weight development.Methods Using food frequency questionnaire,we collected data on the dietary intake of women during the second trimester of pregnancy in the past month based on the birth cohort.The revised dietary balance index for pregnancy(DBI-P)was utilized to evaluate dietary quality of pregnant women.Follow-ups were conducted for offspring up to the age of 2 years,with body weight measurements taken at 1,6,12,18,and 24 months respectively.The Z-score of body weight for age and the Z-score of body weight for age from 0 to 24 months of age were calculated.The mixed linear model and multiple regression were used to analyze the correlation.Results A total of 543 mother-child pairs were included,of which 13.45%of pregnant women had overall low intake,84.53%had an overall low intake,and 88.77%had an uneven diet.Fruit intake score during pregnancy was positively correlated with the body weight of infants aged 0-24 months(β=0.065,P=0.002).Gestational added sugar score and DBI-P high bound score(HBS)was positively correlated with weight change at 0-24 months of age(β=0.091,P=0.032).Alcohol consumption score during pregnancy was negatively correlated with weight change of age from 0-24 months(β=-0.282,P=0.032).Conclusions There is a significant dietary imbalance among women in the second trimester of pregnancy in Guangzhou.It is crucial to encourage increased fruit intake,reduce excessive and added sugar consumption,and completely avoid alcohol during pregnancy.