孕期膳食维生素B_(3)摄入与子痫前期及临床亚型发生风险的关系

Association of dietary vitamin B_(3) intake during pregnancy with the risk of preeclampsia and its clinical subtypes

目的:探讨孕期膳食维生素B_(3)摄入与子痫前期(PE)及临床亚型发生风险的关系,为子痫前期护理干预的有效实施提供依据。方法:选取2012年3月—2016年9月在某三级甲等医院产科住院分娩的9 350名孕妇为研究对象。收集孕妇的一般资料、孕期膳食摄入情况等信息,采用非条件Logistic回归分析孕期膳食维生素B_(3)摄入对子痫前期及其临床亚型发病的影响。结果:孕妇孕期膳食维生素B_(3)摄入量与子痫前期发生风险有关。孕早期和孕中期膳食维生素B_(3)摄入量分别达到≥13.70 mg/d、13.74 mg/d是早发型子痫前期(EOPE)的保护因素;孕中期和孕晚期分别达到9.65~<13.74 mg/d、9.63~<13.72 mg/d是晚发型子痫前期(LOPE)的保护因素。孕前体质指数正常的孕妇,其维生素B_(3)摄入量在孕早期达到≥13.70 mg/d可降低早发型子痫前期发生风险,孕中期和孕晚期分别达到9.65~<13.74 mg/d、9.63~<13.72 mg/d可降低晚发型子痫前期发生风险。孕前体质指数≥24.0 kg/m^(2)的孕妇,其维生素B_(3)摄入量在孕早、中、晚期分别达到9.45~<13.70 mg/d、9.65~<13.74 mg/d、9.63~<13.72 mg/d可降低晚发型子痫前期发生风险。结论:不同孕前体质指数孕妇膳食维生素B_(3)摄入量与子痫前期及其临床亚型发病有关。医护人员应指导孕妇实践自我护理,加强对孕前体质指数的监测,保证孕妇膳食维生素B_(3)的充足摄入,从而降低子痫前期的发病风险。

Objective:To explore the relationship between dietary vitamin B_(3) intake during pregnancy and the risk of preeclampsia(PE)and its clinical subtypes,so as to provide reference for the effective implementation of PE nursing intervention.Methods:A total of 9350 pregnant women who gave birth in the obstetrics department of a tertiary class A hospital from March 2012 to September 2016 were selected as the research objects.General demographic characteristics and dietary intake during pregnancy were collected.The effects of dietary vitamin B_(3) intake during pregnancy on the risk of PE and its clinical subtypes were analyzed by unconditioned logistic regression model.Results:Dietary vitamin B_(3) intake during pregnancy was associated with the risk of PE development.Dietary vitamin B_(3) intake at≥13.70 mg/d、13.74 mg/d levels during the first and second trimesters was a protective factor for early-onset preeclampsia(EOPE).9.65~<13.74 mg/d、9.63~<13.72 mg/d levels during the second and third trimesters were a protective factor for late-onset preeclampsia(LOPE).In pregnant women with normal pre-pregnancy BMI,vitamin B_(3) intake reaching≥13.70 mg/d level in early pregnancy could reduce the risk of EOPE.9.65~<13.74 mg/d、9.63~<13.72 mg/d levels during the second and third trimesters reduced the risk of LOPE.In pregnant women with pre-pregnancy BMI≥24.0 kg/m^(2),vitamin B_(3) intake at 9.45~<13.70 mg/d、9.65~<13.74 mg/d、9.63~<13.72 mg/d level during early,the second and third trimesters were associated with a lower risk of LOPE.Conclusions:Dietary vitamin B_(3) intake in pregnant women with different pre-pregnancy BMI was associated with the incidence of PE and its clinical subtypes.Medical staff should guide pregnant women to practice self-care,strengthen monitoring of pre-pregnancy BMI,and ensure adequate intake of dietary vitamin B_(3) for pregnant women,thereby reducing the risk of developing PE.