妊娠期膳食模式与早产风险的meta分析

Maternal dietary patterns and risk of preterm birth:A meta-analysis

目的评估妊娠期膳食模式对早产发生风险的影响,为降低早产发生率提供膳食指导依据。方法系统检索PubMed、Web of Science、知网等数据库关于妊娠期膳食模式和早产关联的相关研究,将膳食模式按照食物成分相似性,分为“健康”“不健康”和“混合”3种膳食模式,运用RevMan5.4软件对纳入研究中妊娠期膳食最高和最低依从性的结局效应进行meta分析,并进行亚组分析和敏感性分析。结果最终纳入23篇文献,总样本量312892例。对其中18篇文献进行meta分析结果显示,健康膳食模式依从性高可降低早产发生风险[OR=0.82,95%CI(0.76,0.89)],进行亚组分析和敏感性分析后结局稳定。纳入文献中的健康膳食模式漏斗图不对称,存在发表偏倚。不健康膳食模式和混合膳食模式与早产发生风险之间未发现显著相关性。结论不同的膳食模式对早产的发生风险具有较大影响,妊娠期高摄入水果、蔬菜、全谷物、低脂乳制品、豆类、植物油和鱼类等健康膳食模式可降低早产发生风险。

Objective To assess the influence of maternal dietary patterns during pregnancy on the risk of preterm birth,and to provide dietary guidance for reducing the incidence of preterm birth.Methods A systematic search of databases including PubMed,Web of Science,CNKI,and others was conducted for relevant studies on the association between maternal dietary patterns and preterm birth.Dietary patterns were categorized into“healthy”“unhealthy”and“mixed”based on food component similarities.Meta-analysis using RevMan 5.4 software was performed to analyze the outcome effects of the highest and lowest adherence to maternal dietary patterns in the included studies,along with subgroup and sensitivity analyses.Results A total of 23 articles with 312892 participants were included.Meta-analysis of 18 articles showed that high adherence to a healthy dietary pattern significantly reduced the risk of preterm birth[OR=0.82,95%CI(0.76,0.89)],with stable outcomes confirmed by subgroup and sensitivity analyses.The funnel plot of included studies on the healthy dietary pattern exhibited asymmetry,indicating publication bias.No significant association was found between unhealthy or mixed dietary patterns and the risk of preterm birth.Conclusion Different dietary patterns have a significant impact on the risk of preterm birth,and healthy dietary patterns such as high intake of fruits,vegetables,whole grains,low-fat dairy products,legumes,vegetable oils and fish during pregnancy can reduce the risk of preterm birth.