22752例孕妇膳食营养评价和体成分分析

Dietary nutrition assessment and body composition analysis of 22752 pregnant women

目的 分析孕期不同孕周膳食营养摄入及体成分的现状,探讨有无相关性,为孕期个体化管理,改善母婴健康提供理论依据。方法 选择2020年—2022年来我院营养门诊和管理的22752名孕妇,分为三组:孕早组(<孕14周)4798人、孕中组(孕14~27+6周)11496人和孕晚组(孕28~40周)6458人,用24小时膳食回顾法行膳食摄入和营养素分析,比较不同孕周的膳食营养摄入差异;采用生物电阻抗法,测定体成分指标,同时收集其年龄、身高、体重等信息;结果 1.纳入孕妇人数孕中组比例最多占50.53%,其次是孕晚期28.38%,孕早期最少占21.09%;2.随着孕周的增加,体成分各指标都是上升的,其中体脂、体脂百分比、肌肉重、去脂体重随孕周上升显著,而细胞外水、细胞内水、无机盐虽也是上升的,但孕中晚组相对于孕早组上升显著,两组间差异却无统计学意义;3.随着孕周的增加,不同食物的摄入量都是上升的;其中总能量、碳水化合物、水果类的摄入都是随着孕周的增加在增加,且有统计学差异;而蛋白质、脂肪、膳食纤维、蔬菜类、鱼禽肉蛋类等孕中晚组较孕早组摄入有差异,但孕中晚组之间是没有统计学差异,奶及奶制品摄入三组均没有统计学差异4.体成分各指标与奶及奶制品、大豆坚果类、蔬菜类、鱼肉亲蛋类摄入呈正相关,与谷薯类、水果类摄入呈负相关;结论 1.随着孕周的增加,孕妇体成分各指标和膳食营养摄入是在增加的;2.高水果、低碳水、高蛋白高热量摄入为目前的膳食特点并影响体成分;3.联合营养评价和体成分检测,尽早个体化干预,可能会为改善母婴结局提供临床和流行病学依据。

Objective To analyze the current status of dietary nutrient intake and body composi-tion in different gestational weeks,and to explore the correlation between them,so as to provide theoretical basis for individualized management during pregnancy and improving maternal and child health.Methods A total of 22280 pregnant women who were consulted and managed in the nutrition outpatient department of our hospital from 2020 to 2022 were selected to analyze di-etary intake and nutrients by 24-hour dietary review method,and the differences of dietary nutri-ent intake in different gestational weeks were compared.The body composition was measured by bioresistive method,and the information of height,weight and pre-pregnancy BMI were collected.The correlation and influencing factors were analyzed.Results 1.Among the enrolled preg-nant women,the proportion of the second trimester group was the highest(50.53%),followed by the third trimester group(28.38%),and the first trimester group(21.09%);2.Body fat,body fat percentage,muscle mass and fat-free mass increased significantly with gestational age.Extracellular water,intracellular water and inorganic salts also increased,but there was no sig-nificant difference between the second and third trimester group.3.With the increase of gestation-al age,the intake of different foods increased.The intakes of total energy,carbohydrate and fruit increased with the increase of gestational age,and the differences were statistically significant.Although the intake of protein,fat,dietary fiber,vegetables,fish,poultry and eggs in the sec-ond and third trimester group was different from that in the first trimester group,there was no statistically significant difference between the two groups.There was no statistically significant difference in the intake of milk and dairy products among the three groups.4.Body composition was positively correlated with the intake of milk and dairy products,soybeans,nuts,vegetables,fish,meat and eggs,and negatively correlated with cereal,tubers and fruits.Conclusion 1.Weight gain and body composition change during pregnancy reflect the degree of nutrient absorp-tion and utilization,which may be related to pregnancy outcome;2.High fruit,low carbohy-drate,high protein and high energy intake were the characteristics of the current diet and affected the body composition.3.Combined nutritional assessment and body composition measurement,as well as early individualized intervention,may provide clinical and epidemiological evidence for improving maternal and infant outcomes.