摘要目的 研究孕妇不同孕期膳食摄入对小于胎龄儿(SGA)发生风险的影响.方法 收集2012年3月至2016年9月在山西医科大学第一医院产科住院分娩孕妇的一般人口学特征、孕早、中、晚期膳食摄入能量、蛋白质、脂肪、碳水化合物以及新生儿基本信息.纳入研究对象8 102例,SGA组961例,适于胎龄儿(AGA)组7 141例.按照中国食物成分表将摄入食物转化为每日膳食营养素摄入量,以AGA组膳食营养素摄入量的三分位数划分为高摄入量组、中等摄入量组及低摄入量组.通过非条件logistic回归分析孕早、中、晚期膳食摄入营养素对SGA的影响.结果 相对于中等摄入量组,孕早期(＜51.60 g/d)、孕中期(＜52.69 g/d)及孕晚期蛋白质摄入量低(＜52.65 g/d)是SGA的危险因素(OR=1.534,95％CI:1.217～ 1.934;OR=1.268,95％CI:1.005～1.599;OR=1.310,95％CI:1.036～ 1.655).按孕前BMI分层后,孕前BMI＜ 18.5 kg/m2的孕妇早期蛋白质摄入量低(＜51.60 g/d)及总能量摄入低(＜1 146.22 kcal/d)是SGA的危险因素(OR=1.872,95％CI:1.033 ～ 3.395;OR=1.754,95％CI:1.125 ～ 2.734);孕前18.5≤BMI＜24.0 kg/m2的孕妇,孕早期膳食蛋白质摄入量低(＜51.60 g/d)是SGA的危险因素(OR=1.465,95％CI:1.089～ 1.972);在孕前BMI≥24.0 kg/m2的孕妇中未发现膳食摄入与SGA有关联.结论 孕期膳食摄入影响SGA的发生风险,且不同孕前BMI人群膳食摄入对SGA的影响有差异,孕早期是膳食摄入对SGA作用的关键期.

abstractsObjective To investigate the relations between dietary intake during pregnancy and the incidence of their babies with small for gestational age (SGA).Methods Data on demographics,dietary intake of protein,fat,and carbohydrates of the pregnant mothers during the first,second and third trimester,were collected.Information related to birth weight and gestational age of the infants were also gathered.A total of 8 102 women,who delivered their babies at the First Affiliated Hospital of Shanxi Medical University from March 2012 to September 2016,were enrolled in this project.Among them,961 mothers had infants with SGA but the other 7 141 of them having normal infants.Unconditional logistic regression model was used to analyze the effect of dietary nutrient intake on SGA the first,second and third trimester.Results We found that low dietary intake of protein during the first trimester and following trimesters during pregnancy were positively associated with higher risk of SGA (OR=1.534,95％CI:1.217-1.934;OR=1.268,95％CI:1.005-1.599;OR=1.310,95％CI:1.036-1.655).When adjusting for maternal pre-pregnancy BMI,we found that when mothers were with a pre-pregnancy BMI less than 18.5 or with low maternal intake of protein during the first trimester,positive association with higher risk of SGA (OR=1.872,95％CI:1.033-3.395;OR=1.754,95％CI:1.125-2.734),was noticed.However,for mothers with a pre-pregnancy BMI between 18.5 and 24.0 or with low protein intake during the first trimester,significant association with higher risk of SGA (OR=1.465,95％CI:1.089-1.972) was found.Conclusions Through our observation,maternal dietary intake during pregnancy seemed to be associated with the risk of SGA but the effects of dietary intake were different,according to the BMI of pre-pregnancy population.Early pregnancy appeares as the key period for dietary intake which may influence the SGA.