摘要目的:研究孕期妇女膳食指南依从性指数（CDGCI_PW）与子代先天性心脏病（先心病）的关系。方法:在陕西省西安市开展以医院为基础的病例对照研究，采用半定量食物频率问卷调查孕妇整个孕期的饮食情况。应用修订的CDGCI_PW评分评估孕期膳食质量，运用logistic回归分析其与子代先心病的关系，采用受试者工作特征曲线（ROC）构建CDGCI_PW对子代先心病患病的预测模型。结果:共纳入1 422名研究对象，病例组474名，对照组948名。病例组CDGCI_PW评分 M（ Q1， Q3）为46.0（26.0，65.0）分低于对照组60.0（40.0，77.0）分，两组间差异有统计学意义（ P<0.001）。与CDGCI_PW评分 Q1组相比，CDGCI_PW评分 Q2、 Q3和 Q4组的子代总先心病发生风险均降低（ OR=0.60，95% CI：0.43~0.83； OR=0.64，95% CI：0.45~0.89； OR=0.29，95% CI：0.19~0.44）（趋势检验 P<0.001）。CDGCI_PW评分每增加10分，子代总先心病的发生风险降低17%（ OR=0.83，95% CI：0.79~0.88）。构建ROC预测的曲线下面积为0.793（95% CI：0.768~0.818），约登指数最大处的灵敏度为0.740、特异度为0.725。 结论:本研究提示改善妇女孕期膳食质量可降低子代先心病的发生风险。

abstractsObjective:To study the relationship between the Chinese dietary guidelines compliance index for pregnant women (CDGCI_PW) and congenital heart disease (CHD) in offspring.Methods:In a hospital-based case-control study conducted in Xi'an, Shaanxi province, semi-quantitative food frequency questionnaires were used to investigate the diets of pregnant women throughout pregnancy. The modified CDGCI_PW score was used to evaluate dietary quality during pregnancy, logistic regression was applied to analyze the relationship between CDGCI_PW score and offspring CHD, and the ROC curve was adopted to construct the prediction model of CDGCI_PW for offspring CHD.Results:A total of 1 422 subjects were enrolled, including 474 in the case group and 948 in the control group. The CDGCI_PW score in the case group M ( Q1, Q3) was 46.0 (26.0, 65.0) lower than that in the control group, which was 60.0 (40.0, 77.0). The difference between the two groups was significant ( P<0.001). Compared with those in the Q1 of CDGCI_PW, the offspring in the Q2, Q3, and Q4 of CDGCI_PW had a lower risk of total CHD ( OR=0.60, 95% CI: 0.43-0.83; OR=0.64, 95% CI: 0.45-0.89; OR=0.29, 95% CI: 0.19-0.44), with the trend test P<0.001. The risk of total CHD was reduced by 17% ( OR=0.83, 95% CI: 0.79-0.88) when 10 points increased the CDGCI_PW score. The area under curve predicted by constructing the ROC curve was 0.793 (95% CI: 0.768-0.818), and at the maximum of the Youden index, the sensitivity was 0.740, and the specificity was 0.725. Conclusion:This study suggests that improving dietary quality during pregnancy may reduce the risk of CHD in offspring.