PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to explore the potential impact of pre-pregnancy and early pregnancy maternal nutrition on the incidence of small-for-gestational-age neonates (SGA) in women with gestational diabetes mellitus (GDM).
METHODS: A prospective cohort study was conducted between 2020 and 2022 at the 3rd Department of Obstetrics and Gynaecology (School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece). Pregnant women from routine care were surveyed about their dietary habits during two distinct periods: six months prior to pregnancy (period A) and from the onset of pregnancy until the oral glucose tolerance test at 24-28 gestational weeks (period B). The intake of various micronutrients and macronutrients was quantified from the questionnaire responses. Logistic regression models, adjusted for potential confounders including age, pre-pregnancy body mass index (BMI), smoking status, physical activity and parity, were used to evaluate the association between nutrient intake and small-for-gestational-age neonate incidence.
RESULTS: In total, 850 women were screened and of these, 90 (11%) were diagnosed with gestational diabetes mellitus and were included in the study. There were significant associations between the intake of specific nutrients and the occurrence of small-for-gestational-age neonates; higher fat intake compared to non-small for gestationa age during period B (aOR: 1.1, p = 0.005) was associated with an increased risk for small-for-gestational-age neonates, while lower intake of carbohydrates (g) (aOR: 0.95, p = 0.005), fiber intake (aOR: 0.79, p = 0.045), magnesium (aOR: 0.96, p = 0.019), and copper (aOR:0.01, p = 0.018) intake during period B were significantly associated with a decreased risk for small-for-gestational-age neonates.
CONCLUSIONS: The findings of this study highlight the potential role of maternal nutrition in modulating the risk of small for gestational age neonatesamong women with gestational diabetes mellitus. The results advocate for further research on the assessment and modification of both pre-pregnancy and early pregnancy nutrition for women, especially those at higher risk of gestational diabetes mellitus, to reduce the risk of gestational diabetes mellitus.
METHODS: A prospective cohort study was conducted between 2020 and 2022 at the 3rd Department of Obstetrics and Gynaecology (School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece). Pregnant women from routine care were surveyed about their dietary habits during two distinct periods: six months prior to pregnancy (period A) and from the onset of pregnancy until the oral glucose tolerance test at 24-28 gestational weeks (period B). The intake of various micronutrients and macronutrients was quantified from the questionnaire responses. Logistic regression models, adjusted for potential confounders including age, pre-pregnancy body mass index (BMI), smoking status, physical activity and parity, were used to evaluate the association between nutrient intake and small-for-gestational-age neonate incidence.
RESULTS: In total, 850 women were screened and of these, 90 (11%) were diagnosed with gestational diabetes mellitus and were included in the study. There were significant associations between the intake of specific nutrients and the occurrence of small-for-gestational-age neonates; higher fat intake compared to non-small for gestationa age during period B (aOR: 1.1, p = 0.005) was associated with an increased risk for small-for-gestational-age neonates, while lower intake of carbohydrates (g) (aOR: 0.95, p = 0.005), fiber intake (aOR: 0.79, p = 0.045), magnesium (aOR: 0.96, p = 0.019), and copper (aOR:0.01, p = 0.018) intake during period B were significantly associated with a decreased risk for small-for-gestational-age neonates.
CONCLUSIONS: The findings of this study highlight the potential role of maternal nutrition in modulating the risk of small for gestational age neonatesamong women with gestational diabetes mellitus. The results advocate for further research on the assessment and modification of both pre-pregnancy and early pregnancy nutrition for women, especially those at higher risk of gestational diabetes mellitus, to reduce the risk of gestational diabetes mellitus.
摘要：
目的：本研究旨在探讨孕前和孕早期孕妇营养对妊娠期糖尿病(GDM)孕妇小于胎龄儿(SGA)发生率的潜在影响。
方法：一项前瞻性队列研究于2020年至2022年在第三妇产科（医学院，健康科学学院，塞萨洛尼基亚里士多德大学,希腊)。对来自常规护理的孕妇在两个不同时期的饮食习惯进行了调查：怀孕前六个月（A期）和从怀孕开始到24-28孕周的口服葡萄糖耐量试验（B期）。从问卷答复中量化了各种微量营养素和常量营养素的摄入量。Logistic回归模型，调整了潜在的混杂因素，包括年龄，孕前体重指数(BMI),吸烟状况,身体活动和奇偶校验，用于评估营养摄入与小于胎龄儿发生率之间的关系。
结果：总计，850名女性接受了筛查，其中，90例（11％）被诊断为妊娠糖尿病，并被纳入研究。特定营养素的摄入与小于胎龄儿的发生之间存在显着关联；在B期期间，与胎龄的非小脂肪相比，较高的脂肪摄入量（aOR：1.1，p=0.005）与小于胎龄儿的风险增加有关。而碳水化合物摄入量较低（g）（aOR：0.95，p=0.005），纤维摄入量（AOR：0.79，p=0.045），镁（AOR：0.96，p=0.019），B期的铜(aOR:0.01,p=0.018)摄入量与小于胎龄儿的风险降低显著相关。
结论：这项研究的结果强调了在妊娠期糖尿病妇女中，母体营养在调节小于胎龄新生儿风险方面的潜在作用。结果主张进一步研究妇女孕前和孕早期营养的评估和修改，尤其是那些妊娠期糖尿病风险较高的人，以降低妊娠期糖尿病的风险。
方法：一项前瞻性队列研究于2020年至2022年在第三妇产科（医学院，健康科学学院，塞萨洛尼基亚里士多德大学,希腊)。对来自常规护理的孕妇在两个不同时期的饮食习惯进行了调查：怀孕前六个月（A期）和从怀孕开始到24-28孕周的口服葡萄糖耐量试验（B期）。从问卷答复中量化了各种微量营养素和常量营养素的摄入量。Logistic回归模型，调整了潜在的混杂因素，包括年龄，孕前体重指数(BMI),吸烟状况,身体活动和奇偶校验，用于评估营养摄入与小于胎龄儿发生率之间的关系。
结果：总计，850名女性接受了筛查，其中，90例（11％）被诊断为妊娠糖尿病，并被纳入研究。特定营养素的摄入与小于胎龄儿的发生之间存在显着关联；在B期期间，与胎龄的非小脂肪相比，较高的脂肪摄入量（aOR：1.1，p=0.005）与小于胎龄儿的风险增加有关。而碳水化合物摄入量较低（g）（aOR：0.95，p=0.005），纤维摄入量（AOR：0.79，p=0.045），镁（AOR：0.96，p=0.019），B期的铜(aOR:0.01,p=0.018)摄入量与小于胎龄儿的风险降低显著相关。
结论：这项研究的结果强调了在妊娠期糖尿病妇女中，母体营养在调节小于胎龄新生儿风险方面的潜在作用。结果主张进一步研究妇女孕前和孕早期营养的评估和修改，尤其是那些妊娠期糖尿病风险较高的人，以降低妊娠期糖尿病的风险。
