METHODS: This is a secondary analysis (n = 543) of women with BMI ≥25 kg/m2 from two randomized controlled trials; PEARS (Pregnancy Exercise and nutrition Research Study with smartphone application support) and ROLO (Randomized cOntrol trial of LOw glycemic index diet to prevent macrosomia in euglycemic women). Blood pressure was measured at 10-18 weeks and 28 weeks of pregnancy. Mean arterial pressure was calculated as (diastolic blood pressure + 1 3 × [systolic blood pressure - diastolic blood pressure]). Diet quality was assessed using 3-day food diaries, and Alternative Healthy Eating Index for Pregnancy (AHEI-P) scores were generated, quantifying alignment of food intakes with dietary guidelines in first and early third trimesters. The cohort was divided based on AHEI-P tertiles to explore differences at an alpha significance value of <0.05.
RESULTS: The mean age of the group was 32.21 ± 4.39 years with a median body mass index (BMI) of 28.13 (IQR 3.47) kg/m2. Mean arterial pressures in the first and third trimesters were 81.07 ± 9.00 mmHg and 82.33 ± 7.53 mmHg, respectively. Rates of elevated blood pressure (≥120/80 mmHg) were 22.33% in trimester 1 and 24.48% in early trimester 3. Mean AHEI-P scores in trimester 1 and early trimester 3 were 53.90 ± 10.43 and 54.05 ± 10.76, respectively. There was no correlation between AHEI-P score and blood pressure and no differences in blood pressure between AHEI-P tertiles at either timepoint (all P-values <0.05). A higher proportion of those with elevated early third trimester blood pressure had a BMI of ≥30 kg/m2 compared with those with normal blood pressure (40.31% vs 28.64%, P = 0.016).
CONCLUSIONS: While diet remains an important factor in maternal health and wellbeing, we did not find a relationship between diet quality as measured by AHEI-P and blood pressure among pregnant women with BMI ≥25 kg/m2. High BMI remains a risk factor for hypertensive disorders of pregnancy.
方法:这是对BMI≥25kg/m2的女性进行的二次分析(n=543),来自两项随机对照试验;PEARS(具有智能手机应用支持的妊娠和运动营养研究)和ROLO(LOW血糖指数饮食预防正常血糖女性巨大儿的随机对照试验)。在怀孕10-18周和28周测量血压。平均动脉压计算为(舒张压+13×$$+\\frac{1}{3}\\乘以$$[收缩压-$$-$$舒张压])。使用3天的食物日记评估饮食质量,并生成妊娠替代健康饮食指数(AHEI-P)评分,在孕早期和孕晚期,量化食物摄入量与饮食指南的一致性。该队列基于AHEI-P三元率进行划分,以探索alpha显著性值<0.05的差异。
结果:该组的平均年龄为32.21±4.39岁,中位体重指数(BMI)为28.13(IQR3.47)kg/m2。妊娠早期和晚期的平均动脉压为81.07±9.00mmHg和82.33±7.53mmHg,分别。血压升高(≥120/80mmHg)的比率在妊娠1期为22.33%,在妊娠3期为24.48%。妊娠1期和早3期的平均AHEI-P评分分别为53.90±10.43和54.05±10.76。AHEI-P评分与血压之间无相关性,且在任一时间点AHEI-P三位数之间的血压无差异(所有P值<0.05)。与正常血压相比,孕早期血压升高的人的BMI≥30kg/m2的比例更高(40.31%vs28.64%,P=0.016)。
结论:虽然饮食仍然是孕产妇健康和福祉的重要因素,在BMI≥25kg/m2的孕妇中,我们没有发现AHEI-P测量的饮食质量与血压之间的关系.高BMI仍然是妊娠期高血压疾病的危险因素。