目的:了解孕妇孕期膳食质量状况,探讨孕妇膳食指数与胎儿免疫功能的相关性。
方法:以2010年9月至2011年2月广州市越秀区和白云区妇幼保健院常规体检的孕妇为研究对象,采用3天24小时饮食回顾调查孕期饮食情况。通过问卷调查收集孕妇的一般人口统计信息,分娩时采集新生儿脐带血。实验室检测的免疫学指标包括IgG、IgA,IgM,IFN-γ和IL-6。采用孕期饮食质量指数(DQI-P)评价孕期饮食质量,妊娠膳食平衡指数(DBI-P)和替代地中海饮食评分(aMED)。采用Spearman相关分析和多元线性回归分析探讨孕期膳食质量与胎儿免疫功能的相关性。
结果:研究对象DQI-P总分平均得分为55.8±10.0,总体食物多样性和蛋白质食物来源多样性平均得分为12.0±2.4和4.8±0.7。营养能量比和脂肪酸能量比的平均得分仅为0.3±1.0和0.4±1.0,说明该人群在孕期具有良好的膳食多样性,但是饮食充足,适宜性和平衡性差。DBI-P总分为-19.2±9.4。阳性终点评分为4.6±2.9,只有7.2%的受试者在怀孕期间饮食摄入量高。负终点评分为23.9±7.9,表明适度饮食摄入的状态。膳食质量为28.5±7.1。只有0.6%的研究人群饮食均衡,超过67.9%的孕妇存在高摄入失衡。aMED评分的平均总分为4.9±1.3,豆类和坚果的食物摄入量少于中位数人群的比例为62.5%和79.1%,分别,这表明该人群的豆类和坚果摄入量不足。在调整了母亲年龄等混杂因素后,奇偶校验,奇偶校验,孕前BMI,怀孕期间体重增加,和交付方式,多元线性回归分析显示DQI-P与IL-6呈负相关(β=0.143,β=-0.155,P<0.05)。DBI-P与IL-6(β=-0.177,P&lt;0.01),aMED和IFN-γ(β=-0.161,P&lt;0.01)呈负相关。
结论:广州市妊娠晚期妇女膳食质量较低,饮食结构不平衡。孕期较高的膳食质量可促进胎儿免疫系统发育,提高胎儿免疫功能。
OBJECTIVE: To investigate the situation of women's dietary quality during pregnancy and explore the correlations between maternal dietary index and fetal immune function.
METHODS: From September 2010 to February 2011, pregnant women who had routine physical examination in Yuexiu District and Baiyun District Maternal and Child Health Hospital of Guangzhou were recruited as study objects to use 3-day 24-hour dietary review to investigate diet during pregnancy, and general demographic information of pregnant women was collected through questionnaire, and the neonatal umbilical cord blood was collected during delivery. Laboratory detection of immunological indicators included IgG, IgA, IgM, IFN-γ and IL-6. The quality of diet during pregnancy was evaluated by diet quality index for pregnancy(DQI-P), dietary balance index for pregnancy(DBI-P) and alternate Medierranean diet score(aMED). Spearman correlation analysis and multiple linear regression analysis were used to explore the correlations between dietary quality during pregnancy and fetal immune function.
RESULTS: The mean score of total DQI-P score of the study subjects was 55.8±10.0, and the mean score of overall food diversity and protein food source diversity was as high as 12.0±2.4 and 4.8±0.7. The mean score of nutrient energy ratio and fatty acid energy ratio was only 0.3±1.0 and 0.4±1.0, indicating that the population had good dietary diversity during pregnancy, but the dietary adequacy, suitability and balance were poor. The total score of DBI-P score was-19.2±9.4. The positive end score was 4.6±2.9, only 7.2% of the subjects had a high degree of dietary intake during pregnancy. The negative end score was 23.9±7.9, indicating the status of moderate dietary intake. Dietary quality was 28.5±7.1. Only 0.6% of the study population had a balanced dietary situation, and more than 67.9% of pregnant women had high intake imbalance. The mean total score of aMED score was 4.9±1.3, and the proportion of the food intake of beans and nuts was less than the median population was 62.5% and 79.1%, respectively, indicating that the food intake of beans and nuts was insufficient in this population. After adjusting for confounding factors such as maternal age, parity, parity, prepregnancy BMI, weight gain during pregnancy, and mode of delivery, multiple linear regression analysis showed DQI-P during pregnancy and negatively with IL-6(β=0.143, β=-0.155, P<0.05). DBI-P was negatively associated with IL-6(β=-0.177, P<0.01) and aMED and IFN-γ(β=-0.161, P<0.01).
CONCLUSIONS: The dietary quality of women in late pregnancy in Guangzhou is low, the dietary structure is unbalanced. Higher dietary quality during pregnancy can promote the development of fetal immune system and improve fetal immune function.