目的:妊娠期高血压疾病(HDP)是发病和死亡的重要原因。本研究旨在探讨孕前膳食纤维摄入是否与新发HDP相关。
方法:我们确定了84,873(初产妇,33,712;多段,来自日本环境儿童研究数据库的51,161)正常血压参与者,他们在2011年至2014年之间交付。随后根据他们的孕前膳食纤维摄入量五分位数(Q1-Q5)将参与者分为五组。
方法:产科的主要结局是HDP,继发性产科结局包括早发性(Eo,<34周)-HDP,迟发性(Lo,≥34周)-HDP,小于胎龄(SGA)的出生,和HDP有/没有SGA。
结果:多元logistic回归分析显示,在初产妇中,HDP的风险,Lo-HDP,与Q3组相比,Q5组中无SGA的HDP较低(HDP:调整比值比[aOR]=0.73,95%置信区间[95%CI]=0.58-0.93;Lo-HDP:aOR=0.72,95%CI=0.55-0.94;无SGA的HDP:aOR=0.68,95%CI=0.53-0.88).然而,与Q3组相比,Q1组采用SGA的Eo-HDP和HDP的风险更高(Eo-HDP:aOR=1.66,95%CI=1.02-2.70;HDP采用SGA:aOR=1.81,95%CI=1.04-3.17).在多段中,与Q3组相比,Q1组Lo-HDP和SGA的风险更高(Lo-HDP:aOR=1.47,95%CI=1.10-1.97;SGA:aOR=1.17,95%CI=1.02-1.35).
结论:孕前膳食纤维的摄入有利于预防HDP的发生。因此,应该考虑新的建议,以鼓励更高的膳食纤维摄入量,作为孕前保健的一部分。
OBJECTIVE: Hypertensive disorders of pregnancy (HDP) are a significant cause of morbidity and mortality. This study aimed to investigate whether preconception dietary fiber intake is associated with new-onset HDP.
METHODS: We identified 84,873 (primipara, 33,712; multipara, 51,161) normotensive participants from the Japan Environmental Children\'s Study database who delivered between 2011 and 2014. The participants were subsequently categorized into five groups based on their preconception dietary fiber intake quintiles (Q1-Q5).
METHODS: The main obstetric outcome was HDP, and the secondary obstetric outcomes included early-onset (Eo, <34 weeks)-HDP, late-onset (Lo, ≥34 weeks)-HDP, small for gestational age (SGA) births, and HDP with/without SGA.
RESULTS: Multiple logistic regression analysis showed that in primiparas, the risks of HDP, Lo-HDP, and HDP without SGA were lower in the Q5 group compared with the Q3 group (HDP: adjusted odds ratio [aOR] = 0.73, 95 % confidence intervals [95 % CI] = 0.58-0.93; Lo-HDP: aOR = 0.72, 95 % CI = 0.55-0.94; and HDP without SGA: aOR = 0.68, 95 % CI = 0.53-0.88). However, the risks of Eo-HDP and HDP with SGA were higher in the Q1 group compared with the Q3 group (Eo-HDP: aOR = 1.66, 95 % CI = 1.02-2.70; and HDP with SGA: aOR = 1.81, 95 % CI = 1.04-3.17). In multiparas, the risks of Lo-HDP and SGA were higher in the Q1 group compared with the Q3 group (Lo-HDP: aOR = 1.47, 95 % CI = 1.10-1.97; SGA: aOR = 1.17, 95 % CI = 1.02-1.35).
CONCLUSIONS: Preconception dietary fiber intake is beneficial in preventing HDP onset. Therefore, new recommendations should be considered to encourage higher dietary fiber intake as part of preconception care.