陜西省育齡婦女孕期宏量營養素攝入與新生兒出生體重的關系

嚴惠+吳小艷+池方方

摘要：目的 探討陜西省育齡婦女孕期宏量營養素攝入狀況與新生兒出生體重的關系。

方法 數據來源于2013年7—11月在陜西省30個縣進行的出生缺陷現況及其危險因素橫斷面調查。采用分層多階段隨機抽樣方法選取在2010年1月—2013年12月間曾經懷孕的婦女，在這些婦女中隨機抽取個體完成半定量膳食頻率問卷，同時收集新生兒相關信息，篩選出0～1歲孩子及其母親作為研究對象。進行孕期宏量營養素攝入狀況分析，并采用多元logistic回歸分析探討其與新生兒出生體重的關系。

結果 共納入7 024名調查對象。陜西育齡婦女孕期平均每日蛋白質攝入量低于中國居民膳食營養素推薦攝入量，三大營養素所占供能比不滿足推薦值。所有新生兒中，小于胎齡兒（SGA）發生率為14.7%，大于胎齡兒（LGA）發生率為7.6%。對于SGA，孕期多攝入蛋白質和脂肪，可降低其發生率，而攝入過多碳水化合物是其發生的危險因素；對于LGA，孕期多攝入蛋白質是其保護因素，而攝入過多的脂肪及碳水化合物，可增加其發生率。

結論 妊娠期應適當增加蛋白質，減少碳水化合物的攝入，保證三大產能營養素的合理比例，改善自身營養狀況，減少SGA及LGA的發生。

關鍵詞： 宏量營養素； 出生體重； 育齡婦女； 孕期中圖分類號： R 153 文獻標志碼： A

Abstract： Objective To explore the relationship between the intake of macronutrients in pregnant women in Shaanxi province and the neonatal birth weight.

Methods Data were derived from a crosssectional investigation named “The prevalence and risk factors of birth defects in Shaanxi Province ”，which were collected from 30 counties in Shaanxi Province from July to November in 2013. A stratified multistage random sampling method was used to select women who had been pregnant between January 2010 and December 2013. Out of these women were randomly selected individuals for the semiquantitative diet frequency questionnaire， with the data on newborn infants collected， and the children aged 01 and their mothers were as the study subjects. The intake of macronutrients during their pregnancy was analyzed， whose relationship with the neonatal birth weight was studied by multivariate logistic regression analysis.

Results A total 7 024 participants were included in this study. The average daily protein intake of women of childbearing age in Shaanxi was lower than the recommended intake of dietary nutrients in China， and the energy supply ratio of the three nutrients did not meet the recommended values. The incidence of SGA was 14.7%， and the LGA 7.6%. The intake of protein and fat during pregnancy reduced the incidence of SGAe， and excessive intake of carbohydrates proved a risk factor for SGA； more protein intake during pregnancy proved a protective factor for LGA， and excessive intake of fat and carbohydrates increased its incidence.

Conclusion Pregnant women should increase intake of protein， and reduce intake of carbohydrate， so as to ensure a rational proportion of the three major nutrients， improve pregnancy nutritional status， and reduce the occurrence of SGA and LGA.

Keywords： macronutrients； birth weight； women of childbearing age； pregnancy

受孕是婦女生命中一個特殊的生理過程，孕期婦女的各項生理應激要求其攝入全面的營養物質和足夠的能量[1]。平衡合理的膳食能量及全面的營養素不僅關系到母體自身的健康，同時也與胎兒在宮內生長發育的良好環境有著密切關系[2]。……