孕期加工型饮食模式与婴幼儿生长轨迹的关联

Association between processed diet patterns during pregnancy and growth trajectories of infants and toddlers

摘要

目的 探讨孕期加工型饮食模式与0~36月龄婴幼儿体质量指数(BMI)轨迹的关系。方法 选取2015年4月至2021年3月在安徽医科大学第一附属医院、安徽省妇幼保健院和合肥市第一人民医院门诊招募的18~45岁、妊娠18~23⁺⁶周的4914名孕妇为研究对象.通过问卷调查收集了孕妇的人口学特征和食物摄入频率,通过电子病历获得孕期健康及并发症信息.产后随访0~36月龄婴幼儿身高和体重.利用探索性因子分析法进行孕期饮食模式评价,潜类别生长模型计算婴幼儿BMI-z轨迹,采用线性回归和Logistic回归模型分析加工型饮食模式和婴幼儿BMI-z轨迹的关联。结果 本研究孕期加工型饮食模式得分低、中、高三组人数分别为1637人(33.3%)、1639人(33.3%)和1638人(33.3%).线性回归分析结果显示,孕期加工型饮食模式得分与18~36月龄幼儿BMI-z分存在显著正向关联(β值介于0.034~0.059之间,P<0.05),与0~12月龄婴儿BMI-z分无显著关联(P>0.05);采用潜类别生长模型将婴幼儿生长轨迹分为慢速生长(27.1%)、正常生长(57.4%)和快速生长(15.5%)三种模式,Logistic回归分析结果显示,孕期加工型饮食模式得分高分组子代发生慢速生长风险降低,发生快速生长风险升高,其OR值及95%CI分别为0.82(0.70~0.96)、1.29(1.06~1.56)。结论 孕期加工型饮食模式与18~36月龄幼儿体质量指数存在正向关联,并可能增加婴幼儿快速生长风险.

Abstract

Objective To investigate the association between processed diet patterns during pregnancy and body mass index (BMI) trajectories of infants and toddlers from birth to 36 months of age. Methods A total of 4914 pregnant women aged 18 to 45 years, at 18 to 23⁺⁶ weeks of gestation, were recruited from the outpatient clinics of The First Affiliated Hospital of Anhui Medical University, Anhui Women and Children's Medical Center, and Hefei First People's Hospital between April 2015 and March 2021. The demographic characteristics and food intake frequency of pregnant women were collected by questionnaire, and information on pregnancy health and complications was obtained through electronic medical records. Postnatal follow-up measured infants' and toddlers' length/height and weight from 0 to 36 months of age. Exploratory factor analysis was used to derive dietary patterns during pregnancy; latent class growth model was applied to identify BMI-for-age Z-score (BMI-z) trajectories in the infant and toddler; and linear regression and logistic regression models were used to examine associations between the processed diet pattern and infant and toddler BMI-z trajectories. Results Participants were categorized into low, medium, high processed diet pattern score groups, with 1637 (33.3%), 1639 (33.3%), and 1638 (33.3%) women in each group, respectively. Linear regression analyses showed that the processed diet pattern score during pregnancy was significantly and positively associated with BMI-z scores at 18-36 months of age (β values ranged from 0.034 to 0.059, P<0.05), whereas no significant association was observed for BMI-z scores at 0-12 months (P>0.05). Using latent class growth model, three distinct growth trajectories were identified for the infant and toddler: slow growth (27.1%), normal growth (57.4%), and rapid growth (15.5%). Logistic regression analysis indicated that offspring in the high processed diet pattern score group had a reduced risk of slow growth and an increased risk of rapid growth, with odds ratios (OR) and 95% confidence intervals (CI) of 0.82 (0.70-0.96) and 1.29 (1.06-1.56), respectively. Conclusion A processed diet pattern during pregnancy is positively associated with body mass index in children aged 18-36 months and may increase the risk of rapid growth in infants and toddlers.

关键词

孕期 / 加工型饮食 / 婴幼儿 / 体质量指数 / 生长轨迹

Key words

pregnancy / processed diet / infant and toddler / body mass index / growth trajectory

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基金资助

国家自然科学基金(82373580)

国家自然科学基金(82173531)

国家重点研发计划(2024YFC2706900)

国家重点研发计划(2022YFC2702901)

安徽医科大学科研提升基金(2021xkjT009)