2017年成都市孕早中期妇女铁补充剂摄入量对妊娠期糖尿病的影响

目的探讨成都地区孕早中期妇女铁补充剂摄入量对妊娠期糖尿病(gestational diabetes mellitus,GDM)的影响。方法采用前瞻性研究,于2017年2-4月通过立意抽样方法选取成都市某妇幼保健机构产前门诊807名孕早期妇女为研究对象。通过问卷调查于孕早期收集孕妇基本信息,于孕早、中期收集孕妇铁补充剂摄入剂量及频率,计算铁补充剂平均日摄入量,采用连续3天24小时膳食回顾法收集孕妇孕早、中期食物摄入量。根据WHO推荐孕期补铁60 mg/d为分界点,<60 mg/d为低水平组,≥60 mg/d为高水平组。于孕24~28周进行口服葡萄糖糖耐量试验,根据《中国妊娠合并糖尿病诊治指南(2014)》诊断GDM。采用多因素非条件Logistic回归方法分析孕早、中期妇女铁补充剂平均摄入量和摄入水平对GDM的影响。结果最终纳入有效样本739例,年龄(28.22±3.75)岁。孕早、中期铁补充剂使用率分别为5.0%和67.9%,铁补充剂摄入量≥60 mg/d比例分别为3.8%和47.1%。调整年龄、孕次、产次、孕前体质指数、膳食铁摄入量、膳食能量摄入量等混杂因素后,孕中期铁补充剂平均摄入量与GDM发生风险呈正相关(OR=1.059,95%CI 1.016~1.104);孕中期铁补充剂摄入高水平组(≥60 mg/d)GDM发生风险是孕中期铁补充剂摄入低水平组(<60 mg/d)的1.406倍(95%CI 1.019~1.939)。未发现孕早期铁补充剂摄入量与GDM发生有关。结论孕期铁补充剂使用可能会增加GDM发生风险,孕妇铁补充剂适宜摄入量值得探讨。     

西南地区孕妇膳食蛋白摄入与妊娠期糖尿病发生风险的前瞻性研究

目的探讨孕前期、孕早期、孕中期累积平均膳食蛋白摄入情况与妊娠期糖尿病(GDM)的关系。方法采用前瞻性队列研究方法,选取2 579名22~43岁于2014年在四川省和贵州省5所妇幼保健院定期产前检查的孕妇。使用食物频率问卷收集孕妇孕前期(孕前1年)、孕早期(孕0~11+6周)及孕中期(孕12+0~23+6周)的膳食情况;于孕24~28周时进行口服葡萄糖耐量试验(OGTT)筛查,判定孕妇是否患有GDM。采用多因素Logistic回归分析膳食蛋白摄入情况与GDM的关系。结果总蛋白及植物蛋白供能比五分位数最高组GDM发病风险是最低组的2.51、3.03倍,OR值(95%CI)分别为2.51(1.50~4.28)、3.03(1.84~5.09)。蛋类、奶类的蛋白质供能比五分位数最高组GDM发病风险是最低组的1.82、2.46倍,OR值(95%CI)分别为1.82(1.10~3.05),2.46(1.51~4.05)。结论孕前期、孕早期、孕中期的膳食中较高的总蛋白质、植物蛋白质的摄入量可能与增加GDM的发生风险有关,尤其是较高的蛋类、奶类摄入量可能会增加GDM的发生风险。     

妊娠期糖尿病相关危险因素分析

目的探讨妊娠期糖尿病(GDM)相关危险因素。方法选择2013年11月至2014年12月在东莞市石碣医院产科门诊完成75 g口服葡萄糖耐量试验(OGTT)检测的孕妇作为研究对象。以新的妊娠期糖尿病诊断标准进行分组,分为GDM组和非GDM组。收集两组临床资料进行Logistic多因素分析。结果共312例孕妇纳入研究,GDM组孕妇54人,非GDM组孕妇258人。两组的平均年龄、孕前BMI、孕早期空腹血糖、糖尿病家族史等有统计学差异(P<0.05)。通过多因素Logistic分析,有统计学意义的GDM危险因素包括:年龄(OR=1.980,95%CI为1.233~3.180,P=0.005)、孕前BMI(OR=3.111,95%CI为1.884~5.138,P<0.001)、孕早期空腹血糖(OR=3.187,95%CI为1.637~6.206,P=0.001)、糖尿病家族史(OR=3.823,95%CI为1.373~10.644,P=0.006)。结论早孕期FBG超过5.1 mmol/L、孕前BMI升高、年龄增长、糖尿病家族史等因素为GDM发病的独立危险因素。     

不同孕前BMI孕妇孕早期增重对妊娠期糖尿病的影响

目的探讨不同孕前身体质量指数(BMI)孕妇孕早期增重与妊娠期糖尿病(GDM)的关系。方法采用前瞻性队列研究,选取2017年12月至2019年12月在湖北医药学院附属国药东风总医院建档产检孕妇491例,专人记录孕妇的身高、年龄、孕前体重、BMI、孕早中期体重、分娩结局等一般信息,采用Logistic回归分析不同孕前BMI的孕妇孕早期体重增长与GDM的关系。结果孕早期增重不足、适宜及过多的孕妇GDM发病率比较差异有统计学意义(χ²=8.417,P<0.05),而孕中期不同的体重增长情况,孕妇GDM发病率差异无统计学意义(χ²=0.951,P>0.05)。孕早期增重按不同孕前BMI进行分组,Logistic回归分析显示:孕前BMI为18.5~24.9kg/m²的孕妇,孕早期增重过多,GDM发病风险增至1.913倍(OR=1.913,95%CI:1.033~3.543);孕前BMI≥25.0kg/m²的孕妇,孕早期增重适宜、过多,GDM的发病风险分别增至4.900倍(OR=4.900,95%CI:1.179~20.373)和5.444倍(OR=5.444,95%CI:1.290~22.976)。孕前BMI<18.5kg/m²的孕妇,孕早期增重不足、适宜、过多,妊娠期高血压疾病(χ²=118.600)、羊水异常(χ²=6.750)及剖宫产(χ²=6.166)的发生差异有统计学意义(均P<0.05);孕前BMI≥25.0kg/m²的孕妇,孕早期增重不足、适宜、过多,巨大儿发生率差异有统计学意义(χ²=19.372,P<0.05);孕前BMI=18.5~24.9kg/m²的孕妇,孕早期不同增重情况,其不良妊娠结局差异无统计学意义(均P>0.05)。结论孕前体重正常和孕前超重肥胖者,孕早期体重增长过多增加了GDM发生风险;而孕前低体重者,孕早期体重增长增加了妊娠期高血压疾病、羊水异常及剖宫产的发生风险,并不增加GDM的发生风险。     

孕早期焦虑和抑郁对妊娠期糖尿病的影响

目的探讨孕早期焦虑和抑郁对妊娠期糖尿病(gestational diabetes mellitus,GDM)的影响。方法采用前瞻性研究,于2017年通过立意抽样方法选取四川省妇幼保健院产前门诊1426名孕8~14周单胎健康孕妇为研究对象,年龄为(28.6±4.0)岁。通过问卷调查收集其年龄、孕前体重、产次、孕次等基本信息,分别采用焦虑自评量表(self-rating anxiety scale,SAS)与抑郁自评量表(self-rating depression scale,SDS)收集孕早期焦虑和抑郁信息,根据中国常模标准评价其焦虑和抑郁症状;于孕24~28周行口服葡萄糖耐量试验(oral glucose tolerance test,OGTT),根据《中国妊娠合并糖尿病诊治指南(2014)》诊断GDM。多因素非条件Logistic回归模型分析孕早期焦虑和抑郁对GDM的影响。结果孕早期焦虑组和抑郁组GDM发生率分别为41.8%和33.6%。孕早期妇女焦虑、抑郁、焦虑合并抑郁发生率分别为7.7%、10.5%和4.8%,<30岁组孕早期焦虑和抑郁发生率(9.0%和11.7%)均高于≥30岁组孕妇(5.3%和8.1%),初产妇组孕早期焦虑和抑郁发生率(8.8%和11.9%)均高于经产妇组(5.4%和6.4%),差异均有统计学意义(P<0.05)。调整年龄、孕前体质指数、糖尿病家族史、孕次、产次、能量摄入量、受孕方式、文化程度、职业、吸烟否及饮酒否混杂因素后,多因素非条件Logistic回归分析结果显示:与孕早期非焦虑组孕妇比较,焦虑组孕妇GDM发生风险增加(OR=1.556,95%CI 1.014~2.387),未观察到孕早期抑郁与GDM发生有关(P>0.05)。在<30岁孕妇中,与孕早期非焦虑组比较,孕早期焦虑组GDM发生风险增加(OR=1.654,95%CI 1.004~2.726);在初产妇中,与孕早期非焦虑组比较,焦虑组GDM发生风险增加(OR=1.633,95%CI 1.013~2.634)。在≥30岁孕妇和经产妇中,均未观察到焦虑与GDM发生风险有关(P>0.05)。结论孕妇孕早期焦虑增加GDM发生风险,30岁以下孕妇及初产妇为焦虑高危人群。     

膳食胆固醇摄入对妊娠期糖尿病的影响

目的 研究妊娠期妇女孕前1年、孕早期、孕中期膳食胆固醇摄入对妊娠期糖尿病的影响。方法 收集2012年3月至2016年9月在山西医科大学第一医院产科住院分娩孕妇的一般人口学特征、妊娠期糖尿病诊断结果及膳食胆固醇摄入情况,根据对照组孕妇不同时期胆固醇摄入的P₂₅、P₅₀、P₇₅将其分为4组。采用非条件logistic回归分析孕前1年、孕早期、孕中期膳食胆固醇摄入量与妊娠期糖尿病的关系,及不同年龄段孕妇膳食胆固醇摄入对妊娠期糖尿病发生的影响。结果 共纳入研究对象9 005人,其中妊娠期糖尿病1 388例。多因素分析结果显示,孕前1年胆固醇摄入量≥ 76.50 mg/d且孕中期摄入量为≥ 46.75 mg/d的孕妇患GDM的风险增加。按年龄分层后,年龄<35岁孕妇的孕前1年和孕中期胆固醇摄入量≥ 76.50 mg/d是妊娠期糖尿病的危险因素（分别为OR=1.336,95%CI：1.083~1.647;OR=1.341,95%CI：1.087~1.654）,孕妇年龄≥ 35岁组未发现膳食胆固醇摄入与妊娠期糖尿病发生有关。结论 妊娠期妇女孕前1年及孕中期膳食胆固醇摄入高均会增加妊娠期糖尿病的发生风险。     

妊娠期膳食结构和血脂水平与妊娠期糖尿病发生风险的相关性分析

目的探讨妊娠期膳食结构和血脂水平与妊娠期糖尿病(GDM)发生风险的相关性。方法将2018年1月-2018年12月在菏泽家政职业学院实习教学医院,即菏泽市立医院进行常规产检且诊断为GDM的126例孕妇纳入GDM组,另将100例未诊断为GDM的孕妇纳入对照组。比较两组孕妇的一般资料、膳食结构、妊娠早期、中期的三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)以及低密度脂蛋白(LDL-C)水平的差异,分析膳食结构和血脂水平与GDM发生风险的相关性。结果GDM组孕妇年龄>35岁者、孕前BMI≥25.0 kg/m2者、有不良妊娠史者和有糖尿病家族史者的比例显著高于对照组(P<0.05)。GDM组孕妇谷类/薯类、水果类、鱼禽蛋肉类以及坚果的日均摄入量显著高于对照组(P<0.01),而蔬菜类、大豆类的日均摄入量显著低于对照组(P<0.01)。妊娠早期时,GDM组孕妇TG水平显著高于对照组(P<0.01),妊娠中期时,GDM组孕妇TG水平显著高于对照组,HDL-C水平显著低于对照组(P<0.01)。Logistic回归分析结果显示,每日谷类/薯类摄入量>270 g、水果类摄入量>550 g、鱼禽蛋肉类摄入量>200 g、坚果摄入量>14 g、蔬菜类摄入量<320 g、大豆类摄入量<12 g以及妊娠早期TG水平>1.33 mmol/L、妊娠中期TG水平>1.70 mmol/L均是导致GDM发生的危险因素。结论对于有生育需求和妊娠期妇女,进行严格的膳食结构管理和监督十分必要,尤其对于妊娠中期者,更应加强对膳食和各项指标的干预和筛查,这不仅有利于营养物质的全面、合理及有效摄入,更有利于控制血脂、血糖代谢,预防GDM的发生。     

血清铁蛋白水平与妊娠期糖尿病的相关性研究

目的 探讨孕早期血清铁蛋白水平(SF)与妊娠期糖尿病(GDM)的相关性及对GDM诊断的临床意义.方法 对2015年6月至2017年2月在宜宾市第一人民医院产科门诊行产检并且住院分娩的58例GDM孕妇(GDM组)和同期58例正常对照孕妇(NGT组)的一般资料、孕早期(11~13周)和孕中期(24~28周)SF水平、空腹血糖水平(FPG)、空腹胰岛素(FINS)和胰岛素抵抗指数(HOMA-IR)进行回顾性分析.比较两组孕妇孕早、中期SF水平和HOMA-IR.运用Pearson相关分析孕早、中期SF水平与HOMA-IR的相关性.采用受试者工作(ROC)曲线评估SF在孕早期SF在GDM中的诊断价值.结果 孕早、中期GDM组孕妇SF水平和HOMA-IR高于NGT组(t值为5.472~10.635,均P<0.05);运用Pearson相关分析显示,孕早期SF水平与HOMA-IR呈正相关(r=0.672,P<0.05);孕中期SF水平与HOMA-IR呈正相关(r=0.783,P<0.05);孕早期SF水平对GDM的诊断的曲线下面积(AUC)为0.925.最佳阈值为22.96μg/L,其敏感度为89.26%、特异度为85.97%.Youden指数为0.891,阳性预测值为96.51%,阴性预测值为60.32%.结论 孕早期SF水平变化与GDM的发病相关,孕早期SF水平可能作为早期诊断和预防GDM的血清学指标.     

早、中孕期血清铁蛋白水平及其变化与妊娠期糖尿病的相关性研究

目的研究早、中孕期血清铁蛋白(SF)水平及其变化与妊娠期糖尿病(GDM)之间的关系。方法将260例孕妇根据是否患有GDM分为研究组(n=53)和对照组(n=207),观察两组孕妇孕、早期SF水平、红细胞压积及血红蛋白的变化。对两组孕妇孕早、中期的SF水平及变化进行分析,分析孕早中期SF水平变化与GDM的关系。结果两组孕妇早中期红细胞压积和血红蛋白比较均无差异(P0.05)。两组孕中期SF水平与孕早期相比均明显降低;研究组孕早中期SF水平均高于同期对照组(P0.05);孕早期SF水平对GDM诊断的AUC为0.732,Youden指数为0.432,SF临界值为46.55 ng/ml,敏感性和特异性分别为71.8%、65.4%;孕中期SF水平对GDM诊断的AUC为0.676,Youden指数为0.351,SF临界值为43.10 ng/ml,敏感性、特异性分别为64.1%、60.4%。孕早中期SF变化量对GDM诊断的AUC为0.716,Youden指数为0.393,SF变化量临界值为29.95 ng/ml,敏感性、特异性分别为71.3%、64.5%。孕早期SF46.55 ng/ml时,OR=2.832;孕中期SF43.10ng/ml时,OR=2.443。结论孕早期SF水平及孕早中期SF变化量对GDM具有一定预测价值。     

孕早期血浆硒水平与妊娠期糖尿病关联的队列研究

目的 探讨孕早期血浆硒水平与妊娠期糖尿病（GDM）发病风险的关联。方法 采用前瞻性队列研究,选取“同济母婴健康队列（TMCHC）”中具有孕早期（≤20 w）血样且于孕24～28 w完成口服75g葡萄糖耐量试验（OGTT）的单胎孕妇作为研究对象,于纳入时通过问卷收集孕妇的社会人口学资料;使用电感耦合等离子体质谱仪(ICP-MS)测定血浆硒、锰、铜等20种元素浓度;采用多元Logistic回归模型评估孕早期血浆硒水平与GDM的关联。结果 本研究最终纳入2388名孕妇,其中222人（9.3%）被诊断为GDM。孕早期孕妇血浆硒浓度均值±标准差为（51.9±11.5）μg/L,中位数（四分位间距）为50.8(44.6-58.3)μg/L。孕早期血浆硒水平与GDM发生风险呈显著负相关,调整相关混杂因素后,Logistic回归分析显示,与最高四分位相比,血浆硒水平最低四分位OR值（95%CI）为2.06(1.35-3.14);以血浆硒水平<45μg/L作为孕妇硒缺乏的标准,与硒不缺乏组（≥45μg/L）相比,硒缺乏组OR值（95%CI）为1.88(1.37-2.59)。结论 孕早期硒营养缺乏可...     

Pregnancy increases urinary loss of carnitine and reduces plasma carnitine in Korean women

This study compared plasma and urinary carnitine concentrations in pregnant and non-pregnant Korean women. The subjects were fifty pregnant women and thirty non-pregnant women aged 24-28 years. During the first trimester, dietary carnitine intakes in the pregnant women were much lower than in non-pregnant women (70.00 (SD 29.22) micromol/d), but over the course of pregnancy carnitine intake increased from 44.64 (SD 24.84) micromol/d during the first trimester to 96.11 (SD 36.56) micromol/d during the third trimester. Pregnant women had a significantly lower plasma carnitine concentration than non-pregnant women. Plasma concentrations of non-esterified carnitine, acid-soluble acylcarnitine and total carnitine were significantly lower during the second and third trimesters than the first. Plasma acid-insoluble acylcarnitine levels, which tended to be higher in the non-pregnant women compared with the pregnant women, increased significantly as gestation proceeded. The urinary excretion of non-esterified carnitine, acid-soluble acylcarnitine and total carnitine was significantly higher in the pregnant women during the first and second trimesters than in non-pregnant women and decreased significantly as gestation proceeded. We found that there was a significant decrease in plasma carnitine level even though dietary carnitine intake increased as gestation proceeded. The low urinary excretion of carnitine in late pregnancy may be caused by an increased demand during pregnancy.     

Beverage Intake and the Risk of Gestational Diabetes Mellitus: The SECOST

The contribution and impact of beverage intake to total nutrient and energy intake may be substantial. Given the link between lifestyle, diet, and the risk of pregnancy complications, this study investigated the association between the quantity and types of beverages with gestational diabetes mellitus (GDM) risk. The study included 452 women from the Seremban Cohort Study (SECOST). The mean energy by beverage intake was 273 ± 23.83 kcal/day (pre-pregnancy), 349 ± 69.46 kcal/day (first trimester) and 361 ± 64.24 kcal/day (second trimester). Women significantly increased intake of maternal milks and malted drinks, but significantly reduced the intake of carbonated drinks and other drinks from before until the second trimester of pregnancy. For chocolate drinks, carbonated drinks, and soy milk, women increased intake from pre-conception to the first trimester, but reduced their intake from the first to the second trimester. While higher intake of cultured-milk drinks was associated with an increased risk of GDM, higher fruit juice intake was associated with a lower risk of GDM. However, these associations were only observed for intake prior to pregnancy and during the first trimester. Further research is needed to corroborate these findings and investigate the contributions of different beverages to overall diet quality as well as adverse health outcomes during pregnancy.     

Dietary folate intake during pregnancy and birth weight in Japan

BACKGROUND: Inadequate folate status has been associated with many negative reproductive outcomes, such as neural tube defects (NTD), low birth weight and placental abruption. AIM OF THE STUDY: The objectives of this study were to evaluate the levels of dietary folate intake during pregnancy in Japanese women and the subsequent birth weight of their babies. METHODS: A longitudinal prospective study was conducted with 197 women with a singleton pregnancy in 2005. Dietary folate was investigated 3 times: in the first trimester at 12 weeks, in the second trimester at 20 weeks and in third trimester at 32 weeks using a diet history questionnaire (DHQ). Non fasting blood samples were collected from the women for measurement of homocysteine, hemoglobin, ferritin, unbound iron-binding capacity (UIBC) and total iron-binding capacity (TIBC). RESULTS: Energy intake increased as pregnancy advanced, but not significantly. The daily intake of folate increased from 248.5 +/- 113.1 microg/d in the first trimester to 275.4 +/- 100.2 microg/d in the third trimester (P = 0.04). This was well below the recommended level of 440 microg/d and only 10% of mothers were above the levels. In the third trimester, plasma homocysteine concentration was significantly higher in the low folate group of less than 250 microg/d (P = 0.02), but not the first and second trimesters. Dietary folate intake and plasma homocysteine concentrations were not likely to be predictors of birth weight in our subjects. CONCLUSIONS: Our study shows that Japanese women's energy and folate intakes do not meet their energy needs during pregnancy and are at an extremely low recommended dietary allowance level throughout pregnancy.     

Adequacy and Sources of Protein Intake among Pregnant Women in the United States,NHANES 2003–2012

Limited information is available on protein intake and adequacy of protein intake among pregnant women. Using data from a sample of 528 pregnant women in the National Health and Nutrition Examination Surveys (NHANES) 2003–2012, usual intake of protein (g/day and g/kg body weight (bw)/day) and prevalence of intake below the Estimated Average Requirement (EAR) by trimester of pregnancy were calculated using the National Cancer Institute method. Percent contributions to protein intake by source (i.e., plant and animal, including type of animal source) were also calculated. Mean usual intake of protein was 88 ± 4.3, 82 ± 3.1, and 82 ± 2.9 g/day among women in trimester 1, 2, and 3 of pregnancy, respectively, or 1.30 ± 0.10, 1.35 ± 0.06, and 1.35 ± 0.05 g/kg bw/day, respectively. An estimated 4.5% of women in the first trimester of pregnancy consumed less protein than the EAR of 0.66 g/kg bw/day; among women in the second and third trimesters of pregnancy, 12.1% and 12.8% of women, respectively, consumed less protein than the EAR of 0.88 g/kg bw/day. Animal sources of protein accounted for approximately 66% of total protein. Findings from this study show that one in eight women in the second and third trimesters of pregnancy have inadequate intake of protein. Pregnant women should be encouraged to consume sufficient levels of protein from a variety of sources.     

A cross sectional study of maternal iron status of Korean women during pregnancy

The purpose of this study was to determine the iron status of Korean women during pregnancy and to assess the relationship between maternal iron status and the outcome of their newborns. A total of eighty-one pregnant women living in Gwangju, Korea, participated in the study: 26 women were in the first trimester, 23 in the second trimester, and 32 in the third trimester. Maternal red blood cell (RBC) number, hemoglobin (Hb) concentration, and serum iron and ferritin levels were reduced significantly in the last trimester (p < 0.05) compared to the findings both in the first and second trimesters. On the other hand, total iron binding capacity (TIBC), transferrin level, and the ratio of sTfR to ferritin in the third trimester were higher (p < 0.05) than those both in the first and second trimesters. Dietary intake of iron in the three trimesters was 9.7 ± 2.3, 13.3 ± 4.3, and 10.6 ± 2.5 mg/day, respectively. All were far below the Korean Recommended Dietary Allowances (RDA) of iron for pregnant women. Approximately, ninety percent of the subjects consumed iron supplements after the 20th week of their pregnancies until delivery. The supplemental iron intake in the second and third trimesters was 40 ± 12 and 46 ± 11 mg/day, respectively. There was a significant correlation between the maternal Hb level in the third trimester and the birth weight of infants. In conclusion, maternal iron status deteriorated during pregnancy, although most subjects consumed more than the RDA of iron by taking iron supplements after the 20th week of pregnancy. The results confirm that maternal iron deficiency during pregnancy negatively affects the outcome of newborns.     

孕早期焦虑、抑郁与孕中期增重关系的前瞻性研究

目的 调查了解成都地区孕早期妇女焦虑、抑郁现状,探讨孕早期焦虑、抑郁对孕中期增重的影响。方法 利用成都孕妇队列开展前瞻性研究,整群随机选取2017年成都市某三甲妇幼保健机构产前门诊孕6～14周单胎健康孕妇作为研究对象。通过问卷调查收集孕妇基本信息。采用《焦虑自评量表》(self-rating anxiety scale, SAS)和《抑郁自评量表》(self-rating depression scale, SDS)收集孕早期妇女焦虑和抑郁信息,分别计算孕早期焦虑和抑郁标准得分,按三分位数分别由低到高分为三水平组(T1、T2、T3),参照中国常模标准分别评价孕早期焦虑和抑郁状态。分别于孕6～14周、24～28周测量孕妇体重,计算孕中期增重速率,依据《中国妊娠期妇女体重增长推荐值标准》(WST801-2022)判断孕中期增重状态（过缓、适宜和过快）。采用多因素非条件logistic回归分析探讨孕早期焦虑和抑郁分别与孕中期增重之间的关系。结果最终有效样本量为986例。孕早期平均焦虑、抑郁标准得分分别为(37.94±7.00)、(40.43±8.95)分,焦虑、抑郁发生率分别为6.5%、9....     

妊娠压力对上海孕妇孕晚期饮食倾向的影响

目的研究上海孕妇受孕前后3个月、孕中晚期妊娠压力对于孕晚期饮食倾向的作用。方法 2016年4月-2018年4月在上海市两家接产医院首次建卡的孕妇中,经知情同意纳入上海亲子队列研究,利用孕妇生活事件量表分别评估其在受孕前后3个月、孕32~36周的妊娠压力,采用食物频率问卷和因子分析法评估孕晚期饮食倾向,同时问卷获取重要混杂因素。采用二分类Logistic回归模型分析妊娠压力与饮食倾向的关系。结果纳入分析的2634名孕妇中,因子分析得到6类孕晚期饮食倾向,分别为"均衡"类、"荤食和豆"类、"高糖或高油"类、"腌制品和内脏"类、"营养补充"类和"咖啡因"类。控制潜在混杂因素(包括孕妇年龄、文化程度、职业、家庭年收入、孕前体质指数、产次、孕中晚期焦虑情况、孕中晚期抑郁情况)后,受孕前后3个月较高的总体和主观妊娠压力可使孕妇在孕晚期更不倾向于"均衡"类饮食(OR=0.76,95%CI 0.61~0.95);孕中晚期较高妊娠压力可使孕妇更倾向于"均衡"类饮食(OR=1.66,95%CI 1.22~2.25),但同时也促进其对"腌制品和内脏"类饮食的倾向(OR=1.32,95%CI 0.98~1.78),并可抑制对"荤食和豆"类饮食的倾向(OR=0.72,95%CI 0.53~0.96)。结论孕期较低的妊娠压力有利于孕晚期膳食的均衡;相较于孕中晚期,受孕前后3个月的妊娠压力更可能对孕晚期饮食倾向造成负面影响。     

8 264例住院孕妇妊娠期糖尿病的发病率及其危险因素分析

目的 分析8 264例住院孕妇妊娠期糖尿病（GDM）的发病情况及危险因素,为其防治提供依据。方法 收集2013年1月 - 2018年12月在海南妇产科医院住院分娩的孕妇8 264例,参考2010年国际妊娠糖尿病研究协会（IADPSG）制定的GDM诊断标准分为GDM组（n = 1 207）和非GDM组（n = 7 057）。采用自行设计的调查表收集相关临床资料,应用单因素及多因素logistic回归分析GDM发生的危险因素。结果 8 264例孕妇发生GDM 1 207例,GDM发病率为14.61％。多因素logistic回归分析显示,年龄≥35岁（OR = 2.337,95%CI:1.512～5.480）、孕前BMI≥25 kg/m2（OR = 3.193,95%CI:2.485～10.108）、孕次≥3次（OR = 2.104,95%CI:1.382～4.927）、产次≥3次（OR = 1.862,95%CI:1.204～3.218）、流产次数≥2次（OR = 2.902,95%CI:2.114～7.913）、高能量摄食（OR = 5.714,95%CI:4.526～12.685）及饮食不规律（OR = 3.319,95%CI:2.905～10.794）是GDM发生的危险因素。结论 年龄≥35岁、孕前BMI≥30岁、孕次≥3次、产次≥3次、流产次数≥2次、高能量摄食及饮食不规律是GDM发生的危险因素,临床上应对此类孕妇加强GDM的早期筛查。