PLOS Medicine:母亲炎症饮食程度与后代出生结局的关系

2021-02-15 MedSci原创 MedSci原创

低质量和高炎症潜能的母亲饮食与较低的后代出生体重和较高的后代SGA的风险相关。

包括低出生体重(LBW)、巨大儿、早产或过期妊娠在内的不良出生结局与儿童期较高的发病率和死亡率以及成人期较高的非传染性疾病风险都密切相关。全球范围内,出生体重不足与早产分别占所有活产儿的15%-20%和5%-18%。因此,识别不良出生结果的可变风险因素对于改善儿童和成人健康结果至关重要。

健康与疾病的发展起源理论认为,母亲孕期和宫内营养可以改变后代的健康状态。尽管如此,人类在自由生活条件下的饮食结构十分复杂,营养物质和食物之间有很高的相关性和相互作用。

众所周知,怀孕还会改变母亲体内的免疫和炎症程度,而炎症细胞因子的失衡反过来又与妊娠并发症和不良分娩结局相关。因为饮食是炎症程度的主要可变因素。许多专家认为,优化出生结局的潜在策略之一可能是通过减少饮食炎症。

为此,来自欧洲的ALPHABET联盟对7个相关队列的个体参与者数据进行了汇总分析,旨在阐明母亲孕期和产前期间的饮食炎症水平和质量对后代出生结局的影响。相关结果发表在最新的美国科学公共图书馆杂志PLOS Medicine上。

研究人员统一和汇集了来自7个欧洲队列中多达24861对母子的个体参与者数据(IPD): 英国ALSPAC、法国EDEN、荷兰Generation R、爱尔兰Lifeways、波兰REPRO_PL、爱尔兰ROLO、与英国SWS。孕产妇饮食按先入为主(2个队列)和产前(7个队列)两个维度进行评估。

母亲的饮食炎症潜能和质量分别使用根据能量调整的饮食炎症指数(DII)和DASH指数进行评估。主要结果是胎儿出生体重和出生时的胎龄。不良出生结局,即低出生体重、巨大儿、小于胎龄儿(SGA)、大于胎龄儿(LGA)、早产和过期妊娠根据标准临床临界值进行定义。

该研究中的母亲在分娩时的平均年龄为29.5±4.9岁,平均BMI为23.3±4.2kg/m2。总得说来,较高的妊娠DASH评分(较高的饮食质量)与新生儿较高的出生体重相关[β= 18.5]、头围[0.03cm]、胎长更长 [0.05cm]、分娩LBW的风险较低[OR=0.89]和SGA [OR=0.87]。更高的孕前DII评分(更促炎的饮食)与更低的出生体重相关[β= 18.7]和更短的出生长度[0.07]以及更高的SGA风险[OR= 1.18]有关。

进一步分析显示,较高的孕前母体DII值与男婴较低的出生体重和头围、较短的出生长度和较高的SGA风险相关(性别交互作用分别为0.029、0.059、0.104和0.075),而与女婴上述指标无关。同时,没有观察到母亲的DII评分和DASH评分与胎龄、早产和足月后分娩、巨大儿和LGA之间关系。

在该研究中,研究员将红肉 、加工肉、内脏、精制谷物和甜饮料等作为促炎食物,将绿叶蔬菜(甘蓝、菠菜、卷心菜、芝麻菜等)、 黄色蔬菜(南瓜、黄椒、胡萝卜等)、全谷物、水果、茶叶、咖啡和红酒等作为抗炎食物。

综上,在这项统一IPD的多中心荟萃分析中,研究人员报道了低质量和高炎症潜能的母亲饮食与较低的后代出生体重和较高的后代SGA的风险相关。因此,根据预先定义的标准改善总体产妇饮食模式可以优化胎儿生长,避免与不良出生结局相关的重大医疗负担。

参考文献:

Chen LW, et al. Associations of maternal dietary inflammatory potential and quality with offspring birth outcomes: An individual participant data pooled analysis of 7 European cohorts in the ALPHABET consortium. PLoS Med. 2021 Jan 21;18(1):e1003491. doi: 10.1371/journal.pmed.1003491.

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    2021-11-17 jeanqiuqiu
  4. [GetPortalCommentsPageByObjectIdResponse(id=1981393, encodeId=88a8198139332, content=<a href='/topic/show?id=9e3331440a2' target=_blank style='color:#2F92EE;'>#出生结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31440, encryptionId=9e3331440a2, topicName=出生结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Fri Jul 30 06:23:16 CST 2021, time=2021-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1940757, encodeId=8f801940e578b, content=<a href='/topic/show?id=a3216e0618e' target=_blank style='color:#2F92EE;'>#炎症饮食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67061, encryptionId=a3216e0618e, topicName=炎症饮食)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/iaP1mV9qBwx5tE2F4xcG1r4x1PibWvluIFLB8VsViakqNMBia2Z0wFibVrYwDEILvHB1OomzzTAAGy5MVl5BrdEv9Bw/132, createdBy=e11f100, createdName=guguangxiang, createdTime=Mon Oct 18 13:23:16 CST 2021, time=2021-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1859113, encodeId=30261859113de, content=<a href='/topic/show?id=e0a9593596' target=_blank style='color:#2F92EE;'>#DIC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5935, encryptionId=e0a9593596, topicName=DIC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6f7770, createdName=jeanqiuqiu, createdTime=Wed Nov 17 09:23:16 CST 2021, time=2021-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950322, encodeId=d61a95032291, content=非常具有科学意义!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210606/3360b859ba944059aaffe8a1847ab57b/e91f325d086a40b2b9805211738111d1.jpg, createdBy=b3982392941, createdName=牟德武, createdTime=Tue Mar 23 11:50:44 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1773917, encodeId=de1d1e7391715, content=<a href='/topic/show?id=5f014e1852' target=_blank style='color:#2F92EE;'>#CIN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4718, encryptionId=5f014e1852, topicName=CIN)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9a038523631, createdName=kalseyzl, createdTime=Wed Jan 19 09:23:16 CST 2022, time=2022-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1577772, encodeId=90f415e7772c3, content=<a href='/topic/show?id=cda91148004' target=_blank style='color:#2F92EE;'>#Medicine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11480, encryptionId=cda91148004, topicName=Medicine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=54cd16396700, createdName=ms1692212821629096, createdTime=Wed Feb 17 00:23:16 CST 2021, time=2021-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610897, encodeId=cf24161089e10, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Feb 17 00:23:16 CST 2021, time=2021-02-17, status=1, ipAttribution=)]
    2021-03-23 牟德武

    非常具有科学意义!

    0

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    2022-01-19 kalseyzl
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在调整了孕产妇健康状况之后,AYA癌症幸存者,尤其是那些接受过放射治疗的幸存者,仍然具有更高的不良分娩结局风险,该人群可能需要进行孕前咨询和额外的监视。

JCEM:孕妇重金属暴露、甲状腺激素与出生结局

由此可见,妊娠早期孕妇暴露于V、As和Pb与孕妇FT3或FT3/FT4比率下降有关,这可能导致婴儿出生体重减轻。中介分析表明,孕妇甲状腺激素可能是尿重金属与出生体重之间关联的中介因素。