目的 评估华中地区孕妇的膳食质量,并探索其影响因素。方法 本研究基于《中国孕产妇营养与健康科学调查》横断面研究,根据纳排标准共纳入10,116例孕妇,收集其膳食、社会人口学特征、生活方式及社会支持等信息,综合评价孕妇膳食多样性、充足性、适宜度和平衡性,计算孕期膳食质量指数（dietary quality index for pregnancy,DQI-P）得分,并使用线性回归分析其相关影响因素。结果 华中地区孕妇DQI-P平均得分为（61.0±12.0）分,孕早、中、晚期孕妇平均能量摄入分别为（1687.5±441.9、1895.2±474.3、1956.5±497.1）kcal/d,农村孕妇DQI-P总分、膳食适宜度、充足性（孕晚期）、平衡性得分高于城市（均P<0.001）,城市孕妇膳食多样性得分高于农村（P<0.001）;进一步发现城市孕妇脂肪摄入与宏量营养素供能比得分相对较差,农村孕妇钠摄入得分相对较差（均P<0.001）;相关因素分析显示,华中地区城市孕妇DQI-P得分与孕前BMI呈负相关（孕早期B =–0.3、孕中期B=–0.2、孕晚期B=–0.3,均P<0.05）,信任公共机构者（孕中期B=2.7,P<0.001）DQI-P得分高,农村地区孕妇DQI-P得分与孕前BMI呈负相关（孕晚期B =–0.4,P<0.001）,初产妇DQI-P得分低（孕早期B =–1.7、孕中期B =–2.3、孕晚期B =–3.7,均P<0.05）,锻炼（孕早期B=5.8、孕中期B =2.9、孕晚期B =2.6,均P<0.001）、参与社团网络活动者（孕早期B =1.6、孕晚期B =2.4,均P<0.05）DQI-P得分高。结论 华中地区孕妇膳食质量仍需改善,孕前体重管理及城乡差异化营养干预可能有助于改善孕期膳食质量。
Abstract
Objective To assess dietary quality among pregnant women in Central China and explore its related factors. Methods This cross-sectional study was based on the Maternal Nutrition and Health Scientific Survey in China. A total of 10,116 pregnant women meeting inclusion and exclusion criteria were enrolled. Information on dietary intake, sociodemographic characteristics, lifestyle, and social support was collected. Dietary quality was comprehensively evaluated in terms of diversity, adequacy, moderation, and balance, and the dietary quality index for pregnancy (DQI-P) was calculated. Linear regression analyses were conducted to identify the factors associated with DQI-P. Results The mean DQI-P score of pregnant women in Central China was 61.0±12.0. Average energy intakes in the first, second, and third trimesters were 1687.5±441.9, 1895.2±474.3, and 1956.5±497.1 kcal/d, respectively. Rural pregnant women had higher total DQI-P scores, moderation, adequacy (in the third trimester), and balance scores than urban counterparts (all P<0.001), whereas urban women scored higher in dietary diversity (P<0.001). Urban women showed relatively lower scores for fat intake and energy contribution ratio by macronutrients, while rural women had lower sodium-related scores (both P<0.001). Multivariable analysis showed that in urban areas, pre-pregnancy BMI was negatively associated with DQI-P (first trimester B=–0.3; second trimester B=–0.2; third trimester B=–0.3, all P<0.05), whereas public institutional trust was associated with higher DQI-P (second trimester B=2.7, P<0.001). In rural areas, pre-pregnancy BMI was negatively associated with DQI-P (third trimester B=–0.4, P<0.001) and primiparity was associated with lower DQI-P (first trimester B=–1.7; second trimester B=–2.3; third trimester B=–3.7, all P<0.05), whereas exercise (first trimester B=5.8; second trimester B=2.9; third trimester B=2.6, all P<0.001) and participation in social organizations (first trimester B=1.6; third trimester B=2.4, both P<0.05) were associated with higher DQI-P. Conclusion sDietary quality among pregnant women in Central China remains suboptimal. Pre-pregnancy weight management and urban-rural differentiated nutritional interventions may contribute to improving dietary quality during pregnancy.
关键词
孕妇 /
孕期膳食质量指数 /
膳食质量 /
相关因素
Key words
pregnant women /
dietary quality index for pregnancy /
dietary quality /
related factors
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基金
科技基础资源调查专项（No.2019FY101003）
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