目的 了解广州市孕妇孕期膳食质量情况，探究孕期膳食指数与胎儿免疫功能的关系。方法 于2010年9月-2011年2月招募在广州市越秀区和白云区妇幼保健院进行常规体检的孕期妇女作为研究对象，采用膳食问卷3天24小时膳食回顾法调查孕期膳食情况，通过问卷收集孕妇的一般人口学信息，分娩时收集新生儿脐血，实验室检测脐血免疫球蛋白和免疫细胞因子水平。采用孕期膳食质量指数(diet quality index for pregnancy，DQI-P)、孕期膳食平衡指数(dietary balance index for pregnancy，DBI-P)和替代地中海膳食评分(alternate Medierranean diet score，aMED)对孕期膳食质量进行评价。采用多元线性回归分析等方法探究孕期膳食指数与胎儿免疫功能的关系。结果 研究对象DQI-P评分总分均值为55。8±10。0，食物总体多样性和蛋白质食物来源多样性平均得分高达12。0±2。4和4。8±0。7，产能营养素供能比和脂肪酸供能比平均得分只有0。3±1。0和0。4±1。0，提示该人群孕期膳食多样性较好，但膳食充足性、适宜度以及平衡性不佳。DBI-P总分为-19。2±9。4;正端分为4。6±2。9，仅有7。2％的研究对象孕期膳食存在中高度摄入过量问题;负端分为23。9± 7。9，提示该人群膳食处于中度摄入不足状态;膳食质量距分值为28。5±7。1，仅有0。6％的研究人群整体膳食情况较为均衡，67。9％的孕妇存在中高度摄入不平衡问题。aMED总分为4。9±1。3，豆类和坚果食物摄入量少于人群中位数的比例分别为62。5％和79。1％，提示该人群豆类和坚果食物摄入不足。校正孕妇年龄、胎次、产次、孕前BMI、孕期增重、分娩方式等混杂因素后，多元线性回归分析显示孕期DQI-P与胎儿IgG呈正相关，与白细胞介素-6呈负相关(β=0。143，β=-0。155，P＜0。05);DBI-P与白细胞介素-6呈负相关(β=-0。177，P＜0。01);aMED与干扰素-γ呈负相关(β=-0。161，P＜O。01)。结论 广州市孕期妇女膳食质量较低，膳食结构不平衡。较高的孕期膳食质量能促进胎儿免疫系统发育，提高胎儿免疫功能水平。
Association of dietary quality during pregnancy with fetal immune function in Guangzhou
OBJECTIVE To investigate the situation of women's dietary quality during pregnancy and explore the correlations between maternal dietary index and fetal immune function.METHODS From September 2010 to February 2011,pregnant women who had routine physical examination in Yuexiu District and Baiyun District Maternal and Child Health Hospital of Guangzhou were recruited as study objects to use 3-day 24-hour dietary review to investigate diet during pregnancy,and general demographic information of pregnant women was collected through questionnaire,and the neonatal umbilical cord blood was collected during delivery.Laboratory detection of immunological indicators included IgG,IgA,IgM,IFN-γ and IL-6.The quality of diet during pregnancy was evaluated by diet quality index for pregnancy(DQI-P),dietary balance index for pregnancy(DBI-P)and alternate Medierranean diet score(aMED).Spearman correlation analysis and multiple linear regression analysis were used to explore the correlations between dietary quality during pregnancy and fetal immune function.RESULTS The mean score of total DQI-P score of the study subjects was 55.8±10.0,and the mean score of overall food diversity and protein food source diversity was as high as 12.0±2.4 and 4.8±0.7.The mean score of nutrient energy ratio and fatty acid energy ratio was only 0.3±1.0 and 0.4±1.0,indicating that the population had good dietary diversity during pregnancy,but the dietary adequacy,suitability and balance were poor.The total score of DBI-P score was-19.2±9.4.The positive end score was 4.6±2.9,only 7.2％of the subjects had a high degree of dietary intake during pregnancy.The negative end score was 23.9±7.9,indicating the status of moderate dietary intake.Dietary quality was 28.5± 7.1.Only 0.6％of the study population had a balanced dietary situation,and more than 67.9％of pregnant women had high intake imbalance.The mean total score of aMED score was 4.9±1.3,and the proportion of the food intake of beans and nuts was less than the median population was 62.5％and 79.1％,respectively,indicating that the food intake of beans and nuts was insufficient in this population.After adjusting for confounding factors such as maternal age,parity,parity,prepregnancy BMI,weight gain during pregnancy,and mode of delivery,multiple linear regression analysis showed DQI-P during pregnancy and negatively with IL-6(β=0.143,β=-0.155,P＜0.05).DBI-P was negatively associated with IL-6(β=-0.177,P＜0.01)and aMED and IFN-γ(β=-0.161,P＜0.01).CONCLUSION The dietary quality of women in late pregnancy in Guangzhou is low,the dietary structure is unbalanced.Higher dietary quality during pregnancy can promote the development of fetal immune system and improve fetal immune function.
dietary qualitydietary evaluation indexfetusimmunity function
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