婦女懷孕前飲食營養攝取狀態與新生兒體型之相關性研究

Examination of relationships between maternal nutrition status in prepregnancy and birth outcomes

林筱菁(Lin Hsiao Ching)

指導教授 ： 盧立卿

國立臺灣師範大學/教育學院/人類發展與家庭學系/碩士(2007年)

摘要

本研究分析個人飲食頻率問卷和生產後回憶各時期典型一天飲食問卷來評估現今台灣婦女懷孕期前後飲食營養的攝取狀況，探討婦女懷孕期間飲食狀況與新生兒體型之間的關係，並比較婦女懷孕前及懷孕期飲食營養攝取是否有差異。合併兩個小型世代研究的受試者為分析對象，民91世代於民國91年至民國92年間，於台北市立婦幼醫院招募181名孕婦為受試者；民93世代自民國93年至95年間於台北市立婦幼醫院和臺大醫院招募150位生產後的婦女參加。以面對面或電話訪談方式收集孕婦的飲食相關資料。利用問卷調查飲食狀況、基本資料、身體測量值、新生兒健康狀況等。最後研究分析人數為306人，平均年齡30.9±4.0歲，懷孕前平均體重53.5±7.7公斤，BMI值21.0±2.9 kg/m2，懷孕期間體重平均增加14.4±4.3公斤。新生兒平均出生週數38.9±1.0週，平均出生身長49.1±2.4公分，平均出生體重3227.1±463.5公克，平均出生頭圍34.3±2.0公分。男新生兒出生體重平均比女新生兒多220公克。個人飲食頻率問卷和生產後回憶各時期典型一天飲食問卷由於需請受試者自行郵寄回本研究室，因此會有回收率較低的問題。由生產後回憶各時期典型一天飲食問卷得知，懷孕前一年孕婦平均攝取2813 kcal的熱量，懷孕前期、後期平均熱量攝取為2076 kcal和2300 kcal。由個人飲食頻率問卷發現，孕婦懷孕前一年膳食纖維、膽固醇、維生素E、維生素K、維生素B1、維生素B2、鈣、鎂、磷、鋅、葉酸、植物性蛋白質、動物性脂肪等營養素密度皆顯著低於懷孕全期；維生素A、菸鹼酸、維生素B6、維生素B12、鈉、鐵則顯著高於懷孕全期。且婦女懷孕期間比懷孕前一年攝取較多的奶類、水果、蛋類和黃豆類食物。母親懷孕週數、未懷孕BMI值、孕期總體重增加量、母親身高、新生兒性別與新生兒體型呈顯著正相關；父母教育年數、家庭社經地位與新生兒體形呈顯著負相關。在新生兒出生體重迴歸模式發現，新生兒出生體重與懷孕前葉酸、膽固醇營養素密度呈顯著正相關(p<0.05)，與鈉營養素密度呈顯著負相關(p<0.05)。

關鍵字

飲食頻率問卷 ； 生產後回憶各時期典型一天飲食 ； 營養素密度 ； 孕婦

並列摘要

We used two dietary assessment methods including food frequency questionnaire (FFQ) and a typical day recall for postnatal women to collect dietary information during pregnancy and before pregnancy. This study analyzed the correlations and explored the possible relationships between maternal dietary status and infant outcomes including birth weight, length and head circumference. Our study subjects were from two cohort studies. First cohort were 181 pregnant women who received prenatal follow-up at Taipei Municipal Women’s and Children’s Hospital. Second cohort consists of 150 postnatal women recruited at Taipei Municipal Women’s and Children’s and National Taiwan University Hospital. Before pregnancy, the participants’ average age was 30.9years old, weight was 53.5 kg, BMI was 21.0 kg/m2, and the gestational weight gain was 14 kg. Newborn’s average gestational age was 38.9 weeks. The average birth height, weight, and head circumference of the newborns was 49.1 cm, 3227.1 g, and 34.3 cm, respectively. Regarding the FFQ and a typical day recall, because participates were asked to mail the records back to us, the response rate was much lower. By using a typical diet from postnatal women recalled, the average energy intakes before pregnancy was 2813 kcal, the first and the third trimesters were 2076 kcal, and 2300 kcal, respectively. By using the FFQ, we found that the nutrient densities of dietary fiber, cholesterol, vitamin E, vitamin B1, vitamin B2, calcium, magnesium, phosphorous, zinc, folate, plant protein, and animal fat during pregnancy were higher than pre-pregnancy, while the nutrient densities of vitamin A, niacin, vitamin B6, vitamin B12, sodium, and iron were lower than pre-pregnancy. In addition, women during pregnancy ate more milk, eggs, fruit, and soybean products than pre-pregnancy (p<0.05). We also found that maternal gestational age, BMI before pregnancy, weight gain during pregnancy, and newborn gender were positively correlated with birth outcomes, but parent’s education, and family socioeconomic status were negatively correlated with birth outcomes. The nutrient densities of folate and cholesterol before pregnancy were positively correlated with newborn weight (p<0.05), while the nutrient densities of sodiun before pregnancy was negatively correlated with newborn weight (p<0.05).

並列關鍵字

FFQ ； remote diet recall ； nutrient density ； pregnancy

參考文獻

李佩珍、郭素珍、鄧森文、呂宗學、李中一(2003)。台灣地區嬰兒出生體重與妊娠週數分佈之長期變化趨勢。台灣公共衛生雜誌，22(5)，376-385。

陳培君、李中一、林瑞雄、宋鴻樟(2002)。婦女抽菸及二手煙暴露和低出生體重嬰兒。台灣公共衛生雜誌，21(5)，p.321-328。

陳冠如、蕭寧馨、林璧鳳(2006)。台北地區醫院產檢孕婦的葉酸營養狀況。中華民國營養學會雜誌，31 (1)，8-16。

黃伯超、游素玲(1991)。營養學精要。臺北市，健康文化事業股份有限公司。

蔡佩伶 (2006)。營養素攝取/GNB3 C825T基因多型性與懷孕婦女體重變化之相關性研究。高雄醫學大學醫學研究所碩士論文。