孕婦第三孕期營養狀況與新生兒營養及生理之研究－以台南地區婦產科診所為例

Study on the nutritional status of pregnant women in third trimester in relation to the nutritional and physiological condition of their newborns-The cases of OBS clinics in Tainan

廖苑秀(Yuan-Hsiu Liao)

指導教授 ： 張承晉

台南應用科技大學/生活科技學院/生活應用科學研究所/碩士(2007年)

摘要

孕婦孕期前後的飲食營養素攝取量及營養狀況是影響母親與胎兒兩者健康的重要因素。本研究主要探討孕婦基本資料及第三孕期飲食對孕婦及新生兒體型、Apgare score、血中維生素B12、葉酸及貧血指標（血色素、紅血球）之影響。本研究以大台南地區診所自2006年（民國九十五年）六月至十二月定期作產前檢查之孕婦為調查對象，最後完成所有調查者共有88名。研究主要工具為自行編製的結構性問卷，包括個人資料問卷、產檢各項測量，並且在第三孕期作24小時飲食回憶法及三天飲食調查，生產時記錄產婦及嬰兒之各項測量及抽血檢查維生素B12、葉酸及貧血指標（血色素、紅血球）進行t檢定、單因子變異數（ANOVA）、卡方檢定及淨相關分析研究。研究結果顯示，新生兒男孩的出生體型皆比女孩大；尤其體重、頭圍有顯著差異性（p < 0.01）。孕婦懷孕前及分娩時體重越重則新生兒體重越重、頭圍越大且身長亦越高。孕期中增加的總體重越重則新生兒體型越大。服用維生素B12補充劑的孕婦飲食中維生素B12與母血維生素B12、母血血色素、及新生兒血中維生素B12比未服用者較高（p＜0.05）。飲食中的葉酸越多則母血葉酸越多，新生兒血中葉酸及新生兒血中紅血球均越高（p＜0.01）。服用葉酸補充劑者飲食中葉酸、母血葉酸、母血血色素及新生兒血中葉酸均比未服用者較高（p＜0.05）。孕婦第三孕期營養素攝取，熱量越高則新生兒體重越重（p＜0.05）；蛋白質攝取越高，新生兒體重越重且身高越高（p＜0.05）。因為本研究中嬰兒週數均大於32週以上，較少極低體重兒，所以新生兒的性別、體重、身高、頭圍、胸圍與其一分鐘及五分鐘Apgar Score均無相關性。孕婦體型、懷孕前身體質量指數BMI、分娩時身體質量指數BMI、孕婦身高、母血紅血球、母血血色素與新生兒一分鐘及五分鐘的Apgar Score均無相關性。本研究結論，孕婦第三孕期服用維生素B12與葉酸補充劑對孕婦及新生兒的貧血均有助益。熱量與蛋白質攝取量分別與新生兒體重及身高呈正相關。然而第三孕期營養素攝取量達營養素攝取建議量者不影響新生兒健康。

關鍵字

懷孕期飲食 ； 飲食攝取量 ； 新生兒體型 ； 維生素B12 ； 葉酸 ； 新生兒Apgar Score

並列摘要

The quantity and nutritional status of the pregnant women’s dietary intake before, during and after the gestational period are deciding factors that can greatly affect the mother and the embryo’s health. This research focuses on discussing pregnant women’s basic index and the third trimester diet’s impact on the mother and the newborns’ stature, Apgare score, vitamin B12 level in blood, folic acid level and anemia index. The main research subjects are pregnant women who took periodical prenatal examination at local clinic in the Tainan region from June to December, 2006. A total of 88 responses were fully completed. The main method used to conduct this research is a self-designed constructive questionnaire which includes basic questionnaire for each individuals, medical assessments of the prenatal examination, three-day of 24 hour diet recollection investigation during the third trimester, childbirth records of medical assessments of pregnant women and newborn infants and regular blood test to follow the quantity of Vitamin B12, folic acid and anemia index (hemoglobin, red blood cell). Afterward, we proceed to conduct the t-Test, the one way analysis variance (ANOVA), the Chi-Square Test and the partial correlations studies. The research results show that the newborn boys’ birth statures are larger than the girls’; especially in the body weights and the head circumferences, both of which have significant differences (p < 0.01). Another finding is that when the woman are heavier before their pregnancy and at the time of childbirth, the newborns’ body weight is heavier, the head circumference larger, and the height taller. The results also show that when the women’s pregnancy periods are longer or when the women accumulated more weight during pregnancies, the newborns also tend to have larger statures. In the pregnant women who took the Vitamin B12 supplement, their dietary Vitamin B12 and maternal blood Vitamin B12, maternal blood hemoglobin, maternal blood red cell and newborn infant blood Vitamin B12 are higher (p<0.05). Subjects who took the folic acid supplement have more dietary folic acid, maternal blood folic acid; they also have more maternal blood hemoglobin, newborn infant blood folic acid and newborn infant blood hemoglobin (p<0.05). Because all of newborn infants in this conducted research are birthed after 32 weeks of gestation, resulting in only very few extremely low weight newborn infants, therefore, the gender of newborn infants, the body weight, the height, the head circumference, the chest circumference, the first minute and the fifth minute Apgar Score are not correlated. The pregnant women’s stature, body mass index (BMI) before pregnant, body mass index (BMI) during childbirth, weeks of gestation, the maternal blood red cell, the maternal blood hemoglobin and the first minute and fifth minute of newborn infants’ Apgar score are also not related. In this study we can conclude that: Pregnant women have taken vitamin B12 and folate will get benefit to prevent Mothers’and newborns’anemia. In the third trimester, if the subjects’ nutrient ingestion of calorie are higher, then the newborns’ body weight are also increasingly heavier (p<0.05). Same as when they have more protein intakes; in those cases, the newborns’ body weight are also heavier and the heights are taller (p<0.05).

並列關鍵字

Diet during pregnancy ； Dietary intake ； Newborn sizes ； Vitamin B12 ； folate ； Newborn Apgar Score

參考文獻

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