孕期食物摄入与婴儿湿疹关联的队列研究

叶佩琪; 吴维佳; 万年青; 谈敏怡; 唐努; 陈裕明; 陈亚军; 静进; 蔡莉

doi:10.16462/j.cnki.zhjbkz.2019.10.011

孕期食物摄入与婴儿湿疹关联的队列研究

doi: 10.16462/j.cnki.zhjbkz.2019.10.011

1.
510080 广州, 中山大学公共卫生学院预防医学专业
2.
510080 广州, 中山大学公共卫生学院妇幼卫生系
3.
510080 广州, 中山大学公共卫生学院流行病与卫生统计学系

基金项目:

国家自然科学基金青年项目 81602862

广东省自然科学基金-博士启动项目 2016A030310150

深圳市“三民”工程项目 SZSM201803061

详细信息

通讯作者:
蔡莉, E-mail: caili5@mail.sysu.edu.cn

中图分类号: R715.3
计量
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- 被引次数: 0
出版历程
- 收稿日期: 2019-05-08
- 修回日期: 2019-08-05
- 刊出日期: 2019-10-10

The effect of maternal food consumption during pregnancy on infantile eczema: a cohort study

1.
Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
2.
Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
3.
Department of Epidemiology and Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China

Funds:

National Natural Science Foundation of China 81602862

The Natural Science Foundation of Guangdong Province 2016A030310150

Sanming Project of Medicine in Shenzhen SZSM201803061

More Information

Corresponding author: CAI Li, E-mail: caili5@mail.sysu.edu.cn

摘要

摘要: 目的探讨孕期各大类食物摄入量与婴儿湿疹发病风险之间的关联。方法采用前瞻性出生队列研究方法，选取广州市某区妇幼保健院常规孕检的孕20~28周孕妇523名。采用具有81个条目的半定量食物频率问卷调查孕妇过去一个月的膳食摄入情况，根据中国膳食指南划分食物摄入类别，并计算各大类别食物摄入量。于产后6个月通过电话随访调查婴儿湿疹的发病情况。将孕期各类食物摄入量进行四等分（Q1-Q4），采用多因素Logistic回归分析模型分析其与婴儿湿疹之间的关联。结果产后6个月婴儿湿疹累计发病率为51.8%。在孕期各类食物摄入方面，湿疹组的禽肉类摄入量高于非湿疹组（27.62±25.20 vs.22.03±22.63 g/d，P=0.022）；谷类、蔬菜类、水果类、红肉类、蛋类、奶类、大豆、坚果的摄入在两组间差异均无统计学意义（均有P>0.05）。多因素Logistic回归分析结果显示，母亲孕期较高的禽肉类摄入（Q4）和鱼类摄入（Q3）与最低四分位数组（Q1）相比，婴儿湿疹发生风险增加（OR=2.71，95% CI=1.24~4.81；OR=2.38，95% CI=1.23~4.59）。结论孕期禽肉类或鱼类摄入过多与更高的婴儿湿疹发生风险有关。
- 母亲饮食 /
- 孕期 /
- 婴儿湿疹 /
- 队列研究
Abstract: Objective To investigate the association between maternal food group intakes during pregnancy and the risk of infantile eczema in a Chinese population. Methods A prospective birth cohort study was conducted and 523 women were recruited at 20-28 weeks of pregnancy in Guangzhou from 2017 to 2018. A validated 81-item quantitative food frequency questionnaire was used to assess maternal dietary intakes during the past month. Food items were divided into ten food groups according to the Chinese Dietary Guidelines. Offspring were followed up at 6 months by the symptom questionnaire of eczema. Multivariate Logistic regression model was conducted to evaluate the association between maternal food group intakes during pregnancy and the risk of infantile eczema. Results The cumulative incidence of eczema at 6 months was 51.8%. Maternal consumption of poultry was higher in the eczema group (27.62±25.20 g/d) than the control group (22.03±22.63 g/d, P=0.022). Comparing to the lowest quantile (Q1), higher maternal intake of poultry (Q4) and fish (Q3) were significantly associated with an increased risk of infantile eczema (OR=2.71, 95% CI=1.24-4.81; OR=2.38, 95% CI=1.23-4.59, respectively) after multivariate adjustment. Conclusion Higher intakes of poultry or fish during pregnancy were associated with an increased risk of infantile eczema in Chinese population.
- Maternal diet /
- Pregnancy /
- Infantile eczema /
- Cohort study

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表 1 研究对象一般特征

Table 1. General characterstics of research subjects

基本特征	合计	湿疹组	非湿疹组	t/χ²值	P值
孕妇基线资料
总体	388	201(51.80%)	187(48.20%)
年龄(岁)				1.04	0.309
≥35	77	36(46.75%)	41(53.25%)
＜35	311	165(53.22%)	146(47.10%)
孕前BMI(kg/m²)^a	20.71±2.89	20.47±2.88	20.98±2.88	1.70	0.090
调查时孕周(周)	25.69±3.82	25.75±4.35	25.62±3.15	-0.34	0.734
文化程度^b				2.29	0.514
初中及以下	57	26(45.61%)	31(54.39%)
高中或中专	70	34(48.57%)	36(51.43%)
大专	119	62(52.10%)	57(47.90%)
大学及以上	133	75(56.39%)	58(43.61%)
家庭人均月收入(元/月)^b				3.45	0.328
≤4 000	88	41 (46.59%)	47 (53.41%)
4 001~	86	51 (59.30%)	35 (40.70%)
6 001~	93	46 (49.46%)	47 (50.54%)
＞10 000	111	61 (54.95%)	50 (45.05%)
食物过敏^b				0.14	0.704
是	74	40 (54.05%)	34 (45.95%)
否	312	161(51.60%)	151(48.40%)
孕期被动吸烟^b				0.18	0.674
是	79	39 (49.37%)	40 (50.63%)
否	296	154(52.03%)	142(47.97%)
首次怀孕^b				2.86	0.091
是	138	80 (57.97%)	58 (42.03%)
否	247	121(48.99%)	126(51.01%)
6个月婴儿随访资料
喂养方式^b				0.15	0.926
人工喂养	27	15 (55.56%)	12 (44.44%)
混合喂养	192	100 (52.08%)	92 (47.92%)
母乳喂养	167	86 (51.50%)	81 (48.50%)
纯母乳喂养持续时间(月)^b				0.78	0.677
＜4	177	96 (54.24%)	81 (45.76%)
4~	66	34(51.52%)	32(48.48%)
≥6	144	71(49.31%)	73(50.69%)
6个月内引入辅食				1.07	0.300
是	185	91 (49.19%)	94 (50.81%)
否	202	110(54.46%)	92(45.54%)
过敏性疾病家族史				5.80	0.016
是	189	110(58.20%)	79 (41.80%)
否	198	91(45.96%)	107(54.04%)
湿疹家族史				8.20	0.004
是	33	25 (75.76%)	8 (24.24%)
否	354	176(49.72%)	178(50.28%)
注：^a表示体重指数(body mass index，BMI)；连续变量表示为(x±s)，分类变量表示为人数(%)；^b缺失数据未列出。

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表 2 婴儿湿疹组和非湿疹组母亲孕期总能量及各大类食物摄入量的比较

Table 2. Maternal daily intake of energy and main food groups during pregnancy between the eczema group and the control group

	湿疹组(n=201)	非湿疹组(n=187)	t值	P值
总能量摄入 (kcal/d)	1 857.21±514.66	1 769.98±458.95	-1.75	0.080
各大类食物摄入(g/d)
谷类	214.92±82.98	204.24±69.99	-1.36	0.174
蔬菜类	241.02±129.69	224.86±120.91	-1.27	0.207
水果类	250.21±152.87	256.83±167.50	0.41	0.685
红肉类	94.95±67.00	85.84±59.59	-1.41	0.160
家禽类	27.62±25.20	22.03±22.63	-2.29	0.022
鱼类	30.79±29.08	28.20±31.70	-0.84	0.400
淡水鱼类	19.28±19.98	18.41±23.71	-0.39	0.697
海水鱼类	11.52±21.18	9.78±18.19	-0.86	0.390
蛋类	36.73±24.36	35.07±25.34	-0.66	0.512
奶类	204.91±154.02	202.79±136.64	-0.14	0.887
大豆	6.50±7.54	6.23±6.87	-0.37	0.712
坚果类	16.77±20.86	15.78±21.94	-0.45	0.652

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表 3 各大类食物摄入量与湿疹的关联性分析

Table 3. The associations between maternal dietary intake and infantile eczema

食物类别	OR (95% CI)值	调整OR (95% CI)值
食物类别	OR (95% CI)值	模型1^a	模型2^b
谷类
Q1	1.00	1.00	1.00
Q2	0.94 (0.54, 1.65)	0.86 (0.48, 1.56)	0.77 (0.41, 1.44)
Q3	0.88 (0.50, 1.55)	0.84 (0.46, 1.53)	0.68 (0.35, 1.34)
Q4	1.28 (0.73, 2.26)	1.06 (0.57, 1.96)	0.82 (0.35, 1.96)
蔬菜类
Q1	1.00	1.00	1.00
Q2	1.42 (0.81, 2.51)	1.40 (0.77, 2.56)	1.40 (0.75, 2.63)
Q3	1.23 (0.70, 2.16)	1.20 (0.66, 2.18)	1.22 (0.65, 2.32)
Q4	1.39 (0.79, 2.45)	1.37 (0.75, 2.50)	1.31 (0.67, 2.59)
水果类
Q1	1.00	1.00	1.00
Q2	1.23 (0.70, 2.16)	0.98 (0.54, 1.78)	0.97 (0.52, 1.81)
Q3	1.13 (0.64, 1.99)	1.10 (0.60, 2.02)	1.20 (0.63, 2.29)
Q4	0.90 (0.51, 1.59)	0.81 (0.45, 1.48)	0.74 (0.37, 1.48)
红肉类
Q1	1.00	1.00	1.00
Q2	1.28 (0.73, 2.25)	1.26 (0.69, 2.29)	1.17 (0.62, 2.20)
Q3	1.26 (0.71, 2.21)	1.12 (0.61, 2.05)	0.96 (0.50, 1.84)
Q4	1.28 (0.73, 2.25)	1.16 (0.64, 2.12)	0.82 (0.40, 1.68)
家禽类
Q1	1.00	1.00	1.00
Q2	2.07 (1.16, 3.68)^c	2.08 (1.12, 3.84)^c	2.07 (1.08, 3.94)^c
Q3	1.42 (0.80, 2.52)	1.46 (0.79, 2.70)	1.54 (0.80, 2.98)
Q4	2.61 (1.46, 4.68)^c	2.62 (1.41, 4.86)^c	2.71 (1.24, 4.81)^c
鱼类
Q1	1.00	1.00	1.00
Q2	1.91 (1.08, 3.39)^c	2.00 (1.09, 3.69) ^c	2.07 (1.10, 3.87) ^c
Q3	2.35 (1.32, 4.17)^c	2.37 (1.28, 4.39) ^c	2.38 (1.23, 4.59) ^c
Q4	1.76 (0.99, 3.12)	1.65 (0.91, 3.02)	1.54 (0.81, 2.94)
淡水鱼类
Q1	1.00	1.00	1.00
Q2	1.13 (0.63, 2.02)	1.21 (0.65, 2.24)	1.27 (0.66, 2.42)
Q3	2.08 (1.17, 3.69)^c	2.24 (1.21, 4.13) ^c	2.18 (1.13, 4.21) ^c
Q4	1.57 (0.89, 2.75)	1.61 (0.88, 2.93)	1.48 (0.77, 2.84)
海水鱼类
Q1	1.00	1.00	1.00
Q2	1.61 (1.00, 2.58)	1.65 (0.98, 2.74)	1.62 (0.95, 2.75)
Q3	1.53 (0.93, 2.53)	1.41 (0.80, 2.46)	1.42 (0.79, 2.55)
Q4	1.72 (0.88, 2.10)	1.38 (0.91, 2.57)	1.53 (0.84, 2.60)
蛋类
Q1	1.00	1.00	1.00
Q2	1.27 (0.72, 2.25)	1.19 (0.65, 2.17)	1.22 (0.64, 2.30)
Q3	1.64 (0.74, 3.66)	1.25 (0.54, 2.89)	1.40 (0.57, 3.42)
Q4	1.34 (0.77, 2.33)	1.21 (0.67, 2.18)	1.15 (0.61, 2.18)
奶类
Q1	1.00	1.00	1.00
Q2	1.00 (0.57, 1.75)	0.89 (0.48, 1.63)	0.80 (0.43, 1.52)
Q3	0.78 (0.44, 1.37)	0.73 (0.40, 1.34)	0.58 (0.31, 1.11)
Q4	0.76 (0.43, 1.34)	0.72 (0.39, 1.31)	0.57 (0.29, 1.12)
大豆
Q1	1.00	1.00	1.00
Q2	1.28 (0.73, 2.26)	1.17 (0.65, 2.12)	1.17 (0.63, 2.17)
Q3	1.16 (0.66, 2.04)	1.28 (0.70, 2.34)	1.23 (0.65, 2.31)
Q4	1.00 (0.57, 1.76)	1.05 (0.58, 1.91)	0.96 (0.50, 1.86)
坚果类
Q1	1.00	1.00	1.00
Q2	0.82 (0.46, 1.43)	0.86 (0.47, 1.56)	0.96 (0.51, 1.80)
Q3	1.25 (0.71, 2.20)	1.42 (0.78, 2.58)	1.53 (0.81, 2.92)
Q4	1.35 (0.76, 2.39)	1.38 (0.75, 2.54)	1.37 (0.68, 2.74)
注：^a模型1校正了孕妇年龄、孕前BMI、文化程度、家庭人均月收入；^b模型2校正了孕妇年龄、孕前BMI、文化程度、家庭人均月收入、调查时孕周、食物过敏史、是否首次怀孕、孕期被动吸烟史、湿疹家族史、每日总能量摄入，婴儿喂养模式、纯母乳喂养持续时间、6个月内是否引入辅食。^cP < 0.05。

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基本特征	合计	湿疹组	非湿疹组	t/χ²值	P值
孕妇基线资料
总体	388	201(51.80%)	187(48.20%)
年龄(岁)				1.04	0.309
≥35	77	36(46.75%)	41(53.25%)
＜35	311	165(53.22%)	146(47.10%)
孕前BMI(kg/m²)^a	20.71±2.89	20.47±2.88	20.98±2.88	1.70	0.090
调查时孕周(周)	25.69±3.82	25.75±4.35	25.62±3.15	-0.34	0.734
文化程度^b				2.29	0.514
初中及以下	57	26(45.61%)	31(54.39%)
高中或中专	70	34(48.57%)	36(51.43%)
大专	119	62(52.10%)	57(47.90%)
大学及以上	133	75(56.39%)	58(43.61%)
家庭人均月收入(元/月)^b				3.45	0.328
≤4 000	88	41 (46.59%)	47 (53.41%)
4 001~	86	51 (59.30%)	35 (40.70%)
6 001~	93	46 (49.46%)	47 (50.54%)
＞10 000	111	61 (54.95%)	50 (45.05%)
食物过敏^b				0.14	0.704
是	74	40 (54.05%)	34 (45.95%)
否	312	161(51.60%)	151(48.40%)
孕期被动吸烟^b				0.18	0.674
是	79	39 (49.37%)	40 (50.63%)
否	296	154(52.03%)	142(47.97%)
首次怀孕^b				2.86	0.091
是	138	80 (57.97%)	58 (42.03%)
否	247	121(48.99%)	126(51.01%)
6个月婴儿随访资料
喂养方式^b				0.15	0.926
人工喂养	27	15 (55.56%)	12 (44.44%)
混合喂养	192	100 (52.08%)	92 (47.92%)
母乳喂养	167	86 (51.50%)	81 (48.50%)
纯母乳喂养持续时间(月)^b				0.78	0.677
＜4	177	96 (54.24%)	81 (45.76%)
4~	66	34(51.52%)	32(48.48%)
≥6	144	71(49.31%)	73(50.69%)
6个月内引入辅食				1.07	0.300
是	185	91 (49.19%)	94 (50.81%)
否	202	110(54.46%)	92(45.54%)
过敏性疾病家族史				5.80	0.016
是	189	110(58.20%)	79 (41.80%)
否	198	91(45.96%)	107(54.04%)
湿疹家族史				8.20	0.004
是	33	25 (75.76%)	8 (24.24%)
否	354	176(49.72%)	178(50.28%)
注：^a表示体重指数(body mass index，BMI)；连续变量表示为(x±s)，分类变量表示为人数(%)；^b缺失数据未列出。

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孕期食物摄入与婴儿湿疹关联的队列研究

doi: 10.16462/j.cnki.zhjbkz.2019.10.011

通讯作者:
蔡莉, E-mail: caili5@mail.sysu.edu.cn

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The effect of maternal food consumption during pregnancy on infantile eczema: a cohort study

Corresponding author: CAI Li, E-mail: caili5@mail.sysu.edu.cn

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孕期食物摄入与婴儿湿疹关联的队列研究

doi: 10.16462/j.cnki.zhjbkz.2019.10.011

通讯作者: 蔡莉, E-mail: caili5@mail.sysu.edu.cn

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The effect of maternal food consumption during pregnancy on infantile eczema: a cohort study

Corresponding author: CAI Li, E-mail: caili5@mail.sysu.edu.cn

计量

出版历程

目录

通讯作者:
蔡莉, E-mail: caili5@mail.sysu.edu.cn