研究生: |
陳姮霏 Heng-Fei Chen |
---|---|
論文名稱: |
懷孕婦女飲食狀況對新生兒體型影響之前瞻性研究 A prospective study of maternal nutrient intakes on infant anthropometric outcomes |
指導教授: |
盧立卿
Lyu, Li-Ching |
學位類別: |
碩士 Master |
系所名稱: |
人類發展與家庭學系 Department of Human Development and Family Studies |
論文出版年: | 2004 |
畢業學年度: | 92 |
語文別: | 中文 |
論文頁數: | 191 |
中文關鍵詞: | 懷孕期飲食 、新生兒體型 、懷孕期飲食頻率問卷 |
英文關鍵詞: | diet during pregnancy, newborn outcomes, food frequency questionnaire during pregnancy |
論文種類: | 學術論文 |
相關次數: | 點閱:355 下載:29 |
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本研究目的為希望藉由前瞻性之研究設計追蹤收集並評估母親懷孕期的飲食狀況,以了解台灣地區母親懷孕期間的飲食狀況和社經教育背景對新生兒體型(出生體重、出生身長和出生頭圍)的影響。本研究在民國91年10至11月中招募台北市立婦幼醫院懷孕20週以內的健康婦女參與研究。並利用電話和面對面訪談的方式收集研究相關資料,包括孕婦基本資料及飲食相關問卷(健康狀況家庭生活及個人飲食頻率問卷、一週飲食及活動頻率問卷、三天飲食紀錄本、24小時飲食回憶)、測量身體測量值、新生兒健康狀況問卷,以及追蹤過程登記表。本研究將所收集的資料整理、編碼之後,利用電腦建檔形成資料庫,再以統計軟體SPSS 11.0版進行資料分析。統計分析方法包含有:次數分配與百分比、平均值與標準差、t 考驗、單因子變異數分析、斯皮爾曼等級相關、淨相關和多元迴歸分析。本研究共招募151位孕婦參加,平均年齡30.2歲,懷孕週數4-20週。至生產前共有11位孕婦中途退出,所以研究分析以140位孕婦和其新生兒的資料為主。孕婦未懷孕時平均體重53.4公斤,平均BMI值21.0公斤/公尺2,孕婦懷孕後期平均體重67.6公斤,平均體重總增加量為14.2公斤。新生兒平均出生週數38.7週,平均出生體重3166公克,平均出生身長49公分,平均出生頭圍34公分。利用24小時飲食回憶分析的孕婦懷孕三期熱量攝取分別為:1861大卡、1971大卡(比第一期增加110大卡)、2163大卡(比第二期增加192大卡),三大營養素攝取百分比分別為:醣類52%、蛋白質15%、脂肪33%。分析資料發現,懷孕週數、孕期體重增加量和未懷孕BMI值與新生兒體型呈顯著正相關,但孕婦的年齡、教育年數、已有子女數、家庭總月收入、家庭社經背景和配偶教育年數則與新生兒體型沒有相關性存在。孕婦懷孕全期維生素B12的營養素密度與新生兒出生身長呈正相關(p<0.05),而維生素A、維生素C、葉酸、鉀和膳食纖維與新生兒出生身長呈負相關(p<0.05)。孕婦懷孕全期維生素B1和鋅的營養素密度與新生兒出生體重呈正相關(p<0.05),而維生素A、維生素B2、維生素C、葉酸、鉀、鐵和膳食纖維與新生兒出生體重呈負相關(p<0.05)。由多元迴歸模式可知,出生週數每增加1週新生兒的出生體重會增加106公克。新生兒出生體重與懷孕全期維生素C的營養素密度呈負相關(p<0.05),與懷孕全期鋅的營養素密度呈正相關(p<0.05)。
The purposes of this study are to collect and evaluate mother’s dietary information during pregnancy and to examine the effects between maternal diet and newborn outcomes including weight, height, and head circumference. We recruited health pregnancy women less than 20 weeks from Taipei Municipal Women’s and Children’s Hospital. We collected data including mother’s general characteristics, dietary information, anthropometry assessment and newborn outcomes by face-to-face and telephone interview. The SPSS 11.0 software package was used for all statistical analyses. The study initially recruited 151 pregnant women to participate, there were 11 dropped out until delivery, therefore the final analyses included 140 women and their newborn. Before pregnancy, the subjects’ average age was 30.2 years old, weight was 53.4 kg, and BMI was 21.0 kg/m2, total gestational weight gain was 14.2 kg. Newborns’ average gestational age was 38.7 weeks, birth weight was 3166 g, height was 49 cm, and head circumference was 34 cm. By 24 hour recall the women’s three trimesters energy intake were 1861 Kcal, 1971 Kcal and 2163 Kcal, respectively. The percentage of energy was 52% of carbohydrate, 15% of protein and 33% of fat. We found gestational age, gestational weight gain and BMI before pregnancy were positively correlated with newborn outcomes (p<0.05), but mother’s age, educational years, children’s number, family incomes, family social-economical status and father’s educational years had no correlation with newborn outcomes. During pregnancy, mother’s vitamin B12 nutrition density intakes was positively correlated with newborn height (p<0.05), but vitamin A, vitamin C, folate, potassium and dietary fiber had negative correlations (p<0.05). Mother’s nutrition density intakes including vitamin B1 and zinc were positively correlated with newborn weight (p<0.05), but vitamin A, vitamin B2, vitamin C, folate, potassium, iron and dietary fiber had negative correlations (p<0.05). In multiple regression analysis, the results show that when gestational age increases 1 week, newborn weight increases 106 g. Newborn weight was negatively correlated with gestational intakes of vitamin C density, and positively correlated with zinc density.
ㄧ、中文部份
白玉莊(民91)。台灣地區新生兒早產與低出生體重之研究。高雄醫學大學公共衛生學研究所碩士論文。
任倩儀(民91)。家庭親子間飲食與身體活動量之研究。國立台灣師範大學家政教育研究所碩士論文。
行政院衛生署(民91)。國人膳食營養素參考攝取量。
何啟功(民76)。懷孕婦女中西藥物使用情形及新生兒出生體重影響因素之探討。國立台灣大學公共衛生研究所碩士論文。
李燕鳴、傅振宗(民90)。產婦年齡與不良懷孕結果的探討─花蓮縣三年生產紀錄分析。慈濟醫學,13,95-103。
林金定(民79)。台灣地區婦幼衛生服務模式之研究─孕產婦及新生兒保健醫療服務模式之研究。國防醫學院公共衛生研究所碩士論文。
林綽娟、郭憲文(民82)。某教學醫院新生兒出生體重與頭圍之相關因素之探討。公共衛生,20(1),58-69。
林薇、劉貴雲、杭極敏、高美丁、張幸真、梁藝馨(民92)。媽媽寶寶的約定─懷孕及哺乳期營養參考手冊。行政院衛生署。
張素瓊(民80)。台南地區孕乳婦營養素攝取之調查研究。中華民國營養學會雜誌,16,101-118。
張雪子(民91)。影響孕婦服用營養補充劑行為之相關因素研究。國立台灣師範大學衛生教育研究所碩士論文。
陳正宇(民75)。餵奶方式與母親有無工作對6個月大嬰兒健康與照顧之比較研究。國防醫學院公共衛生研究所碩士論文。
黃惠煐、高美丁(民83)。高雄地區孕婦之膳食攝食狀況。中華民國營養學會雜誌,19,279-294。
黃惠煐、蔡鴻德、葉兆雲、高美丁(民83)。孕婦鐵營養狀況之評估─中國醫藥學院附設醫院門診病人。中國醫藥學院雜誌,3(1),35-44。
劉珍芳(民89)。探討懷雙胞胎或多胞胎孕婦的營養需求量及與胎兒健康之相關性。衛生署科技計畫DOH89-TD-1075。
劉桂霞、李鴻森(民88)。懷孕週數與低出生體重及極低出生體重嬰兒盛行率之研究。中山醫學雜誌,10(1),29-33。
藍守仁、嚴雅音、李建宏、邱正芬、張宜娟、謝淑芬(民80)。懷孕週數與出生體重及體重/身長比之研究。高雄醫學科學雜誌,7,168-172。
二、英文部分
Andersen, L. T., Thilsted, S. H., Nielsen, B. B., & Rangasamy, S. (2003). Food and nutrient intakes among pregnant women in rural Tamil Nadu, South India. Public Health Nutr, 6(2), 131-7
Antal, M., Regoly-Merei, A., Varsanyi, H., Biro, L., Sagi, K., Molnar, D. V., Zajkas, G., Nagy, K., Avar, Z., & Biro, G. (1997). Nutritional survey of pregnant women in Hungary. Int J Vitam Nutr Res, 67(2), 115-22.
Benny, P. S., Benny, S. C., & Sin, I. L. (1991). Nutrition in pregnancy in the Wellington region. N Z Med J, 104(905), 29-32.
Brown, J. E., Murtaugh, M. A., Jacobs, D. R. Jr., & Margellos, H. C. (2002). Variation in newborn size according to pregnancy weight change by trimester. Am J Clin Nutr, 76, 205-9.
Brown, J. E., Buzzard, I. M., Jacobs, D. R. Jr., Hannan, P. J., Kushi, L. H., Barosso, G. M., & Schmid, L. A. (1996). A food frequency questionnaire can detect pregnancy-related changes in diet. J Am Diet Assoc, 96(3), 262-6.
De Vriese, S. R., De Henauw, S., De Backer, G., Dhont, M., & Christophe, A. B. (2001). Estimation of Dietary Fat Intake of Belgian Pregnant Women. Ann Nutr Metab, 45, 273-278.
Erkkola, M., Karppinen, M., Javanainen, J., Rasanen, L., Knip, M., & Virtanen, S. M. (2001). Validity and reproducibility of a food frequency questionnaire for pregnant Finnish women. Am J Epidemiol, 154(5), 466-76.
Ferland, S., & O'Brien, H. T. (2003). Maternal dietary intake and pregnancy outcome. J Reprod Med, 48(2), 86-94.
Fichtner, R. R., Sullivan, K. M., Zyrkowski, C. L., & Trowbridge, F. L. (1990). Racial/ethnic differences in smoking, other risk factors, and low birth weight among low-income pregnant women, 1978-1988. MMWR CDC Surveill Summ, 39(3), 13-21.
Food and Agriculture Organization of the United Nations, World Health Organization. (2002). Human vitamin and mineral requirement. Report of a joint FAO/WHO expert consultation. Rome: FAO.
Hsieh, T. T., Hsu, J. J., Chen, C. J., Chiu, T. H., Liou, J. D., Hsieh, C. C., Lo, L. M., Kuo, D. M., & Soong, Y. K. (1991). Analysis of Birth Weight and Gestational Age in Taiwan. J Formosan Med Assoc, 90(4), 382-387.
Hunt, I. F., Jacob, M., Ostegard, N. J., Masri, G., Clark, V. A., & Coulson, A. H. (1976). Effect of nutrition education on the nutritional status of low-income pregnant women of Mexican descent. Am J Clin Nutr, 29(6), 675-84.
Institute of Medicine. (2001). Dietary reference intakes: Application in dietary assessment. Washington, DC: National Academy Press.
Kolasa, K. M. & Weismiller, D. G. (1997). Nutrition during pregnancy. Am Fam Physician, 56(1), 205-12.
Ladipo, O. A. (2000). Nutrition in pregnancy: mineral and vitamin supplement. Am J Clin Nutr, 72, 280S-90S.
Landman, J. P. & Hall, J. S. (1989). Dietary patterns and nutrition in pregnancy in Jamaica. J Trop Pediatr, 35(4), 185-90.
Mathews, F., Yudkin, P., & Neil, A. (1999). Influence of maternal nutrition on outcome of pregnancy: prospective cohort study. Br Med J, 319, 339-43.
Mikode, M. S. & White, A. A. (1994). Dietary assessment of middle-income pregnant women during the first, second, and third trimesters. J Am Diet Assoc, 94(2), 196-9.
Muslimatun, S., Schmidt, M. K., West, C. E., Schultink, W., Gross, R., & Hautvast, J. G. (2002). Determinants of weight and length of Indonesian neonates. Eur J Clin Nutr, 56, 947-951.
Naeye, R. L. (1979). Weight gain and the outcome of pregnancy. Am J Obstet Gynecol, 135(3), 3-9.
Neggers, Y. H., Goldenberg, R. L., Tamura, T., Cliver, S. P., & Hoffman, H. J. (1997). The relationship between maternal dietary intake and infant birthweight. Acta Obstet Gynecol Scand Suppl, 165, 71-5.
Newman, V., Norcross, W., & McDonald, R. (1991). Nutrient intake of low-income Southeast Asian pregnant women. J Am Diet Assoc, 91(7), 793-9.
Oguntona, C. R. & Akinyele, I. O. (2002). Food and nutrient intakes by pregnant Nigerian adolescents during the third trimester. Nutrition, 18(7-8), 673-9.
Perry, H., Muita, J. W., & Omwega, A. M. (1996). Dietary habits, pregnancy weight gain and birthweights in a highland population of Kenya. East Afr Med J, 73(7), 424-6.
Prema Ramachandran, M. D. (2002). Maternal Nutrition-Effect on fetal Growth and Outcome of Pregnancy. Nutr Rev, 61(5), S26-34.
Robinson, S., Godfrey, K., Osmond, C., Cox, V., & Barker, D. (1996). Evaluation of a food frequency questionnaire used to assess nutrient intakes in pregnant women. Eur J Clin Nutr, 50(5), 302-8.
Rogers, I. & Emmett, P. (1998). Diet during pregnancy in a population of pregnant women in South West England. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Eur J Clin Nutr, 52(4), 246-50.
Suitor, C. J. W., Gardner, J., & Willett, W. C. (1989). A comparison of food frequency and diet recall methods in studies of nutrient intake of low-income pregnant women. J Am Diet Assoc, 89(12), 1786-94.
Swensen, A. R., Harnack, L. J., & Ross, J. A. (2001). Nutritional assessment of pregnant women enrolled in the Special Supplemental Program for Women, Infants, and Children (WIC). J Am Diet Assoc, 101(8), 903-8.
Takimoto, H., Yoshiike, N., Katagiri, A., Ishida, H., & Abe, S. (2003). Nutritional status of pregnant and lactating women in Japan: a comparison with non-pregnant/non-lactating controls in the National Nutrition Survey. J Obstet Gynaecol Res, 29(2), 96-103.
van Raail, J. M. A. (1995). Energy requirements of pregnancy for healthy Dutch women. Eur J Obstet Gynecol Reprod Biol, 61(1), 7-13.
Wei, E. K., Gardner, J., Field, A. E., Rosner, B. A., Colditz, G. A., & Suitor, C. J. W. (1999). Validity of a food frequency questionnaire in assessing nutrient intakes of low-income pregnant women. Matern Child Health J, 3(4), 241-6.