Association between the Diet Quality Index Adapted for Pregnant Women (IQDAG) and excess maternal body weight

Abstract Objectives: to investigate the relationship between the Diet Quality Index Adapted for Pregnant Women (IQDAG) and excess maternal body weight. Methods: a cross-sectional study was conducted with 754 adult pregnant women, in Ribeirão Preto, São Paulo, between 2011 and 2012. The criteria proposed by Atalah were used to classify the body mass index (BMI). Adjusted multinomial logistic regression models were employed to investigate the relationship between the IQDAG and being overweight and obese, estimating the odds ratio (OR) and the 95% confidence interval (CI95%). Results: the mean (SD) age of women was 28 (5) years, 33.4% were overweight and 25.6% obese. The pregnant women with higher scores in the IQDAG were less likely to be overweight [OR= 0.56 (CI95% = 0.37-0.85)] or obese [0.43 (0.26-0.71)]; those with higher scores in the "Fiber" [0.51 (0.33; 0.78)] and "Iron" [0.62 (0.40-0.96)] components were less likely to be overweight. However, women with higher scores in the percentage of energy from ultra-processed foods were more likely to be overweight [1.72 (1.10-2.94)] or obese [5.24 (2.80-9.80)], when compared to women with lower scores. Conclusions: poorer quality maternal diets were observed among the women who were overweight and obese during pregnancy.

摘要
研究目的：探讨适配孕妇的饮食质量指数（Diet Quality Index Adapted for Pregnant Women, IQDAG）与孕产妇体重超重及肥胖的相关性。
研究方法：于2011年至2012年在巴西圣保罗州里贝朗普雷图开展横断面研究，共纳入754名成年孕妇。采用Atalah提出的判定标准对体重指数（Body Mass Index, BMI）进行分级。通过校正后的多项逻辑回归模型分析IQDAG与超重、肥胖的关联，估算比值比（Odds Ratio, OR）及95%置信区间（95% Confidence Interval, CI95%）。
研究结果：受试孕妇的平均年龄为28±5岁，其中33.4%存在超重情况，25.6%达到肥胖标准。IQDAG得分较高的孕妇，发生超重[OR=0.56, 95%CI=0.37-0.85]或肥胖[OR=0.43, 95%CI=0.26-0.71]的风险显著降低；其中“膳食纤维”分量表得分较高者，超重风险更低[OR=0.51, 95%CI=0.33-0.78]；“铁”分量表得分较高者，同样表现出更低的超重风险[OR=0.62, 95%CI=0.40-0.96]。但与得分较低的孕妇相比，超加工食品供能占比更高的孕妇，其超重[OR=1.72, 95%CI=1.10-2.94]或肥胖[OR=5.24, 95%CI=2.80-9.80]的风险显著升高。
研究结论：妊娠期间合并超重及肥胖的孕产妇，其饮食质量普遍较差。