膳食营养及情绪对妊娠晚期睡眠障碍的影响

Effects of Dietary Nutrition and Mood on Sleep Disorders in Late Pregnancy

摘要: 目的：调查孕晚期妇女睡眠状况与妊娠期营养和情绪的关系，为通过饮食干预改善孕期睡眠质量、降低围产期心理疾病提供依据。方法：选取2023年1月至2023年12月于暨南大学附属第一医院产检的245名孕晚期(孕周 ≥ 28周)孕妇进行横断面调查。使用匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index, PSQI)量表评价孕妇的睡眠质量，采用抑郁量表(Patient Health Questionnaire, PHQ-9)和焦虑量表(Generalized Anxiety Disorder-7, GAD-7)评估孕妇的抑郁和焦虑情绪。通过食物频率问卷(Food Frequency Questionnaire, FFQ)收集孕妇对29种营养素和12种食物种类的摄入量，同时记录其不同社会人口学资料、产科资料及心理学资料。结果：调查显示245名孕妇中有89例(36.33%)存在妊娠晚期睡眠障碍，156例(63.67%)无睡眠障碍。膳食纤维摄入量、坚果类食物摄入量、GAD-7评分和PHQ-9评分均与孕妇妊娠晚期睡眠障碍有关(P < 0.05)。Logistic回归分析结果显示，抑郁情绪(OR = 0.089, 95% CI = 0.048~0.165)是孕妇妊娠晚期睡眠质量的独立危险因素(P < 0.05)。睡眠障碍组孕妇的膳食纤维(13.28 ± 9.02 g/天)和坚果类食物摄入量(10.69 ± 14.73 g/天)均低于无睡眠障碍组(18.18 ± 11.09 g/天和19.28 ± 38.86 g/天)，差异具有统计学意义(P < 0.05)。与睡眠障碍组相比，无睡眠障碍组的抑郁和焦虑情绪比例较低(P < 0.05)。结论：孕晚期妇女的睡眠障碍可能与膳食纤维和坚果摄入不足有关。针对性的饮食干预可能通过改善孕妇的睡眠质量，从而有助于降低妊娠期情绪问题。

Abstract: Objective: To investigate the relationship between sleep status and nutrition and mood during pregnancy in women in late pregnancy, and to provide a basis for intervening in sleep quality during pregnancy through diet and reducing perinatal mental illness. A cross-sectional survey was conducted on 245 pregnant women in late pregnancy (gestational age ≥ 28 weeks) who received prenatal check-up at the First Affiliated Hospital of Jinan University from January to December 2023. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of pregnant women. The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) were used to assess whether pregnant women had depression and anxiety, respectively. The intake of 29 nutrients and 12 food types of pregnant women was collected through a food frequency questionnaire (FFQ), and the relationship between various nutritional components in the diet of pregnant women with different sociodemographic, obstetric and psychological data and sleep disorders in late pregnancy was recorded. Methods: A total of 245 pregnant women were investigated, 89 cases (36.33%) had sleep disorders in late pregnancy, and 156 cases (63.67%) had no sleep disorders. Dietary fiber intake, nut food intake, GAD-7 score, and PHQ-9 score during pregnancy were all associated with sleep disorders in late pregnancy (P < 0.05). Logistic regression analysis showed that depression (OR = 0.089, 95% CI = 0.048~0.165) was an independent risk factor for sleep quality in late pregnancy (P < 0.05). The dietary fiber (13.28 ± 9.02 g/day) and nut intake (10.69 ± 14.73 g/day) of pregnant women in the sleep disorder group were lower than those in the non-sleep disorder group (18.18 ± 11.09 g/day; 19.28 ± 38.86 g/day), which was statistically significant (P < 0.05). Compared with the sleep disorder group, the proportion of depression and anxiety in the non-sleep disorder group was also lower (P < 0.05). Conclusion: Sleep disorders in women during late pregnancy may be related to insufficient intake of dietary fiber and nuts. Targeted dietary intervention may improve mood during pregnancy by regulating maternal sleep.