| 摘要: | 國人服用膳食補充品（簡稱補充品）的趨勢日益提昇，但國內卻缺乏服用補充品對孕婦影響的相關研究。本研究採用橫斷式調查嘉南地區懷孕婦女服用補充品的現況，收集孕婦基本資料、24小時飲食回憶、飲食頻率、疾病史、併發症和血液營養生化檢驗。共收案人數418人，結果顯示服用補充品人數為73.2%。服用綜合維他命65.4% 最高、其次為鈣片39.9%、媽媽奶粉30.7%。最近一個月有無服用補充品與血液生化值的分析中，服用補充品的孕婦，其血清鐵 (Fe)、運鐵蛋白飽和度 (TS) 及葉酸 (folate) 的值皆顯著高於沒有服用補充品的孕婦，分別依序增加了 30.2% (Fe) 、29.6% (TS) 及 76.4% (folate)；未服用補充品的孕婦，其 Fe 的平均值未達正常標準。依據孕婦二十四小時飲食回憶與補充品的攝取，估算總鈣攝取量，顯示服用高鈣組（鈣≧1000 mg）的孕婦，其Fe、TS 顯著高於中鈣組（500 mg≦鈣<1000 mg）及低鈣組（鈣<500 mg），Folate顯著高於低鈣組；每日總鐵攝取量≧45mg的高鐵組孕婦，其 Fe顯著高於低鐵組 ( 鐵<15 mg )，TS、Folate 的平均值顯著高於中鐵組 ( 15 mg≦鐵<45 mg) 與低鐵組，顯示總鐵攝取量須達高鐵組劑量，孕婦之 Fe 及 TS 血液生化值始達正常標準；服用高劑量葉酸組 ( 葉酸≧400 μg ) 的孕婦，血液生化值中 Fe、TS、Folate 的平均值顯著高於低葉酸組（葉酸<400 μg），分別依序增加了 21.5% ( Fe)、25.7% (TS)、84.7% (Folate)。最近一個月服用補充品的孕婦，懷孕初期有水腫、失眠症狀的比率顯著高於沒有服用的孕婦 ( p < 0.05 )；此外，服用 ”營養保健食品” 的孕婦，第一孕期有過敏症狀為沒有服用的13.5倍 (OR=13.5，95%CI=1.4-130.2)；服用補充品的孕婦，其第三孕期有脹氣的比率顯著較高 (p < 0.05)。然而，懷孕初期傾向不會害喜，而第三孕期較無抽筋症狀的現象 (OR=0.5，95%CI=0.3-1.0)。服用補充品與孕婦的疾病、醫療史及新生兒的體重皆無顯著影響。綜合研究結果顯示服用膳食補充品確實會影響血液生化值，可能也與併發症互有因果關係。
Little is known about the effects of dietary supplements ingested by pregnant woman on health, though the usage rate of dietary supplements grows with each passing day. The purpose of this study was to investigate the usage patterns of supplements, and to identify factors that might influence these patterns of the pregnant women in Chia-Nan area, Taiwan. A cross sectional survey was used in this study. Data were collected by basic demographics, 24 hour dietary recall, food frequency, disease history, complication and blood sample for measurement of nutritional biochemical indicators. A total of 418 pregnant women were analyzed to delineate patterns of supplement usage. The results indicated that 306 (73.2 %) of subjects took dietary supplements. The top three types of supplements consumed were: multivitamins and minerals (65.4 %), calcium (39.9 %) and Mama milk (30.7 %) in that order. Use of dietary supplements of pregnant women in recent a month had significantly higher serum iron (Fe), transferrin saturation (TS) and folate than nonuser; the above examinations were increased 30.2%, 29.6%, 76.4%, respectively. However, the serum iron was under the normal value in supplements nonusers. According to 24 hour dietary recall and supplements intake, high calcium intake in pregnant women (calcium≧ 1000 mg) were significantly higher Fe and TS than middle (500 mg≦ calcium < 1000 mg) and low calcium (calcium < 500 mg) intake; and higher folate than low calcium intake. High iron intake in pregnant women (iron≧ 45mg) were significantly higher Fe than low iron (iron < 15mg) intake; and higher TS and folate than middle (15 mg≦ iron < 45 mg) and low calcium intake. Moreover, Fe and TS approached to normal level must be only in a high iron intake. High folate intake (folate ≧ 400 μg) in pregnant women were significantly higher Fe, TS and folate than low folate intake (folate < 400 μg), the above examinations were increased 21.5%, 25.7%, 84.7%, respectively. Supplements user of pregnant women in recent a month showed more edema and were more likely to have insomnia in the first gestation (p < 0.05). Furthermore, pregnant women who took “nutritional supplements” had trouble with 13.5 times for allergic symptom in the first gestation (OR=13.5, 95% CI=1.4-130.2 ), and who took supplements had higher flatulence in the third gestation (p < 0.05). However, they were less likely to have morning sickness in the first gestationand spasm symptom in the third gestation (OR=0.5, 95% CI=0.3-1.0).There were no relationship between medical / diseases history, outcome of newborn and use of dietary supplements. In conclusion, the frequency and number of supplement types could affect nutritional biochemical indicators from blood sample, and may be related to complication in the pregnancy. |
