卫生研究

目的 调查评价成都地区各孕期孕妇钙摄入水平及来源。方法 利用成都孕妇队列数据，以成都市2017年某三甲妇幼医疗机构产前门诊孕8～14周健康单胎孕妇为研究对象，通过问卷调查收集孕妇基本信息及各孕期近1个月内钙补充剂使用情况，采用3天24小时膳食回顾法收集孕妇各孕期膳食信息，依据《中国食物成分表(2018)》计算膳食钙摄入量和不同食物钙贡献率，将膳食钙和补充剂钙摄入量累加获得总钙摄入量。参照《中国居民膳食营养素参考摄入量(2013)》评价钙摄入。结果 最终纳入有效样本孕早期1653例，孕中期1024例，孕晚期1017例。孕早、中、晚期总钙摄入量中位数分别为523.3、1280.5和1491.3 mg/d;总钙摄入量充足率分别为16.3%、63.2%和67.1%,总钙不足率分别为69.0%、15.7%和11.2%,总钙过量率分别为0.2%、9.1%和14.4%。孕早、中、晚期膳食钙摄入量中位数分别为453.0、613.0和723.0 mg/d;膳食钙充足率分别为7.1%、9.7%和16.2%,膳食钙不足率分别为82.0%、75.0%和62.6%。各孕期膳食钙主要来源均为奶类、蔬菜类、谷薯类，奶类钙贡献率分别为33.8%、37.7%和40.2%,奶类摄入量中位数分别为125.0、235.3和250.0 g/d。总体孕妇孕早、中、晚期钙补充剂使用率分别为36.2%、93.4%和91.7%,补充剂钙摄入量中位数分别为0.0、625.0和750.0 mg/d。膳食钙充足的孕妇孕早、中、晚期钙补充剂使用率分别为38.1%、95.0%和94.5%,补充剂钙摄入量中位数分别为0.0、725.0和750.0 mg/d。结论 成都地区孕妇总钙摄入不足和过量问题并存，各孕期膳食钙摄入不足问题均突出，孕中、晚期钙补充剂使用普遍。

OBJECTIVE Investigate and evaluate the levels and sources of calcium intake of pregnant women in Chengdu during three trimesters.METHODS Use the data of a cohort study in Chengdu in 2017. The healthy singleton pregnant women with 8-14 weeks of pregnancy in an obstetrical clinic of a maternal-and-child health care institution in Chengdu were selected as the object of the study.Data on maternal demographic characteristics and the use information of calcium supplements in the past month of each trimester were collected by questionnaire investigation. The dietary intakes data of pregnant women in each trimester was collected by the 3-day 24-hour dietary recall method. The dietary calcium intake and the contribution of calcium from different foods were calculated based on the Chinese Food Composition Table(2018). The total calcium intake was obtained by adding the dietary calcium and supplement calcium intake. The calcium intake was evaluated with reference to the Chinese Dietary Nutrient Reference Intakes(2013).RESULTS Valid samples of 1653 cases in early pregnancy, 1024 cases in middle pregnancy and 1017 cases in late pregnancy were finally included. The median intake of total calcium was 523.3, 1280.5 and 1491.3 mg/d in three trimesters, respectively. The adequate rate of total calcium intake was 16.3%, 63.2% and 67.1%, the insufficient rate was 69.0%, 15.7% and 11.2%, the excess rate was 0.2%, 9.1% and 14.4%, respectively. The median intake of dietary calcium was 453.0, 613.0 and 723.0 mg/d in three trimesters respectively. The dietary calcium adequate rates were 7.1%, 9.7% and 16.2%, the dietary calcium deficiency rates were 82.0%, 75.0%, 62.6%, respectively. The main food sources of dietary calcium in each pregnancy were dairy foods, vegetables, tubers and grains. The contribution of dairy foods to the dietary calcium was 33.8%, 37.7% and 40.2%, respectively. The median intake of milk was 125.0, 235.3 and 250.0 g/d, respectively. Among all pregnant women, the calcium supplement use in three trimesters was 36.2%, 93.4% and 91.7%, respectively; the median intake of supplement calcium was 0.0, 625.0 and 750.0 mg/d, respectively. Among pregnant women who met the dietary calcium standard, the use of calcium supplements in the three trimesters was 38.1%, 95.0% and 94.5%, respectively; the median intake of supplemental calcium was 0.0, 725.0 and 750.0 mg/d, respectively.CONCLUSION The insufficient and excessive total calcium intake coexisted among pregnant women in Chengdu, with the insufficient dietary calcium intake prominent in all trimesters. The use of calcium supplements was common in middle and late pregnancy.