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机构地区:[1]南京中医药大学附属昆山市中医医院妇产科,昆山215300
出 处:《生殖医学杂志》2016年第11期987-991,共5页Journal of Reproductive Medicine
基 金:昆山市社会发展科技专项(KS1560)
摘 要:目的研究孕期体重指数干预对妊娠期糖耐量受损孕妇妊娠结局的影响。方法将120例初次单胎妊娠的糖耐量受损的孕妇随机分为研究组和对照组各60例,对照组给予常规孕期检查及健康宣教,研究组在此基础上,基于孕期体重指数制定干预方案,包括饮食、计步器运动干预。观察两组孕妇妊娠合并症、妊娠结局及围产儿情况。结果研究组FBG(5.4±0.1vs.7.5±1.6)mmol/L、OGTT2h(8.7±0.5vs.10.3±0.8)mmol/L、HbA1c(6.8±0.5vs.8.1±1.0)%、妊娠期增重(6.1±0.3vs.8.4±1.0)Kg、GIGT持续率(44.6%vs.63.8%)、GDM发生率(17.9%vs.34.5%)、妊娠期高血压(14.3%vs.29.3%)、羊水异常(10.7%vs.25.9%)、早产(3.6%vs.13.6%)、产后出血(3.6%vs.8.6%)明显低于对照组,研究组胎儿窘迫(1.8%vs13.8%)、巨大儿(3.6%vs.15.5%)、新生儿低血糖发生率(3.6%vs.13.6%)均低于对照组,差异有统计学意义(P<0.05)。结论孕期体重指数制定个体化的干预措施,明显改善妊娠期糖耐量受损孕妇的妊娠结局,值得推广应用。Objective: To investigate the effects of intervention of pre-pregnancy body mass index on pregnancy outcome of pregnant women with gestational impaired glucose tolerance(GIGT). Methods: A total of 120 initial single pregnancy women with GIGT were randomly divided into experimental group(n=60)and control group(n=60). The patients in the control group were treated with routine pregnancy test and health education, while the patients in the experimental group experienced the intervention based on pre-pregnancy body mass index, including diet intervention and pedometer sports. The pregnancy complications, pregnancy outcome and perinatal situation were compared between the two groups. Results. The incidences of abnormal fasting blood glucose (FBG) ( 5.4 ± 0.1 vs. 7.5 ± 1.6) mmol/L, oral glucose tolerance test(OGTT)2 hours [(8.7±0.5 vs. 10.3±0.8)mmol/L],HbAlc(6.8±0.5 vs. 8.1 ±1.0)%,weight gain during pregnancy (6.1 ± 0. 3 vs. 8.4 ± 1.0) kg, and gestational impaired glucose tolerance(GIGT) persistence rate (44.6% vs. 63.8%), gestational diabetes mellitus (GDM) rate ( 17.9% vs. 34.5%),gestational hypertension rate (14.3% vs. 29.3%), abnormal amniotic fluid rate (10.7% vs. 25.9%),preterm birth rate(3.6% vs. 13.6%),postpartum hemorrhage rate(3.6% vs. 8.6%)in the experimental group were significantly lower than those in the control group(all P〈0.05). The incidences of fetal distress (1.8 % vs. 13.8 % ), fetal macrosomia (3.6 % vs. 15.5 % ) and neonatal hypoglycemia ( 3.6 vs. 13.6%)in the experimental group was significantly lower than those in the control group(all P〈 0.05). Conclusions: The individual intervention plan based on pre-pregnancy body mass index can significantly improve the pregnancy outcome of women with gestational impaired glucose tolerance.
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