早期营养干预对高危糖尿病计划怀孕女性体重、营养及妊娠结局的影响  

Effects of early nutrition intervention on weight,nutrition and pregnancy outcome of planned pregnant women with high risk diabetes mellitus

作　　者：刘艳秋 闵玲[2] LIU Yan-qiu;MIN Ling(Department of Obstetrics and Gynecology,The First People s Hospital of Shuangliu District,Chengdu 610200,China;Department of Obstetrics and Gynecology,West China Women and Children Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]成都市双流区第一人民医院妇产科,四川成都610200 [2]四川大学华西妇女儿童医院妇产科,四川成都610041

出　　处：《实用医院临床杂志》2018年第2期72-75,共4页Practical Journal of Clinical Medicine

基　　金：四川省卫生和计划生育委员会科研基金资助项目(编号:1400592)

摘　　要：目的探讨早期营养干预对高危糖尿病计划怀孕女性体重、营养及妊娠结局的影响。方法回顾性分析于我院行孕前检查并一次性宣教干预的高危糖尿病计划怀孕女性(对照组)和孕前检查后予以院外医学营养治疗(MNT)干预的高危糖尿病计划怀孕女性(对照组)各465例临床资料。比较两组孕前检查及孕前检查后8周时糖代谢、营养状态指标水平变化;随访1年,记录两组妊娠结局及妊娠期糖尿病(GDM)发病率差异。结果孕前检查后8周时,试验组糖代谢指标水平均较孕前检查时下降,且低于同期对照组(P<0.05);试验组体质量指数(BMI)、体脂率、瘦体重水平均较孕前检查时无明显变化(P>0.05),但明显低于对照组(P<0.05);试验组血清总蛋白(TP)、血清白蛋白(ALB)水平均较孕前检查时显著提升,且明显高于对照组(P<0.05)。随访1年内,两组妊娠率比较差异无统计学意义(P>0.05);GDM发病率、剖宫产率、分娩并发症发生率均明显低于对照组(P均<0.05),而分娩率及阴道自然分娩率均明显高于对照组(P<0.05)。结论早期营养干预可有效优化糖尿病高危女性营养状态,改善妊娠结局,有利于其孕期健康及预后分娩。To explore the effects of early nutrition intervention on weight,nutrition and pregnancy outcome of planned pregnant women with high risk diabetes mellitus.The clinical data of patients with high-risk diabetes mellitus was retrospectively analyzed.The control group(n=465)was treated with one-time health education intervention after examination,and the experimental group(n=465)was given medical nutrition therapy(MNT)out of the hospital.The glucose metabolism and the nutritional status were compared between the two groups before prenatal examination and at 8 weeks after prenatal examination.The incidence of pregnancy outcomes and gestational diabetes mellitus(GDM)were recorded at 1 year of follow-up.After 8 weeks of prenatal examination,the glucose metabolism indexes(FPG,2 h-PG and HbA1c)in the experimental group were significantly lower than those before prenatal examination and those in the control group at the same period(all P<0.05).There was no significant change in BMI,body fat rate and lean body weight in the experimental group before prenatal examination(P>0.05),but lower than the control group(all P<0.05).The levels of TP and ALB in the experimental group were significantly higher than those before prenatal examination and in the control group(P<0.05).There was no significant difference in the pregnancy rate between the two groups at 1 year of follow-up(P>0.05).The incidence of GDM,cesarean section and childbirth complications were significantly lower in the experimental group than those in the control group(all P<0.05)while the delivery rate and the natural rate of vaginal delivery were significantly higher than those in the control group(all P<0.05).Early nutrition intervention can effectively optimize the nutritional status of women with high-risk diabetes mellitus,and improve the pregnancy outcome.It is conducive to its pregnancy and prognosis of childbirth.

关 键 词：早期营养干预 糖尿病 高危 营养 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]