孕前优生指导配合孕期饮食规划在预防孕前超重肥胖孕妇妊娠期糖尿病中的应用  

Application of pre-pregnancy eugenic guidance combined with pregnancy diet plan in prevention of gestational diabetes mellitus in overweight and obese pregnant women before pregnancy

作　　者：周海燕 陈如 张王琴 戴慧梅 石晓聪 ZHOU Hai-Yan;CHEN Ru;ZHANG Wang-Qin(Department of Endocrinology,Wenzhou People's Hospital,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州市人民医院内分泌科,浙江温州325000 [2]温州市人民医院产科,浙江温州325000 [3]温州市人民医院输液室,浙江温州325000

出　　处：《中国妇幼保健》2021年第8期1717-1720,共4页Maternal and Child Health Care of China

基　　金：温州市科技局项目(Y20180615)。

摘　　要：目的探讨孕前优生指导配合孕期饮食规划在预防孕前超重肥胖孕妇妊娠期糖尿病的应用效果。方法选择2017年6月-2019年6月温州市人民医院收治的104例孕前超重肥胖孕妇随机分为研究组和对照组各52例,对照组孕妇接受单独的孕期饮食规划干预,研究组孕妇则接受孕前优生指导、孕期饮食规划联合干预,观察两组孕妇血糖、妊娠期体质量变化、妊娠期糖尿病发生率、分娩方式和妊娠结局。结果干预后1个月两组孕妇的空腹血糖、餐后2 h血糖水平均降低,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组孕前超重、肥胖孕妇的体质量增长均低于对照组孕妇,妊娠期糖尿病发生率1.92%低于对照组的15.38%,差异有统计学意义(P<0.05)。研究组孕妇的剖宫产率5.77%低于对照组的23.08%,阴道自然分娩率80.77%明显高于对照组的57.69%,差异有统计学意义(P<0.05)。研究组早产、胎儿窘迫、巨大儿发生率均高于对照组,差异有统计学意义(P<0.05)。结论孕前优生指导配合孕期饮食规划在预防孕前超重肥胖孕妇妊娠期糖尿病的应用效果确切,能有效控制孕妇血糖稳定,调节孕妇妊娠期体质量增长,减少或避免妊娠期糖尿病发生,提高阴道自然分娩率,改善妊娠结局,值得推广。Objective To explore the application effect of pre-pregnancy eugenic guidance combined with pregnancy diet plan in prevention of gestational diabetes mellitus(GDM) in overweight and obese pregnant women before pregnancy.Methods From June 2017 to June 2019,104 pre-pregnancy overweight and obese pregnant women treated in Wenzhou People’s Hospital were selected and randomly divided into study group and control group,52 patients in each group.The pregnant women in control group were given separate diet plan interventions during pregnancy,and the pregnant women in study group were given pre-pregnancy eugenic guidance combined with pregnancy diet plan.The blood glucose levels,the changes of body weight during pregnancy,the incidence rates of GDM,delivery modes,and pregnancy outcomes in the two groups were observed.Results At one month after intervention,fasting blood glucose and 2-hour postprandial blood glucose levels in the two groups decreased significantly,especially in study group(P<0.05).Body weight gain in study group was statistically significantly lower than that in control group,the incidence rate of GDM in study group was 1.92%,which was statistically significantly lower than that in control group(15.38%)(P<0.05).The rate of cesarean section in study group was 5.77%,which was statistically significantly lower than that in control group(23.08%),the rate of vaginal natural delivery in study group was 80.77%,which was statistically significantly higher than that in control group(57.69%)(P<0.05).The incidence rates of premature delivery,fetal distress,and macrosomia in study group were statistically significantly higher than those in control group(P<0.05).Conclusion The application effect of pre-pregnancy eugenic guidance combined with pregnancy diet plan in prevention of GDM in overweight and obese pregnant women before pregnancy is good,the method can effectively control blood glucose stability of pregnant women,regulate body weight gain of pregnant women during pregnancy,reduce or avoid the occurrence of GD

关 键 词：孕前优生指导 孕期饮食规划 孕前超重肥胖孕妇 妊娠期糖尿病 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]