精准营养治疗妊娠期糖尿病孕妇的分娩结局及其子代预后的研究  

Study on the delivery outcome and prognosis of offspring of gestational diabetes mellitus women treated with precision nutrition

作　　者：金日男[1] 蒋秋林 吴聪海 刘文慧 周玉霞[1] 刘钧方 包丽琴 肖丽兴 许玉香 Jin Rinan;Jiang Qiulin;Wu Conghai(Department of Obstetrics,Yuebei People’s Hospital,Shaoguan 512026)

机构地区：[1]粤北人民医院产科,广东韶关512026

出　　处：《中国现代医药杂志》2023年第7期6-11,共6页Modern Medicine Journal of China

基　　金：广东省韶关市科技计划项目(编号:210802174538662)

摘　　要：目的探讨精准营养治疗对妊娠期糖尿病(GDM)孕妇分娩结局的影响,并评价其子代的神经心理发育行为。方法收集2020年7月~2022年6月在我院规范产检并住院分娩的338例妊娠期糖尿病孕妇,其中185例纳入营养组,53例纳入胰岛素组,100例纳入未治疗组,另选择51例正常孕妇作为正常妊娠组。对比4组孕妇年龄、孕周、孕次、体重指数(BMI)、血糖水平、妊娠分娩结局,对比4组孕妇新生儿Apgar评分、体重、身高、不良结局及子代在6月龄、12月龄时的神经心理发育行为评分。结果4组的孕次、孕前BMI差异有统计学意义(P<0.05),未治疗组孕妇的孕次多于其他组,胰岛素组孕前及分娩前BMI均高于其他组。4组干预前及分娩前空腹血糖(FPG)及餐后2h血糖(2hPBG)水平差异均有统计学意义(P<0.05)。未治疗组分娩前FPG及2hPBG水平均高于其他组。4组间除外产后出血发生率,其他不良分娩结局差异均有统计学意义(P<0.05)。正常妊娠组新生儿体重高于其他组,未治疗组新生儿出生后即刻血糖水平低于其他组(P<0.05)。未治疗组新生儿肺炎、转NICU发生率均高于其他组(P<0.05)。4组子代在6月龄、12月龄时的神经心理发育评分差异有统计学意义(P<0.05),妊娠期糖尿病孕妇子代的评分低于正常妊娠组,妊娠期糖尿病孕妇子代组间差异无统计学意义(P>0.05),且4组评分均随月龄的增长而增高(P<0.05)。结论精准营养治疗可以有效降低妊娠期糖尿病孕妇不良妊娠结局及对其子代的不良影响。妊娠期糖尿病对子代早期智能评分有一定影响,但可能与血糖控制程度无明显关系。Objective To explore the effect of precision nutrition therapy on the delivery outcome of pregnant women with gestational diabetes mellitus(GDM)and evaluate the neuropsychological development of their offspring.Methods 338 pregnant women with GDM who underwent standardized prenatal examination and delivered in hospital in our hospital from Jul 2020 to Jun 2022 were collected,including 185 cases in the nutritional group,53 cases in the insulin group,100 cases in the untreated group and 51 normal pregnancy women in the normal pregnancy group.The age,gestational week,gestational frequency,BMI,plasma glucose level,pregnancy and delivery outcomes were compared among the four groups,including Apgar score,weight,height,adverse outcomes,the neuropsychological developmental behavioral scores of the offspring at 6 and 12 months of age were also compared.Results There was significant difference in gravidity and BMI before pregnancy among the four groups(P<0.05).The gravidity of pregnant women in the untreated group were more than those in the other groups,and the pre-pregnancy and pre-delivery BMI in the insulin group were higher than those in the other groups.The average differences of fasting plasma glucose(FPG)and 2-hour postprandial blood glucose(2hPBG)before intervention and delivery were statistically significant in the four groups(P<0.05).The FPG and 2hPBG in the untreated group before delivery were higher than those in the other groups.Except the incidence of postpartum bleeding,there was a significant difference in other adverse pregnancy outcomes among the four groups(P<0.05).The weight of newborns in the normal pregnancy group was higher than that in other groups,while the plasma glucose level of newborns in the untreated group was lower immediately after birth than that in the other groups(P<0.05).The incidence of neonatal pneumonia and NICU conversion in the untreated group was higher than those in the other groups(P<0.05).There was a statistically significant difference in the neuropsychological development ev

关 键 词：妊娠期糖尿病 子代 营养治疗 神经心理发育 

分 类 号：R714.256[医药卫生—妇产科学]