妊娠期糖尿病影响因素及个体化医学营养治疗效果研究  

Analysis of influencing factors of gestational diabetes mellitus and the intervention effect of individualized medical nutrition therapy

作　　者：莫倩 柳学琴 赵茜[1] 王海燕 杭悦霞[2] 牛建梅 杨倩雯 MO Qian;LIU Xue-qin;ZHAO Qian;WANG Hai-yan;Hang Yue-xia;NIU Jian-mei;YANG Qian-wen(Department of Clinical Nutrition,Health Management Center of Ningxia Hui Autonomous Region People's Hospital,Yinchuan,Ningxia 750002,China;不详)

机构地区：[1]宁夏回族自治区人民医院健康管理中心临床营养科,宁夏银川750002 [2]宁夏回族自治区人民医院妇产科

出　　处：《中国妇幼保健》2023年第15期2829-2832,共4页Maternal and Child Health Care of China

基　　金：西北民族大学2019年中央高校基本科研业务项目(31920190189)。

摘　　要：目的 探讨妊娠期糖尿病(GDM)的影响因素及个体化医学营养治疗(MNT)的干预效果。方法 选取2019年6月—2020年12月在宁夏回族自治区人民医院产科产检的孕妇180例,按是否患有GDM分为对照组(60例)和病例组(120例)。病例组随机分为两组(各60例),分别实施个体化MNT和传统营养指导。分别采用单因素、多因素logistic回归分析探讨GDM的影响因素,比较个体化MNT组和传统营养指导组的妊娠结局、妊娠期并发症及新生儿健康情况。结果 单因素logistic回归分析显示,病例组和对照组文化程度、喜爱甜食、孕前BMI、孕前运动及糖尿病家族史比较,差异均有统计学意义(χ^(2)=12.692、4.711、11.141、10.520及7.625,均P<0.05)。多因素分析显示,孕前BMI≥25 kg/m^(2)、糖尿病家族史是GDM发生的危险因素(OR=5.606,95%CI=1.912~16.433;OR=3.210,95%CI=1.244~8.281;均P<0.05);文化程度、孕前运动是GDM的保护因素(OR=0.368,95%CI=0.199~0.679;OR=0.394,95%CI=0.193~0.805;均P<0.05)。巨大儿、剖宫产率(瘢痕子宫除外)、妊娠期高血压疾病发生率在个体化MNT组、传统营养指导组和对照组间比较,差异均有统计学意义(χ^(2)=-3.030、19.557及13.501,均P<0.05),羊水过多、产后出血、胎儿窘迫及早产发生率组间比较,差异均无统计学意义(均P>0.05)。结论 孕前BMI≥25 kg/m^(2)、有糖尿病家族史是GDM发生的危险因素,文化程度高、孕前运动是GDM的保护因素,进行个体化医学营养治疗需综合考虑以上因素并积极干预,以降低GDM的发生率,预防妊娠期并发症和不良妊娠结局的发生。Objective To explore the influencing factors of gestational diabetes mellitus(GDM) and the intervention effect of individualized medical nutrition therapy(MNT).Methods A total of 180 pregnant women who received obstetric examination in Ningxia Hui Autonomous Region People's Hospital from June 2019 to December 2020 were divided into control group(60 cases) and case group(120 cases) according to whether they had GDM.The case group was randomly divided into 2 groups(60 cases in each group),which received individualized MNT and traditional nutrition guidance,respectively.Univariate and multivariate logistic regression analysis was used to analyze the influencing factors of GDM,and the pregnancy outcome,pregnancy complications and neonatal health of the individualized MNT group and the traditional nutrition guidance group were compared.Results Single factor logistic regression analysis showed that there were significant differences in education level,sweet taste,BMI before pregnancy,pre-pregnancy exercise,family history of diabetes mellitus between case group and control group(χ^(2)=12.692,4.711,11.141,10.520 and 7.625,all P<0.05).Multivariate analysis showed that pre-pregnancy BMI≥25 kg/m^(2) and family history of diabetes were risk factors for GDM(OR=5.606,95%CI=1.912-16.433;OR=3.210,95%CI=1.244-8.281;all P<0.05);Education level and pre-pregnancy exercise were protective factors of GDM(OR=0.368,95%CI= 0.199-0.679;OR=0.394,95%CI=0.193-0.805;all P<0.05).There were significant differences in the rates of macrosomia,cesarean section(except scar uterus) and pregnancy hypertension among the individualized MNT group,the traditional nutrition education group and the control group(χ^(2) =-3.030,19.557 and 13.501,all P<0.05).There were no significant differences in the incidence of hyperhydramnios,postpartum hemorrhage,fetal distress and premature delivery(all P>0.05).Conclusion Pre-pregnancy BMI≥25 kg/m^(2) and family history of diabetes are the risk factors for GDM.High education level and pre-pregnancy exercise are t

关 键 词：妊娠期糖尿病 影响因素 医学营养治疗 

分 类 号：R714.25[医药卫生—妇产科学]