膳食营养干预对妊娠期糖尿病妊娠结局的作用

目的 了解妊娠期糖尿病(GDM)患者的膳食营养摄入状况,并探讨膳食营养干预对妊娠结局的影响。 方法 选取2013年6月-2014年12月间因血糖控制不佳而入住上海交通大学医学院附属新华医院产科,并由临床营养科会诊的74例GDM孕妇(GDM组),以及同期入住我院产科的68例健康孕妇(正常组)。分别比较2组的基本资料、孕前体重指数、膳食营养摄入状况以及胎儿出生时情况。 结果 ①GDM组在年龄、总热量、脂肪、膳食纤维、钙及锌的摄入、脂肪占能百分比等指标上均低于正常组,但GDM组的孕前体重指数高于正常组,除年龄和孕前体重指数外,差异均无统计学意义(均P>0.05)。②接受膳食营养干预的GDM组与正常组相比较,娩出胎儿的出生体重、胎龄(38.03±2.08)个月 vs. (38.86±1.96)个月]以及SGA、AGA和巨大儿发生率差异无统计学意义(P>0.05);但在剖宫产率(76.9% vs. 79.4%)、LGA(16.6% vs. 11.61%)等方面,GDM组均低于正常组,且差异有统计学意义(P<0.05);2组新生儿出生时Apar评分均在正常范围内,无抢救史。 结论 GDM患者营养素摄入不均衡、孕前肥胖是其重要影响因素,应尽早积极开展合理有效的膳食营养干预以减少不良妊娠结局。 

Effect of dietary nutritional intervention on pregnancy outcomes of patients with gestational diabetes mellitus

Objective To investigate the dietary nutritional intake status of women with gestational diabetes mellitus (GDM),and study the influence of nutritional intervention to the pregnancy outcomes. Methods The clinical data of 142 pregnant women in our hospital were collected and divided into the GDM group (74 cases) and the healthy control group (68 cases).The basic information,pre-pregnancy BMI and dietary nutrition status of women,the born weight and health status of neonates were compared between the two groups. Results ①The age of pregnant women,nutritional intake (total calories,lipid,dietary fiber,calcium and zinc) and the percentage of fat in the GDM group were lower than those in the control group,however,the prepregnant BMI was higher than that in the control group,and the difference was significant between the two groups (P<0.05).②There were no significant differences in born weight,the incidence of SGA,AGA and macrosomia between the two groups (P>0.05).There were significant differences in gestational age(38.03±2.08) m vs.(38.86±1.96) m],cesarean section rate (76.9% vs.79.4%) and LGA (16.6% vs.11.61%),all of them were lower in the GDM group (P<0.05).The Apgar score of neonates in both groups were in regular range,and they had no history of rescue. Conclusion The unbalanced nutrients intake in patients with GDM is common,and pre-pregnant obesity is one of the important factors.The nutrition intervention should be done as early as it could be to decrease the negative pregnancy outcomes.