孕期个性化膳食营养指导对母婴健康和妊娠结局的影响

EFFECTS OF PERSONALIZED DIETARY GUIDANCE ON MATERNAL AND NEONATAL HEALTH IN PREGNANT WOMEN

目的探讨孕期个性化膳食营养指导对母婴健康和妊娠结局的影响。方法选取2016年6月至2019年6月在武汉市某妇幼保健院产科门诊建立孕产妇保健手册的492名孕妇。按照随机化的方法,把研究对象分对照组和干预组,每组246人。对照组仅给予常规孕期健康知识宣教、健康检查和膳食调查;干预组在对照组的基础上,根据孕妇营养健康状况,给予全面专业的膳食营养宣教和个性化膳食营养指导。干预周期为自怀孕建档起持续到分娩。在孕中期和孕晚期对两组孕妇各开展一次膳食评估。采用t检验和卡方检验探究孕中、晚期两组之间营养素摄入及妊娠结局有无差异,评价个性化膳食营养干预的效果。结果孕中期干预组孕妇能量、蛋白质、钙、铁、维生素A摄入量明显高于对照组(P<0.05);孕晚期干预组孕妇能量、蛋白质、钙、铁、维生素A、维生素B2摄入量显著高于对照组(P<0.05),孕中晚期脂肪供能比均显著低于对照组(P<0.05),低出生体重儿、巨大儿、剖宫产、妊娠期糖尿病发生率均明显低于对照组,其差异具有统计学意义(P<0.05)。结论孕期科学合理的个性化膳食营养指导,在保证孕期均衡营养的同时,可降低巨大儿、剖宫产和妊娠期糖尿病的发生率,促进优生优育,有利于母婴健康。

Objective To investigate the effects of personalized dietary guidance on maternal and child health.Methods A total of 492 pregnant women who registered in a maternal health system in the obstetric clinic of a maternal and child health hospital in Wuhan from June 2016 to June 2019 were included in this study.The participants were randomly divided into the control and intervention groups,with 246 people in each group.The pregnant women in the control group were only given routine health education,health examination and dietary survey during pregnancy.The pregnant women in the intervention group were given comprehensive professional dietary nutrition education and personalized dietary guidance additionally,according to the nutritional health status of pregnant women.The intervention lasted to the delivery.A dietary assessment was performed in each group of pregnant women in the second and third trimesters.Either t-test or chi-square test was used to investigate whether there were differences in nutrient intake and pregnancy outcomes between two groups,and to evaluate the effects of personalized dietary interventions.Results The intake of energy,protein,calcium,iron and vitamin A in the second trimester was significantly higher in the intervention group than in the control group(P<0.05).The intake of energy,protein,calcium,iron,vitamin A and vitamin B2 in the third trimester was significantly higher in the intervention group than in the control group(P<0.05),and the ratio of fat energy supply in the second and third trimesters was also significantly lower than in the control group(P<0.05).The incidences of low birth weight,macrosomia,cesarean section and gestational diabetes were significantly lower in the intervention group than the control group,with statistically significant differences(P<0.05)..Conclusion Scientific and reasonable personalized dietary guidance during pregnancy,while ensuring balanced nutrition during pregnancy,can reduce the incidences of macrosomia,cesarean section and gestational diabetes,promote eugenics and fertility,and benefit the health of mothers and babies.