孕早期体质量控制教育对妊娠期糖尿病发病情况的影响

Influence of Education on Early-pregnancy Body Mass Control on the Incidence of Gestational Diabetes Mellitus

目的探讨孕早期对孕妇进行饮食指导与体质量控制教育对妊娠期糖尿病发病的影响。方法对2004年12月—2007年12月来进行孕检的16595例孕妇,根据孕早期建卡时是否进行过孕期饮食指导与体质量控制教育,分为接受体质量控制教育组(观察组)和未接受体质量控制教育组(对照组),比较两组产妇孕期体质量增加情况,并对两组产妇糖筛查试验阳性和糖耐量试验异常(gestational impaired glucose tolerance,GIGT)、妊娠期糖尿病(gestational diabetes mellitus,GDM)患病情况进行比较。结果对照组孕期体质量增加明显高于观察组(P<0.01),且对照组糖筛查试验阳性和GIGT、GDM发生率亦明显高于观察组(P<0.01)。孕期已发现糖筛查试验阳性和GIGT、GDM的孕妇其体质量增加情况与正常妊娠孕期体质量增加情况进行比较发现,糖筛查试验阳性和GIGT、GDM的孕妇,孕期体质量的增加明显高于正常妊娠者(P<0.01)。结论孕早期合理的体质量控制对预防糖筛查试验阳性和GIGT、GDM发生有明显效果,将体质量控制教育作为孕期初次产检的常规项目是非常必要的。

Objective To explore the influence of education on early-pregnancy body mass control and guidance on diet on the incidence of gestational diabetes mellitus （GDM）. Methods 16 595 pregnant women who had pregnancy tests in our center between Dec. 2004 and Dec. 2007 were divided into the observation group and the control group, according to whether or not they had been offered education on early-pregnancy body mass control and guidance on diet. A comparison was made of the increase in the body mass, the positivity of glucose screening tests, gestational impaired glucose tolerance （GIGT） and GDM between the two groups. Results The body mass increase of the control group was distinctly greater than that of the observation group （P〈0.01）, and the incidence rates of glucose screening test positivity, GIGT and GDM of the former were also significantly higher than those of the latter （P〈0.01）. And compared with the women with normal pregnancy, those with glucose screening test positivity, GIGT and GDM registered a distinctly higher increase in the body mass during pregnancy （P〈0.01）. Conclusion Reasonable control of body mass during pregnancy has a marked effect on the prevention of glucose screening test positivity, GIGT and GDM. Therefore, it is necessary to include the education on body mass control as a routine item in the initial pregnancy test.