饮食干预对妊娠期糖代谢异常围生结局的影响

Effect of diet intervention on perinatal outcomes in pregnant women with abnormal glycometabolism

目的：对妊娠期糖尿病（GDM）和妊娠期糖耐量减低（GIGT）孕妇给予合理的饮食控制，以期降低围生期并发症。方法：选择石家庄市第四医院2008年1～7月产前检查确诊为GDM孕妇62例（其中GDM32例，GIGT30例）为饮食干预组，选择同期正常分娩孕妇62例作为对照组。饮食干预组由“孕期营养分析与指导系统”评估膳食结构及营养代谢状况，然后由产科医生和围产营养门诊医生、专职护士进行饮食指导，两组孕妇均由产科医生和围产营养医生、护士进行定期随访，比较饮食干预组干预前后血糖控制情况和围生结局。结果：饮食干预后孕妇血糖控制满意58例，占93．55％（58／62），其中GDM孕妇4例，需加用胰岛素治疗；GIGT孕妇全部单纯饮食控制满意；干预组剖宫产率与对照组比较具有统计学差异（P〈0．05）；干预组子痫前期、羊水过多、巨大儿、新生儿呼吸窘迫综合征、新生儿低血糖发生率与对照组比较无统计学差异（P〉0．05）。结论：加强饮食干预可有效地改善血糖水平，减少围生期并发症。

Objective： To offer appropriate diet intervention to pregnant women with gestational diabetes （GDM） and gestational impaired glucose tolerance （GIGT）, reduce complications during perinatal period. Methods： 62 pregnant women diagnosed as GDM from January 2008 to July 2008 were selected as intervention group （32 women with GDM and 30 women with GIGT） and 62 normal pregnant women in the same period were selected as control group. Intervention group received diet intervention, pregnant women in two groups were regularly followed up; the level of blood glucose and perinatal outcomes of pregnant women in intervention group were compared before and after the intervention. Results： After the diet intervention, 58 pregnant women （93.55%） were satisfied with the control of blood glucose; and 4 pregnant women （6. 45% ） with GDM needed insulinization; all the pregnant women with GIGT were satisfied with the control of blood glucose by only diet intervention ; there was significant difference in abdominal delivery rate between two groups （ P 〈 0. 05 ） ; while there was no significant difference in the incidence of prceclampsia, hydramnion, giant baby, respiratory distress syndrome of newborn and neonatal hypoglycemia （ P 〉0. 05 ） . Conclusion ： Strengthening the diet intervention can effectively ameliorate the level of blood glucose and reduce the complications in perinatal period.