膳食模式对妊娠糖代谢异常孕妇体重及胎儿出生体重的影响

Effect of dietary patterns on the maternal weight changes and neonatal birth weight in pregnant women with gestational abnormal glucose metabolism

目的:观察膳食模式(低血糖指数食物模式)对妊娠糖代谢异常孕妇体重及胎儿出生体重的影响。方法:糖负荷或糖耐量试验筛查出糖代谢异常、孕24～28周孕妇92例,来营养科就诊46例孕妇为膳食管理组,对其进行糖耐量试验筛查前3个月食物摄入频度调查。根据其营养评价的信息、孕前BMI、个体具体情况,为其制订个性化的营养处方,给予低血糖指数食物模式;没来营养科就诊另外46例孕妇为膳食非管理组,只列行常规的产科检查。观察2组孕妇孕期体重增长速度及巨大儿发生率。结果:膳食管理组孕妇体重增长(孕前～分娩)13.04±4.12 kg;(孕29～分娩)3.04±3.77 kg;巨大儿发生率6.5%,明显低于膳食非管理组孕妇体重增长分别为16.52±4.47 kg;7.06±3.13 kg;巨大儿发生率30.4%(P<0.01),膳食管理组妊娠并发症发生率低于非膳食管理组。结论:合理膳食模式(低血糖指数食物模式)可以改善糖代谢异常孕妇体重增长速度及胎儿出生体重,妊娠并发症发生率减少,母胎结局明显改善。

Objective： To learn the effect of dietary patterns（low glycemic index dietary patterns）on the maternal weight changes and neonatal birth weight in pregnant women with gestational abnormal glucose metabolism.Methods：Ninety-two pregnant women with gestational abnormal glucose metabolism were recruited with the glucose challenge or tolerance test,they have been pregnant for 24 to 28 weeks.Forty-six pregnant women with gestational abnormal glucose metabolism received diet management（low glycemic index dietary patterns）.The food intake frequency for 3 months before the test was investigated of diet management group（dietary patterns regulation group） that dietary patterns regulation was designed for each women based on the nutrtional assessment,individual status,etc.Low glycemic index dietary patterns were adopted by diet management group.Other 46 pregnant women with gestational abnormal glucose metabolism without diet management who only received routine obstetrical checkup.The changes of the weight gain in pregnant women and neonatal birth weight were observed.Results：The maternal weight changes of pregnant women who received diet management increased（13.04±4.12） kg from pre-gestation to delivery and（3.04±3.77） kg from 29 to delivery,which was significantly lower than those of non-diet management pregnant women（16.52±4.47） kg from pre-gestation to deliver and（7.06±3.13） kg from 29 to deliver（P 〈 0.01）.Incidence of fetal macrosomia was significantly lower than 6.5% vs 30.4%（p 〈 0.01）between diet management group and non-diet management group,respectively.Incidence of maternal and fetal outcomes decreased obviously,with diet management group.Conclusions：dietary patterns（low glycemic index dietary patterns）would be beneficial for better pregnancy outcome.