饮食和生活方式的咨询指导对孕妇体重指数及妊娠结局的影响

The influence of consulting diet and life style systematically on BMI and pregnancy outcomes in women

目的探讨系统性饮食和生活方式的咨询指导对孕妇体重指数（body mass index,BMI）及妊娠结局的影响。方法安徽医科大学第一附属医院产科门诊建档的孕妇280例,随机双盲分为接受常规产前检查的对照组（137例）和接受系统性饮食和生活方式咨询指导的实验组（143例）,观察产前干预措施对孕妇孕期BMI、美国医学研究会（the institute of medicine,IOM）指南遵从率、妊娠结局等影响。结果与对照组相比,实验组孕妇自孕28~38周的BMI降低;实验组的孕妇总体IOM遵从率和组内正常体重孕妇（BMI〈25）IOM遵从率均有明显提高,超重孕妇（BMI：25~）和肥胖孕妇（BMI≥30）的IOM遵从率有一定的提高,但差异无统计学意义（均有P〉0.05）;实验组孕妇的不良妊娠结局、妊娠期高血压疾病（hypertensive disorder complicating pregnancy,HDCP）、妊娠期糖尿病（gestational diabetes mellitus,GDM）的发生率均有不同程度地下降。结论系统性饮食和生活方式的咨询指导比常规产前检查更能有效的预防孕妇孕期BMI的过快增长、改善不良妊娠结局。

Objective To discuss the influence of consulting diet and life style on the BMI and the pregnancy outcome in pregnant women. Methods The 280 pregnant women in the Maternity Department of The First Affiliated Hospital of Anhui Medical University were divided into the control group who received routine prenatal check-up（ 137）,and the experiment group who received diet and life style consultation systematically（ 143）. The body mass index（ BMI）,adherence to the Institute of Medicine（ IOM） and the pregnancy outcome were observed. Results The BMI of the experiment group at 28-38 gestational weeks was significantly decreased compared to that of the control group. The adherence to the IOM guidelines of the experiment group and the normal body weight sub-group were both significantly increased. No statistically significant differences were noted in overweight as well as fat sub-group although there was an increasing trend. The incidence of abnormal pregnancy outcome,hypertensive disorder complicating pregnancy（ HDCP） and gestational diabetes mellitus（ GDM） in the experiment group were decreased at various degrees compared with the control group. Conclusions The systematical diet and life style consultation is more effective than the routine prenatal check-up in preventing the excessive increase of BMI and in improving the pregnancy outcome.