孕期保健及营养指导对妊娠期糖尿病孕妇母婴结局及行为习惯的影响

Effects of antenatal care and nutrition guidance on maternal and neonatal outcomes and behavioral habits of pregnant women with gestational diabetes mellitus

目的探讨孕期系统性、针对性保健及营养指导对妊娠期糖尿病(GDM)孕妇母婴结局及行为习惯的影响,为GDM的治疗提供理论依据。方法选取2014年1月-2016年12月成都市金牛区妇幼保健院妇产科收治的320例GDM孕妇为研究对象,采用随机数表法分为对照组和观察组,每组各160例,对照组给予常规孕期保健,观察组在对照组的基础上给予孕期系统性、针对性保健及营养指导。观察两组孕妇干预前后空腹血糖、餐后2h血糖及糖化血红蛋白水平,对比两组孕妇妊娠结局和围生儿结局及两组科学饮食、适当运动、自测血糖、定时产检、讲究卫生等行为习惯的差异。结果干预前,两组空腹血糖、餐后2h血糖及糖化血红蛋白水平比较,差异无统计学意义(P>0.05);干预后,两组空腹血糖、餐后2h血糖及糖化血红蛋白水平均明显降低,且观察组低于对照组,两组相比差异有统计学意义(P<0.05)。两组孕妇剖宫产、妊娠期高血压疾病、羊水过多、感染、胎膜早破、产后出血发生率比较,差异有统计学意义(P<0.05)。两组早产、新生儿低血糖、巨大儿、胎儿窘迫、新生儿窒息、围生儿死亡发生率比较,差异有统计学意义(P<0.05)。观察组孕妇合理膳食、适当运动、卫生习惯、定期产检、自测血糖等行为习惯评分均高于对照组,两组比较,差异有统计学意义(P<0.05)。结论对GDM孕妇实施孕期系统的、针对性保健及营养指导效果显著,可有效控制血糖,改善母婴结局及孕妇不良行为习惯。

Objective To explore the effects of systematic,targeted antenatal care and nutrition guidance on maternal and neonatal outcomes and behavioral habits of pregnant women with gestational diabetes mellitus ( GDM) ,provide a theoretical basis for treatment of GDM.Methods A total of 320 pregnant women with GDM treated in Department of Gynecology and Obstetrics in Maternal and Child Health Care Hospital of Jinniu District from January 2014 to December 2016 were selected as study object,then they were divided into two groups according to random number table,160 pregnant women in each group.The pregnant women in control group were treated by conventional antenatal care,and the pregnant women in observation group were treated by systematic,targeted antenatal care and nutrition guidance based on conventional antenatal care.The levels of fasting blood glucose,postprandial 2-hour blood glucose,and glycosylated hemoglobin before and after intervention in the two groups were observed.The pregnancy outcomes,perinatal outcomes,and behavioral habits ( scientific diet,appropriate exercise,self-test blood glucose,regular checkup,and hygiene) in the two groups were compared.Results Before intervention,there was no statistically significant difference in fasting blood glucose,postprandial 2-hour blood glucose,and glycosylated hemoglobin levels between the two groups ( P>0.05) .After intervention,fasting blood glucose,postprandial 2-hour blood glucose,and glycosylated hemoglobin levels in the two groups decreased significantly,fasting blood glucose,postprandial 2-hour blood glucose,and glycosylated hemoglobin level after intervention in observation group were statistically significantly lower than those in control group ( P<0.05) .There were statistically significant differences in the incidence rates of cesarean section,hypertensive disorder complicating pregnancy,polyhydramnios,infection,premature rupture of membranes,and postpartum hemorrhage between the two groups ( P<0.05) .There were statistically significant differences in the incidence rates of preterm birth,neonatal hypoglycemia,macrosomia,fetal intrauterine distress,neonatal asphyxia,and perinatal death between the two groups ( P< 0.05) .The scores of behavioral habits ( scientific diet,appropriate exercise,self-test blood glucose,regular checkup,and hygiene) in observation group were statistically significantly higher than those in control group ( P< 0.05) .Conclusion The effects of systematic,targeted antenatal care and nutrition guidance on maternal and neonatal outcomes and behavioral habits of pregnant women with GDM are significant,which can effectively control blood glucose,improve maternal and neonatal outcomes and bad behavioral habits of pregnant women.