孕期控制BMI对妊娠期糖尿病患者体重增长及妊娠结局的影响

Effect of controlling BMI during pregnancy on weight gain and pregnancy outcome in patients with gestational diabetes mellitus

目的探讨孕期控制体质量指数(BMI)对妊娠期糖尿病患者体重增长及妊娠结局的影响。方法选取200例孕检被确诊为糖尿病的患者,随机分为对照组和研究组,每组100例。对照组患者给予常规健康饮食宣教,观察组患者根据BMI和营养情况制定出详细、科学合理的饮食方案。统计两组患者孕期BMI增长(BMI△)≥6 kg/m^2的例数,观察比较分娩前体质量增加情况及新生儿并发症发生情况。结果研究组BMI△≥6 kg/m^2的比例为20.0%,明显低于对照组的40.0%,差异有统计学意义(χ~2=9.524, P=0.002<0.05)。研究组分娩前体质量增加(6.23±3.13)kg,明显少于对照组的(9.29±3.45)kg,差异有统计学意义(t=6.569, P=0.000<0.05)。研究组新生儿并发症发生率为5.0%,明显低于对照组的60.0%,差异有统计学意义(χ~2=68.946, P=0.000<0.05)。结论孕期控制BMI有助于妊娠期糖尿病患者将体质量和血糖控制在较为合理的范围内,能够显著改善患者的妊娠结局,降低新生儿并发症发生率,值得临床推广。

Objective To discuss the effect of controlling body mass index (BMI) during pregnancy on weight gain and pregnancy outcome in patients with gestational diabetes mellitus. Methods A total of 200 diabetes patients confirmed by antenatal care were randomly divided into control group and research group, with 100 cases in each group. The control group received regular healthy diet education, and the observation group developed a detailed and scientific diet plan according to BMI and nutritional status. The number of cases with increased BMI (BMI△) ≥6 kg/m^2 during pregnancy was counted. The increase in body mass of pre-partum and the occurrence of neonatal complications were observed and compared. Results The research group had obviously lower proportion of BMI△≥6 kg/m^2 as 20.0% than 40.0% in the control group, and the difference was statistically significant ( χ^2=9.524, P=0.002<0.05). The research group had obviously less increase of body mass before delivery as (6.23±3.13) kg than (9.29±3.45) kg in the control group, and their difference was statistically significant (t=6.569, P=0.000<0.05). The research group had obviously lower incidence of neonatal complications as 5.0% than 60.0% in the control group, and the difference was statistically significant ( χ^2=68.946, P=0.000<0.05). Conclusion Controlling BMI during pregnancy can help patients with gestational diabetes control their body mass and blood sugar within a more reasonable range. It can significantly improve the pregnancy outcome of patients and reduce the incidence of neonatal complications. So it is worthy of clinical promotion.