孕期个性化营养指导对妊娠期糖尿病患者妊娠结局的影响

Clinical effect of individualized dietary instruction during pregnancy on pregnancy outcomes of patients with gestational diabetes mellitus

目的探讨孕期个性化营养指导对妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇妊娠结局的影响。方法将2010年10月至2013年5月佛山市顺德区妇幼保健院产科收治的138例GDM患者随机分为观察组和对照组,每组各69例,观察组给予个性化营养指导;对照组给予常规GDM营养宣教。比较两组患者的体质量增长速率、空腹血糖(fasting blood glucose,FBG)、餐后血糖(postprandial blood glucose,PBG)、并发症及妊娠结局。结果实施营养指导后,观察组患者的体质量增长速率显著低于对照组(P<0.05);PBG、FBG水平优于对照组(P<0.05);羊水过多、胎膜早破、产后出血、巨大儿、早产、剖宫产、胎儿宫内窘迫发生率均低于对照组(P<0.05)。结论个性化营养指导有利于维持GDM患者围产期的血糖处于正常水平,改善妊娠结局。

Objective To explore the clinical effect of individualized dietary instruction during pregnancy on pregnancy outcomes of patients with gestational diabetes mellitus（ GDM）. Methods 138 patients with GDM in Maternal and Child Health Hospital of Shunde District from October 2010 to May 2013 were randomized into observation group and control group with 69 cases in each group,cases in observation group were given individualized dietary guidance,while cases in control group were given conventional nutritional education. The body weight growth rate,fasting blood glucose（ FBG）,postprandial blood glucose（ PBG）,complications and pregnancy outcomes of two groups were compared. Results After dietary guidance,the body weight growth rate of observation group was significantly lower than control group（ P〈0. 05）. FBG,PBG of observation group were significantly better than control group（ P〈0. 05）. Polyhydramnios,premature rupture of membranes,postpartum hemorrhage of observation group were significantly lower than control group（ P〈0. 05）. The incidence of fetal macrosomia,premature delivery rate,cesarean section rate,neonatal birth weight,fetal distress rate of observation group were significantly lower than control group（ P〈0. 05）. Conclusion Individualized dietary guidance has a prominent effect for patients with GDM in keeping blood glucose level,it has a high clinical value in improving pregnancy outcomes.