食物交换份法饮食治疗对控制胎儿体质量的影响

Effect of food exchange portion on controlling fetal weight

目的：探讨食物交换份法饮食治疗对控制胎儿体质量的影响。方法随机抽取产检孕妇500名，根据其意愿分成接受个体化食物交换份营养膳食指导组（观察组）、未接受个体化营养膳食指导组（对照组）。对观察组的孕妇进行既往1周的膳食调查，根据其孕前 BMI 计算一日总热量需求，制定适合个体的优质蛋白质的份量。对照组仅予口头简单的营养知识宣教。2组均在分娩后进行新生儿体质量、分娩结局等对比分析。结果与对照组相比，观察组胎儿生长受限（FGR）的发生率明显降低，产妇软产道裂伤率明显下降（P 均＜0．05）。控制了妊娠期糖尿病（GDM）影响的分层分析显示，观察组无 GDM孕妇胎儿的目标控制体质量（2750～3999 g）达标率较高（P ＜0．05）。结论妊娠期食物交换份法饮食管理可降低 FGR 发生率，有助于控制胎儿体质量和减少产妇软产道裂伤。

Objective To evaluate the effect of food exchange portion upon controlling the fetal weight.Methods Five hundred pregnant women examined were randomly selected and divided into the obser-vation and control groups according to their willingness.In the observation group,the participants were in-structed with individualized food exchange serving,whereas those in the control group received no guidance.In the observation group,the dietary nutrition in the past week was investigated.The daily total amount of calorie was calculated based on the preconception body mass index （BMI）.Individualized portion of high-quality pro-tein was determined.The pregnant women in the control group were only supplied with simple oral instruction regarding dietary nutrition.The fetal weight and pregnant outcome were statistically compared between two groups.Results The incidence of fetal growth restriction （FGR）in the observation group was significantly declined compared with that in the control group （P 〈0.05）.The incidence of soft birth canal injury in the observation group was considerably decreased （P 〈0.05）.After gestational diabetes mellitus （GDM）control, stratified analysis revealed that the control rate of fetal weight control in GDM-free women from the observation group was significantly higher than that in the control group（fetal weight range：2 750 ～3 999 g）（P 〈0.05）. Conclusions Food exchange portion could reduce the incidence of FGR and soft birth canal injury,and help to control fetal weight.