个体化饮食及运动干预对孕前肥胖孕妇妊娠期糖尿病发病率的影响

Effect of dietary and exercise intervention on the incidence of GDM in women with pre-pregnancy obesity

目的探讨个体化饮食干预对孕前肥胖孕妇妊娠期糖尿病（gestational diabetes mellitus,GDM）发病率的影响。方法选择2013年4月-2015年1月在本院门诊建册（孕12周前后）且孕前BMI≥25 kg/m2的孕妇160例,其中2013年4月-2014年1月的80例设为对照组,2014年2月-2015年1月的80例设为研究组。对照组孕妇12周前后开始接受常规产检和孕期健康教育讲座,研究组孕妇在对照组基础上每周由专科护士进行追踪护理干预,营养师根据孕妇每周BMI、体力消耗情况及胎儿体重增加情况,为孕妇动态制订能量饮食食谱及运动计划。比较两组孕妇孕期体重增长及GDM发生率。结果研究组孕妇孕期体重增长及GDM发生率明显低于对照组,两组比较,差异具有统计学意义（均P〈0.05）。结论孕12周前后为肥胖孕妇制订个体化饮食及运动追踪护理干预,可有效控制孕前肥胖孕妇孕期体重,降低GDM发生率。

Objective To investigate the effect of dietary and exercise on the incidence of GDM in women with pre-pregnancy obesity. Methods One hundred and sixty early pregnant women with BMI≥25 kg/m2 in our hospital from April 2013 to January 2015 enrolled in the study were divided into two groups： The eighty women hospitalized during June 2013 to January 2014 were assigned as the control group, while the other 80 women from February 2014 to January 2015 as the study group. In the former group, the routine pregnancy inspection and pregnancy health education seminars were conduced during pregnancy of 12 weeks , and in the study group weekly nutritional assessment , diet planning by a dietitian and exercise guidance by a professional nurse were performed apart from the same care as in the control group. The two groups were compared in terms of weight growth and GDM incidence. Result The weight increased and the GDM incidence in the study was both significantly lower than those in the control group （ P 〈 0 . 05 ） . Conclusion The dietary and exercise during pregnancy can effectively control the weight and decrease the incidence of GDM , which can ensure the health of pregnant women.