孕期营养干预及监测对妊娠结局的改善效果评价

Effect of pregnancy nutrition intervention and monitoring on pregnancy outcomes

目的评价孕期营养干预及监测对妊娠结局的改善效果。方法选取2010年1月至2013年1月在秦皇岛市妇幼保健院营养科接受孕期检查的416名孕妇为研究对象，完全随机分为观察组和对照组，各208人。观察组给予孕期营养干预及监测；对照组常规进行孕期检查，不参与系统营养监测；监测2组受试者营养素摄入情况，比较其妊娠结局及并发症的发生情况。结果观察组孕妇孕晚期蛋白质和脂肪的日均摄入量均低于对照组，而碳水化合物的日均摄入量明显高于对照组[（80±7）g比（97±10）g、（68±20）g比（88±24）g、（364±47）g比（321±70）g]，差异有统计学意义（P〈0．05）。观察组孕妇孕12～40周体质量增长低于对照组[（5．4±1．3）kg比（5．7±1．3）kg]，巨大儿的发生率明显低于对照组[5．8％（12／208）比15．9％（33／208）]，差异均有统计学意义（均P〈0．05）。观察组孕妇在孕晚期发生贫血24人（11．5％），对照组发生贫血30人（14．4％），2组孕妇孕晚期贫血发生率差异无统计学意义（X2=0．766，P=0．381），观察组孕妇孕晚期血红蛋白水平明显高于对照组[（125±4）g/L比（124±4）g/L]（t=2．412，P=0．017）；而观察组的妊娠高血压的发生率明显低于对照组[0．5％（1／208）比3．8％（8／208）]，差异有统计学意义（P〈0．05）。结论孕期的能量、营养素的摄入不合理可能会导致妊娠高血压、妊娠糖尿病、低出生体质量儿、巨大儿、等不良妊娠结局。孕妇应进行孕期营养监测，减少不良妊娠结局的发生。

Objective To evaluate the effect of pregnancy nutrition intervention and monitoring on preg- nancy outcomes. Methods Totally 416 pregnant women from January 2010 to January 2013 were completely ran- domly divided into observation group and control group, 208 cases in each group. The observation group was given nutrition intervention and monitoring; the control group was given routine pregnancy examination. The nutrient in- takes were monitored, the pregnancy outcomes and the complications were compared. Results The protein and fat intakes at late pregnancy in observation group were significantly lower than those in control group, the carbohydrate intake was significantly higher than that in contorl group [ （80 ±7） g vs （97 ± 10） g, （68 ± 20） g vs （88 ± 24） g, （364 ±47） g vs （321±70） g] （P 〈0. 05）. The body weight gain at 12-40 weeks of pregnancy in observation group was lower than that in control group [ （ 5.4 ± 1.3 ） kg vs （ 5.7 ± 1.3 ） kg ], the incidence of fetal macrosonfia was significantly lower than that in control group [5.8% （12/208） vs 15.9% （33/208） 1 （all P 〈 0. 05）. Anemia occurred to 24 cases（ 11.5% ） at late pregnancy in observation group, while control group had 30 cases （ 14. 4% ） , there was no statistically significant difference of the incidence of anemia between groups （X2 =0. 766, P =0. 381 ）. In observation group, the level of hemoglobin was significantly higher [ （ 125 -±4） g/L vs （ 124± 4） g/L （t = 2.412, P = 0. 017 ） and the incidence of pregnancy-induced hypertension was significantly lower than those in control group [ O. fi % （1/208） vs 3.8% （8/208） ] （ P 〈 0. 05 ）. Conclusions [nappropnate energy and nutrient intakes during pregnancy may cause gestational hypertension, gestafional diabetes mellitus, low birth weight infant, fetal macrosomia and other adverse pregnancy outcomes. Pregnancy nutrition monitoring should be considered to reduce the incidence of adverse pregnancy outcomes.