末次月经时间对孕期增重干预效果的影响初探

Preliminary study on intervention effect of time of last menstrual period on gestational weight gain

目的研究现有营养干预手段下末次月经时间对孕妇孕期增重(GWG)和孕晚期血脂水平的影响,为改善孕期体重控制的营养干预手段提供依据。方法以在重庆市北碚区妇幼保健院营养门诊接受干预的272例孕妇为研究对象,根据末次月经时间所在月份分为4个季度组,通过问卷和膳食调查,制定孕期增重标准和食谱。比较各组体重增加值、符合美国医学研究院(IOM)孕期增重标准的体重控制率以及孕晚期血脂水平。结果根据IOM 2009年标准272名孕妇中117人(41.9%)体重控制良好,末次月经时间在不同季度的孕妇间孕期体重控制率和孕晚期甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平差异无统计学意义(χ2=6.398,F值分别为1.073、1.314和0.170,均P>0.05),而第一季度组孕期增重高于其余3个季度(F=2.981,P=0.032,LSD均P<0.05),孕晚期血清TG和LDL-C增长幅度组间差异无统计学意义(F值分别为0.521和0.464,均P>0.05)。结论末次月经时间对孕期增重干预效果有影响,末次月经时间在第一季度的孕妇是孕期体重管理的重点人群。

Objective To investigate the effect of the last menstrual period on gestational weight gain （GWG） and serum lipids levels in the third trimester of pregnancy, so as to provide information for improvement of the control of GWG. Methods Totally 272 pregnant women accepting nutritional intervention in Beibei District Maternal and Child Health Hospital were studied. They were distributed into four quarter groups according to the month of their last menstrual period. They completed questionnaire and dietary survey and weight gain standards and dietary were set. The GWG and whether they were in accordance with those of IOM guideline were compared, so were the serum lipids levels in the third trimester of pregnancy. Results The GWG of 117 out of 272 （41.9%） pregnant women were in accordance with those of IOM guideline. The differences in weight gain control rate of pregnant women whose last menstrual period at different quarter, serum TG, HDL-C and LDL-C levels in the third trimester among four groups showed no statistical significance （x2 = 6. 398, F value was 1. 073, 1.314 and 0. 170, respectively, all P 〉 0.05 ）. While the women in the first quarter group experienced a higher GWG than others （F = 2. 981, P =0.032, LSD all P 〈0.05）. The increased values of serum TG and LDL-C showed no significant difference among different groups （F value was 0. 521 and 0. 464, respectively, both P 〉 0.05）. Conclusion The time of the last menstrual period has effect on GWG control. More attention should he focused on women whose last menstrual period in the first quarter in terms of GWG control.