孕妇依从性对妊娠期糖尿病孕妇妊娠结局的影响

Effects of maternal compliance on patients with gestational diabetes mellitus and their pregnancy outcomes

目的:研究孕妇医嘱依从性(包括日常运动和节食)对妊娠期糖尿病控制和其妊娠结局的影响。方法:纳入从2014年7月到2015年7月的共484例我院产检建卡的孕妇。实验组(GDM组):224例诊断GDM的孕妇,详细进行个体化日常饮食和锻炼宣教。对照组:260例同期非GDM孕妇。入院待产日对全部孕妇进行问卷调查,所有必要的信息及分娩方式及结局均被记录并分析孕产妇的依从性及其妊娠结局。结果:孕前体重指数,经产率,及娩出巨大儿发病率三者在GDM组均显著高于对照组(P<0.01)。另外,依从性好的GDM孕妇巨大儿发病率和剖宫产率低于依从性差的GDM孕妇。结论:GDM增加孕妇及新生儿不良事件风险,GDM孕妇良好的依从性,遵医嘱进行饮食调整和适度的锻炼,可降低GDM相关不良妊娠结局,特别是巨大儿发病率。

Objectives： To investigate the effect of maternal compliance conccrning daily exercise and diet on women with gestational diabetes meUitus and their pregnancy outcomes. Methods： A total of 484 pregnant wom- en who visited the antenatal clinics for establishing health files from July 2014 to July 2015 were included in the study. About 224 pregnant women diagnosed with GDM （GDM group） were selected and advised to follow the daily balanced diet and moderate physical activities. Another 260 non-GDM healthy pregnant women at the same period were selected as the control group. Brief questionnaires were administered to those pregnant women on the delivery date. All the necessary information, delivery mode and outcomes were recorded to analyze maternal compliance and its pregnancy outcome. Results： The prepregnancy BMI, prevalence of multiparity and macrosomia in GDM group were significantly higher than that of the control group （P〈0.01）. In addition, the GDM mothers with good maternal adherence and compliance having good eating habits and moderate physical activities would result in significant lower incidence of macrosomia and cesarean section rate. Conclusion： GDM may increase the risk adverse events of pregnant women and irrfants. Good maternal compliabce and adherence to the prescribed dietary changes and moderate exercises may reduce the adverse pregnancy outcomes, especially macrosolnia can be minimized with controlled blood glucose level.