孕期个体化营养指导对妊娠期糖尿病患者妊娠结局的影响

Effect of individualized nutrition instruction on pregnancy outcome in gestational diabetes mellitus

目的探究孕期个体化营养指导对妊娠期糖尿病患者妊娠结局的影响。方法选择2015年1月~2016年11月我院妇产科收治的GDM患者148例,按随机数字表法分为两组,每组各74例。对照组予以常规健康指导,在此基础上观察组予以孕期个体化营养指导。记录两组体重增长情况、血糖、血脂水平以及并发症和不良妊娠结局发生率。结果观察组平均体重指数(BMI)增长明显低于对照组,差异有统计学意义(P<0.05);观察组空腹血糖、糖化血红蛋白、餐后2h血糖水平均低于对照组,差异有统计学意义(P<0.05);与对照组比较,观察组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)均显著降低,差异有统计学意义(P<0.05);观察组羊水污染、羊水过多、产后出血、胎膜早破等发生率明显低于对照组,差异有统计学意义(P<0.05);对照组和观察组比较,早产、巨大儿、胎儿宫内窘迫、新生儿窘迫等发生率明显提高,差异有统计学意义(P<0.05)。结论对GDM患者实施孕期个体化营养指导,能有效控制体重增长,降低血糖和血脂水平,降低并发症和不良妊娠结局发生率。

Objective To explore the influence of individualized nutrition guidance on pregnancy outcome in gestational diabetes mellitus （GDM）. Methods 148 cases of GDM patients in our hospital were selected and divided into two groups according to the random number table from January 2015 to November 2016,with 74 cases in each group.Control group was given routine health guidance,while observation group was given pregnant individualized nutritional guidance based on control group.The weight gain,levels of blood glucose and blood lipid,the incidence of complications and adverse pregnancy outcome in two groups were recorded. Results The average body mass index （BMI） growth of the observation group was significantly lower than that of the control group,the difference was statistically significant （P 〈 0.05）;The levels of fasting blood glucose, glycosylated hemoglobin,2h postprandial blood glucose in observation group were lower than those in control group （P 〈 0.05）;Compared with control group,the total cholesterol （TC）,low-density lipoprotein cholesterol （LDL-C）,high-density lipoprotein cholesterol （HDL-C） and triglyceride （TG） in the observation group were significantly lower,the difference was statistically significant （P 〈 0.05）;The incidence of amniotic fluid contamination,excessive amniotic fluid,postpartum hemorrhage and premature rupture of membranes in the observation group was significantly lower than that in the control group,the difference was statistically significant （P 〈 0.05）;Compared with the observation group,the incidence of premature birth,macrosomia,fetal distress and neonatal distress in the control group was significantly increased,the difference was statistically significant （P 〈 0.05）. Conclusion Pregnant individualized nutritional guidance for GDM patients can effectively control weight gain,decrease the levels of blood glucose and lipid,reduce the incidence of complications and adverse pregnancy outcome.