个体化的孕前体质量指数干预对妊娠期糖耐量受损孕妇妊娠结局的影响

Effects of individualized progestation body mass index intervention on pregnancy outcomes in pregnant women with impaired glucose tolerance

目的探讨个体化的孕前体质量指数(BMI)干预对妊娠期糖耐量受损(GIGT)孕妇妊娠结局的影响。方法选取2011年1月~2017年5月我院孕检的GIGT孕妇140例。采用随机数字表分为干预组和对照组。对照组孕妇予以常规孕期干预;干预组孕妇予以孕前BMI干预,根据孕妇不同的孕前BMI制定孕期体质量增加的目标,并制定个性化食谱和运动量。观察两组孕妇产前1周FBG、2 h PBG和Hb A1C水平及妊娠期增重情况,并比较其妊娠结局。结果干预组孕妇产前1周FBG、2 h PBG和Hb A1C水平低于对照组,干预组妊娠期增重少于对照组(P<0.05)。干预组孕妇干预后GIGT持续率、GDM发生率、子痫前期、胎膜早破、产褥感染及胎儿窘迫、巨大儿和新生儿低血糖发生率低于对照组(P<0.05)。结论个体化的孕前BMI干预能明显减少GIGT持续率和GDM发生率,有效控制GIGT孕妇的血糖和Hb A1C水平,妊娠期增重控制得当,并能降低妊娠并发症的发生率,改善妊娠结局。

Objective To investigate the effect of individualized progestation body mass index intervention on pregnancy outcomes in pregnant women with impaired glucose tolerance（GIGT）. Methods 140 cases of GIGT pregnant women in our hospital from January 2011 to May 2017 were selected and divided into intervention group and control group by using random number table. The pregnant women in the control group were given routine pregnancy intervention. The pregnant women in the intervention group were given pre-pregnancy BMI intervention,and according to different pre-pregnancy BMI of different pregnant women, the goals were set up to increase the body mass during pregnancy and to develop personalized recipes and exercises. The levels of FBG, 2 h PBG and Hb A1 C in the two groups a week before the parturition and the weight gain during pregnancy were observed and their pregnancy outcomes were compared. Results The levels of FBG, 2 h PBG and Hb A1 C in the pregnant women in the intervention group were lower than those in the control group one week before parturition, and the weight gain in the intervention group was less than that in the control group（P〈0.05）. The intervention group GGT duration, GDM incidence, preeclampsia,premature rupture of embryolemma,puerperal infection and fetal distress, macrosomia and neonatal hypoglycemia of pregnant women after intervention were lower than the control group（P〈0.05）. Conclusion Individualized pre-pregnancy BMI intervention can significantly reduce the duration of GIGT and the incidence of GDM, effectively control the blood glucose and Hb A1 C levels of GIGT pregnant women, control the weight gain during pregnancy, and can reduce the incidence of pregnancy complications and improve pregnancy outcomes.