食疗和运动对妊娠期糖尿病孕妇产后42日血糖及围产儿结局的影响

Effects of Medical Nutrition Therapy and Exercise Therapy on Oral Glucose Tolerance Test 42 d Postpartum and Perinatal Outcomes in Pregnant Women With Gestational Diabetes Mellitus

目的通过比较妊娠期糖尿病孕妇是否接受医学营养治疗(MNT)和运动疗法对GDM孕妇产后42 d OGTT及围产儿结局的影响。方法在四川大学华西第二医院2015-05/12确诊为GDM的孕妇,根据是否接受医学营养治疗和运动疗法将之分为GDM门诊组(614人)与普通门诊组(262人),对其产后42 d OGTT结果及围产儿结局进行数据采集并进行分析。结果 42 d 75 g OGTT复测时,GDM门诊组孕妇血糖正常者较普通门诊组孕妇多(P<0.05);其新生儿结局中,GDM门诊组孕妇其新生儿不良结局人数较普通门诊组孕妇少(P<0.05)。结论通过接受医学营养治疗和运动疗法的干预,可有效降低产后糖代谢异常率,也可以有效的减少围产儿的不良结局。

Objective To investigate the effects of medical nutrition therapy （MNT） and exercise therapy on oral glucose tolerance test （OGTr） 42 d postpartum and perinatal outcomes in pregnant women with gestational diabetes mellitus （GDM）. Methods Depending on whether MNT and exercise therapy were given or not, pregnant women with GDM established between May and December 2015 in West China Second Hospital of Sichuan University were assigned to a GDM outpatient group （n = 614） and a common outpatient group （n = 262） and data about OGTT results 42 d postpartum and perinatal outcomes were collected and analyzed. Results According to 42 d 75 g OGTT retest results, the proportion of pregnant women with normal blood glucose was higher in the GDM outpatient group than in the common outpatient group （P 〈 0. 05 ）; the proportion of pregnant women with bad perinatal outcomes was lower in the GDM outpatient group than in the common outpatient group （P 〈 0. 05 ）. Conclusion MNT and exercise therapy can effectively lower the postpartum glucose metabolism abnormality rate and reduce bad perinatal outcomes.