低血糖生成指数膳食干预对妊娠期糖尿病孕妇母婴结局的影响

Effect of low glycemic index dietary intervention on maternal and neonatal outcomes in pregnant women with gestational diabetes mellitus

目的通过对妊娠期糖尿病孕妇进行低血糖生成指数(LGL)膳食干预,观察干预措施对降低不良妊娠结局的发生影响。方法选取从2015年6月-2016年12月确诊为妊娠期糖尿病孕妇150例,根据自愿原则分为2组,干预组给予低生成血糖指数(GI)膳食并控制每日总能量摄入,对照组只控制每日总能量的摄入。跟踪随访至孕妇分娩,观察干预措施对妊娠结局的影响。结果干预组孕妇孕期体质量增长情况低于对照组,血糖控制有效率高于对照组,住院使用胰岛素治疗率低于对照组,剖宫产率低于对照组,差异均有统计学意义(均P<0.05)。两组妊娠期糖尿病孕妇干预后低密度脂蛋白(LDL)、总胆固醇(TC)、三酰甘油(TG)、糖化血红蛋白(Hb Alc)及高密度脂蛋白(HDL)水平比较,差异均有统计学意义(均P<0.05),但胰岛素抵抗指数(IRI)差异无统计学意义(P>0.05)。两组新生儿出生体质量比较,干预组新生儿出生体质量明显低于对照组,差异具有统计学意义(P<0.01),两组新生儿孕周、身长、头围和Apgar评分比较,差异均无统计学意义(均P>0.05)。结论低血糖生成指数膳食干预能够改善妊娠期糖尿病孕妇的不良妊娠结局,保障母婴健康。

Objective To observe the effect of intervention measures on reducing the incidence rates of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus（ GDM） by means of diet intervention with low glycemic index（ LGL）. Methods From June 2015 to December 2016,150 pregnant women diagnosed as GDM definitely were selected and divided into two groups,the patients in intervention group were given a low glycemic index（ GI） diet and control of total energy intake per day,and the patients in control group were given control of total energy intake per day. All the patients were followed up until delivery. The effect of intervention measures on pregnancy outcome was observed. Results Body weight gain during pregnancy in intervention group was lower than that in control group,the effective rate of blood glucose control in intervention group was higher than that in control group. The rate of insulin treatment in hospital in intervention group was lower than that in control group,the rate of cesarean section in intervention group was lower than that in control group,there were statistically significant differences（ P〈0. 05）. There were statistically significant differences in the levels of low density lipoprotein（ LDL）,total cholesterol（ TC）,triacylglycerol（ TG）,glycosylated hemoglobin（ Hb Alc）,and high-density lipoprotein（ HDL） after intervention between the two groups（ P〈0. 05）,but there was no statistically significant difference in insulin resistance index between the two groups（ P〈0. 05）. Neonatal birth weight in intervention group was statistically significantly lower than that in control group（ P〈0. 01）. There was no statistically significant difference in gestational age,body length,head circumference,and Apgar score between the two groups（ P〈0. 05）. Conclusion Low glycemic index dietary intervention can improve adverse pregnancy outcomes of pregnant women with GDM and ensure health of mothers and infants.