妊娠期糖尿病孕妇个体化孕期体重管理和饮食控制对妊娠结局的影响

Effect of individualized weight management and diet control during pregnancy on pregnancy outcome of pregnant women with gestational diabetes mellitus

目的探讨妊娠期糖尿病(GDM)孕妇个体化孕期体重管理和饮食控制对妊娠结局的影响,对减少GDM孕妇分娩相关并发症和不良妊娠结局的发生提供临床依据。方法选择2016年7月-2017年11月在该院确诊的110例GDM患者为研究对象,按照不同管理方法将研究对象分为观察组和对照组,每组55例。对照组采用常规保健方式,观察组在对照组的基础上进行个体化孕期体重管理和饮食控制,记录两组孕妇血糖、体重、糖化血红蛋白等变化,比较两组孕妇妊娠期结局的差异。结果对照组体重过度增长的比例(21.8%)高于观察组(9.1%)(χ~2=3.409,P<0.05);观察组在分娩前体重低于对照组,孕期的总增重明显低于对照组,差异均具有统计学意义(均P<0.05);观察组的剖宫产、巨大儿的比例明显低于对照组(P<0.05)。结论妊娠期糖尿病孕妇个体化孕期体重管理和饮食控制可以控制孕期体重增加和血糖水平,减少不良妊娠结局的发生。

Objective To explore the effect of individualized weight management and diet control during pregnancy on pregnancy outcome of pregnant women with gestational diabetes mellitus（ GDM）,provide a clinical basis for reducing the occurrence of pregnancy-associated complications and adverse pregnancy outcomes of GDM pregnant women. Methods A total of 110 patients diagnosed as GDM definitely in Guangyuan Municipal Central Hospital from July 2016 to November 2017 were selected as study object,then they were divided into observation group and control group according to different management methods,55 patients in each group. The patients in control group were treated by routine health care,and the patients in observation group were treated by individualized weight management and diet control during pregnancy based on routine health care. The changes of blood glucose,weight,glycosylated hemoglobin in the two groups were recorded. The pregnancy outcomes in the two groups were compared. Results The proportion of patients with excessive weight gain during pregnancy in control group was 21. 8%,which was statistically significantly higher than that in observation group（ 9. 1%）（ χ-2= 3. 409,P〈0. 05）. Weight before delivery and total weight gain during pregnancy in observation group were statistically significantly lower than those in control group（ P〈0. 05）. The incidence rates of cesarean section and macrosomia in observation group were statistically significantly lower than those in control group（ P〈0. 05）. Conclusion Individualized weight management and diet control during pregnancy can control weight gain during pregnancy and blood glucose of GDM pregnant women,and avoid the occurrence of adverse pregnancy outcome.