新型孕期营养体质量管理预防巨大儿及足月低体质量儿的临床研究

New nutritional weight management during pregnancy in prevention of macrosomia and full-term low birth weight infants

目的探讨新型孕期营养体质量管理在预防巨大儿及足月低体质量儿,改善妊娠结局的研究。方法对2017年1月至2018年3月在本院建卡产检及分娩的早孕孕妇600例。随机分为对照组(200例)、宣教实验组(200例)、干预实验组(200例),又根据孕前体质量指数[BMI,BMI=体质量(kg)除以身高(m)的平方]把3组分为体质量不足亚组、标准体质量亚组、超重亚组与肥胖亚组。前瞻性研究各组体质量管理模式对妊娠结局的影响。结果干预实验组早产发生率为5.00%(10/200),宣教实验组为7.50%(15/200),对照组为12.00%(24/200),干预实验组早产发生率低于对照组(P<0.05),干预实验组早产发生率低于宣教实验组,便二者比较差异无统计学意义(P>0.05);干预实验组巨大儿发生率为1.00%(2/200),低体质量儿发生率为0.50%(1/200),对照组巨大儿发生率为7.50%(15/200),低体质量儿发生率为6.00%(12/200),宣教实验组巨大儿发生率为3.00%(6/200),低体质量儿发生率为1.00%(2/200),干预实验组巨大儿及低体质量儿发生率均低于对照组及宣教实验组(均P<0.05);干预实验组糖代谢异常、妊娠高血压、产后抑郁发生率分别为10.00%(20/200)、1.00%(2/200)、0.50%(1/200),宣教实验组糖代谢异常、妊娠高血压、产后抑郁发生率分别为12.00%(24/200)、1.00%(2/200)、2.50%(5/200),对照组糖代谢异常、妊娠高血压、产后抑郁发生率分别为19.00%(38/200)、4.50%(9/200)、7.50%(15/200),干预实验组及宣教实验组糖代谢异常、妊娠高血压、产后抑郁发生率均低于对照组(均P<0.05)。结论与体质量增幅管理相比,按体质量指数管理可以减少早产、足月低体质量儿、巨大儿、糖代谢异常和产后抑郁的发生。

Objective To investigate the effect of new nutritional weight management during pregnancy in the prevention of macrosomia and full-term low birth weight infants and the improvement of pregnancy outcomes. Methods 600 women with early pregnancy were examined and delivered in our hospital from January, 2017 to March, 2018 were randomly divided into a control group (200 cases), an experimental group (200 cases), and a propaganda and education experimental group (200 cases). According to pre-pregnancy body mass index [BMI, BMI = body weight (kg) divided by height (m) square], the three groups were divided into underweight subgroups, standard weight subgroups, overweight subgroups, and obesity subgroups. A prospective study was conducted to investigate the effects of weight management on pregnancy outcomes in each group. Results The incidence of preterm birth was 5.00%(10/200) in the experimental group, 7.50%(15/200) in the propaganda and education experimental group, and 12.00%(24/200) in the control group, with a statistical difference between the experimental group and the control group (P < 0.05). The incidences of macrosomia and low birth weight infants were 1.00%(2/200) and 0.50%(1/200) the experimental group, were 7.50%(15/200) and 6.00%(12/200) in the control group, and were 3.00%(6/200) and 1.00%(2/200) in the propaganda and education experimental group (all P < 0.05). The incidences of abnormal glucose metabolism, pregnancyinduced hypertension, and postpartum depression were 10.00%(10/200), 1.00%(2/200), and 0.50%(1/200)in the experimental group, and were 12.00%(24/200), 1.00%(2/200), and 2.50%(5/200) in the propaganda and education experimental group, and were 19.00%(38/200), 4.50%(9/200), and 7.50%(15/200) in the control group, with statistical differences in those of the experimental group and the propaganda and education experimental group from those of the control group (all P < 0.05). Conclusion Compared with body weight management, BMI management can reduce the incidences of premature birth, full-term low birth weight infants, macrosomia, abnormal glucose metabolism, and postpartum depression.