基于移动医疗的孕期健康管理对GDM发病的预防效果:一项多中心前瞻性对照研究

Preventive effect of pregnancy health management based on mobile medical care on morbidity of GDM:a multicenter prospective randomized controlled trial

目的初步探讨基于移动医疗的孕期健康管理对妊娠期糖尿病(GDM)发病率的影响。方法多中心选择2017年11月在北京市7家医院建档产检的孕妇240例进行前瞻性研究,按建档时间随机编号,单数为对照组,双数为干预组,每组各120例。对照组孕妇参加传统的门诊常规产检及孕期线上孕妇学校,干预组在对照组基础上运用移动医疗平台进行全方位、个体化、实时的、同伴性质的孕期健康管理,时间持续至孕28周前完成GDM的筛查,比较两组GDM的发病情况。结果最终按研究要求完成GDM筛查的入组孕妇共198例(干预组108例,对照组90例)。根据随访成功的回收数据显示,干预组的GDM发病率为18.5%(20/108),对照组的GDM发病率为24.4%(22/90),干预组GDM的发病率有低于对照组的趋势,但差异无统计学意义(P>0.05)。结论基于移动医疗的孕期健康管理对GDM的预防效果尚有待于进一步的研究探讨,但其在GDM患者这一特殊人群中的积极作用值得期待。

Objective:To explore the effect of healthy management based on mobile medical care on the morbidity of gestational diabetes mellitus(GDM).Methods:A multi-center prospective study was conducted in 240 pregnant women who were registered for maternity examination in 7 hospitals in Beijing in November 2017.The number of the enrollments was randomly numbered.The patients with singular number were in the control group,and patients with the double number were the intervention group,120 patients for each group.The pregnant women in the control group participated in the traditional outpatient routine check-up and online maternity school.The pregnant women in intervention group received comprehensive,individualized,real-time and peer-related pregnancy healthy management in the mobile medical care platform on the basis of the control group.The follow-up time lasted until the end of screening for GDM.The GDM morbidity was compared between the two groups.Results:A total of 198 pregnant women(108 in the intervention group and 90 in the control group)were enrolled to complete GDM screening according to the requirements of the study.The incidence of GDM in the intervention group was 18.5%(20/108),and 24.4%(22/90)in the control group.The incidence of GDM in the intervention group was lower than the control group,but the difference was not significant(P>0.05).Conclusions:Preventive effect of pregnancy health management based on mobile medical care on the morbidity of GDM needs further study,but its positive role in the special population is worth of expectancy.