低血糖负荷膳食干预对孕妇孕期体质量管理及新生儿结局的影响

Effect of low glycemic load diet on weight management during pregnancy and neonatal outcomes

目的探讨低血糖负荷膳食干预对孕妇孕期体质量管理及新生儿结局的影响。方法选择2019年2月至2020年6月在宝鸡市妇幼保健院进行常规产检的150例孕妇作为研究对象,按照自愿加入的原则将其分为观察组79例和对照组71例。对照组孕妇在第1次产检(孕12周)后进行常规孕前健康知识宣教,观察组孕妇在上述基础上行低血糖负荷膳食干预。分娩后统计、比较两组孕妇的孕期增重情况、膳食情况,并比较两组孕妇的分娩方式、新生儿不良出生结局及新生儿基本情况。结果孕早期观察组和对照组孕妇的血糖生成指数(GI)[66.23±12.05)vs(66.19±11.88)]、血糖负荷(GL)[(152.25±36.49)vs(153.38±37.14)]水平比较差异均无统计学意义(P>0.05);观察组孕妇在孕中期的GI、GL分别为(54.23±8.46)、(136.23±30.28),孕晚期分别为(55.05±8.43)、(138.28±29.44),明显低于对照组的(60.31±10.21)、(148.22±35.45),(61.21±10.19)、(150.06±33.63),差异均有统计学意义(P<0.05);观察组孕妇的孕期总增重、孕(26±2)周前增重、孕(34±2)周前增重和分娩前增重明显低于对照组,差异均有统计学意义(P<0.05);观察组孕妇的顺产率为70.89%,明显高于对照组的52.11%,剖宫产为29.11%,明显低于对照组的47.89%,差异均有统计学意义(P<0.05);观察组孕妇新生儿中早产儿、巨大儿和窒息的发生率分别为1.27%、1.28%、0,明显低于对照组的7.04%、8.45%和5.63%,差异均有统计学意义(P<0.05);两组孕妇新生儿的胎龄、身长、头围、Apgar评分比较差异无统计学意义(P>0.05);观察组孕妇新生儿的体质量为(3.36±0.41)kg,明显低于对照组的(3.78±0.52)kg,差异有统计学意义(P<0.05)。结论孕妇行低血糖负荷膳食干预能够有效控制孕期体质量增长和新生儿出生体质量,从而使剖宫产率以及新生儿不良结局的发生显著降低,对于改善妊娠结局、保障母婴健康具有重要意义。

Objective To research the effect of low glycemic load diet on weight management during pregnancy and neonatal outcomes.Methods A total of 150 pregnant women,who underwent routine prenatal examination in the Maternal and Child Health Hospital of Baoji City from February 2019 to June 2020,were selected and divided into the observation group(79 cases)and control group(71 cases)according to the principle of voluntary participation.Pregnant women in the control group were given routine health education before pregnancy after the first prenatal examination(gestational age 12 weeks),while pregnant women in the observation group were given diet intervention with hypoglycemia load on the basis of the above.The weight gain and diet of pregnant women in the two groups were compared,and the mode of delivery,adverse neonatal outcomes and the basic situation of newborns of the two groups were compared.Results The levels of glycemic index(GI),blood glucose load(GL)of the observation group in the early pregnancy were 66.23±12.05 and 152.25±36.49 versus 66.19±11.88 and 153.38±37.14 of the control group(P>0.05);the levels of GI and GL in the second and third trimester of pregnancy in the observation group were 54.23±8.46 and 136.23±30.28,55.05±8.43 and 138.28±29.44,which were significantly lower than corresponding 60.31±10.21 and 148.22±35.45,61.21±10.19 and 150.06±33.63 in the control group(all P<0.05);the total weight gain during pregnancy,weight gain before(26±2)weeks,(34±2)weeks and before delivery in the observation group were significantly lower than those in the control group(all P<0.05);the spontaneous delivery rate of the observation group was 70.89%versus 52.11%of the control group(P<0.05);the cesarean section rate of the observation group was 29.11%versus 47.89%of the control group(P<0.05);the incidences of premature,macrosomia and asphyxia in the observation group were 1.27%,1.28%and0,respectively,which were significantly lower than corresponding 7.04%,8.45%and 5.63%of the control group(all P<0.05);there were no significant differences in the gestational age,body length,head circumference and Apgar score of the observation group and the control group(all P>0.05);the body weight of newborns in the observation group was(3.36±0.41)kg,which was significantly lower than(3.78±0.52)kg in the control group(P<0.05).Conclusion Pregnant women with hypoglycemic load diet intervention can effectively control the weight gain during pregnancy and the birth weight of newborns,thus significantly reducing the cesarean section rate and the incidence of adverse neonatal outcomes,which is of great significance for improving pregnancy outcomes and ensuring maternal and infant health.