PCPA饮食干预对孕前超重、肥胖孕妇妊娠糖尿病预防作用的前瞻性研究

Prospective study of PCPA dietary intervention in the prevention of gestational diabetes mellitus in overweight and obese pregnant women

目的探讨PCPA饮食干预对孕前超重、肥胖孕妇妊娠糖尿病(GDM)的预防作用。方法选取2018年1月至12月在广东省佛山市南海区第四人民医院就诊的78例孕前超重、肥胖孕妇作为研究对象。按照产检顺序编号,以随机数字表法分为观察组(n=39)和对照组(n=39)。观察组给予PCPA饮食干预,包括倡议、联盟、宣传和行动4个阶段,对照组给予常规孕期干预。比较两组体重和血糖水平的变化,以及GDM发生率、分娩方式和巨大儿发生率的差异。结果观察组孕28周和分娩时体重、空腹血糖(FPG)、餐后2h血糖(2hPG)和糖化血红蛋白(HbA 1c)水平均显著小于对照组,差异具有统计学意义(P<0.05);观察组GDM和巨大儿发生率显著低于对照组,差异具有统计学意义(P<0.05);两组分娩方式比较,差异无统计学意义(P>0.05)。结论PCPA饮食干预可更为有效地控制孕前超重、肥胖孕妇体重增长,改善血糖代谢,降低GDM和巨大儿发生率。

Objective To explore the PCPA Dietary intervention in the prevention of gestational diabetes mellitus(GDM)in overweight and obese pregnant women.Methods A total of 78 overweight and obese pregnant women who visited the Fourth People′s Hospital of Nanhai District from January to December 2018 were selected as the research subjects.The patients were divided into observation group(n=39)and control group(n=39)by random number table method.The observation group was given PCPA dietary intervention,including four stages of initiative,alliance,publicity and action,while the control group was given routine pregnancy intervention.The changes in body mass and blood glucose levels,the incidence of GDM,delivery mode and the incidence of macrosomia were compared between the two groups.Results The levels of body mass,fasting blood glucose(FPG),2h postprandial blood glucose(2hPG)and HbA 1c in observation group were significantly lower than those in control group at 28 weeks and before delivery(P<0.05).The incidence of GDM and macrosomia in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in delivery mode between the two groups(P>0.05).Conclusions For overweight and obese pregnant women before pregnancy,PCPA diet intervention can more effectively control the weight gain,improve blood glucose metabolism,and reduce the incidence of GDM and macrosomia.