营养干预对妊娠期糖尿病孕妇糖代谢、母婴结局及产后体重滞留的影响

Effects of nutritional intervention on glycometabolism,maternal and infant outcomes and postpartum weight retention in pregnant women with gestational diabetes mellitus

目的分析营养干预对妊娠期糖尿病(GDM)孕妇糖代谢、母婴结局及产后体重滞留的影响。方法选择2018年4月至2019年4月我院收治的150例GDM孕妇作为研究对象,将其随机分为对照组(75例,常规门诊检查+健康教育)和研究组(75例,常规门诊检查+健康教育+营养干预)。比较两组的膳食质量、血糖及胰岛素状态、妊娠期相关并发症、母婴结局、产后体重滞留情况。结果干预3个月后,研究组的LBS、HBS、DQD评分均明显低于对照组,差异具有统计学意义(P<0.05)。干预3个月后,研究组的FBG、2 h PG水平和HOMA-IR明显低于对照组,HOMA-β明显高于对照组,差异具有统计学意义(P<0.05)。研究组的妊娠期相关并发症发生率均明显低于对照组,母婴结局明显优于对照组,差异具有统计学意义(P<0.05)。产后42 d及6、12个月,研究组的体重滞留量均明显低于对照组,差异具有统计学意义(P<0.05)。结论营养干预能够显著提高孕妇的膳食质量,降低血糖及胰岛素抵抗,改善母婴结局,减少孕妇产后体重滞留。

Objective To analyze the effects of nutritional intervention on glycometabolism,maternal and infant outcomes and postpartum weight retention in pregnant women with gestational diabetes mellitus(GDM).Methods A total of 150 pregnant women with GDM admitted in our hospital from April 2018 to April 2019 were selected as the research objects and randomly divided into control group(75 cases,routine outpatient examination+health education)and study group(75 cases,routine outpatient examination+health education+nutritional intervention).The dietary quality,blood glucose and insulin status,pregnancy related complications,maternal and infant outcomes and postpartum weight retention were compared between the two groups.Results After 3 months of intervention,the scores of LBS,HBS and DQD in the study group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).After 3 months of intervention,the FBG,2 h PG levels and HOMA-IR in the study group were significantly lower than those in the control group,while HOMA-βwas significantly higher than that in the control group,and the differences were statistically significant(P<0.05).The incidences of pregnancy related complications in the study group were significantly lower than those in the control group,the maternal and infant outcomes was significantly better than that in the control group,and the differences were statistically significant(P<0.05).At 42 d,6 months and 12 months postpartum,the weight retention in the study group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Nutritional intervention can significantly improve the dietary quality of pregnant women,reduce blood glucose and insulin resistance,improve maternal and infant outcomes,and reduce postpartum weight retention of pregnant women.