妊娠糖尿病患者补充维生素D对改善妊娠结局的影响分析

Effect of vitamin D Supplementation on Improving pregnancy Outcomes in patients with Gestational diabetes

目的研究妊娠糖尿病(GDM)患者在妊娠期补充维生索D对改善妊娠结局的影响。方法选择184例妊娠糖尿病患者,采用随机数字表法分为研究组与对照组,各92例。对照组患者予以饮食和运动指导,研究组患者在对照组基础.上予以补充维生素D。比较两组患者空腹血糖、餐后2 h血糖、空腹胰岛素、25-羟基维生素D(25-OH-VD)、母婴不良结局发生率及分娩情况。结果干预前,两组患者空腹血糖、餐后2 h血糖、空腹胰岛素及25-OH-VD指标比较,差异无统计学意义(P>0.05);干预后,两组患者空腹血糖、餐后2 h血糖、空腹胰岛素指标均低于干预前,25-OH-VD指标高于干预前,且研究组患者空腹血糖、餐后2 h血糖、空腹胰岛素指标均低于对照组,25-OH-VD指标高于对照组,差异具有统计学意义(P<0.05)。研究组母婴不良结局发生率为6.52%,对照组母婴不良结局发生率为26.09%,比较差异有统计学意义(P<0.05);研究组患者剖宫产+阴道助产占比为41.30%,对照组患者剖宫产+阴道助产占比为65.22%,比较差异具有统计学意义(P<0.05)。结论妊娠糖尿病患者在饮食运动外加补充维生索D,可改善血糖,降低母婴不良结局发生率,同时还能一定程度降低患者分娩风险及新生儿出生风险。

Objective To investigate the effect of vitamin D supplementation in gestational diabetes mellitus(GDM)patients during pregnancy on improving pregnancy outcome.Methods 184 patients with gestational diabetes were divided into study group and control group by random number table.The control group was given diet and exercise instruction,and the study group was given vitamin D supplement on the basis of the control group.Fasting blood glucose,2 h postprandial blood glucose,fasting insulin,25-hydroxyvitamin D(25-OH-VD),incidence of maternal and infant adverse outcomes and delivery were compared between 2 groups.Results Before intervention,there were no significant differences in fasting blood glucose,2 h postprandial blood glucose,fasting insulm and 25-OH-VD between 2 groups(P>0.05).After intervention,the indexes of fasting blood glucose,2 h postprandial blood glucose and fasting insulin in 2 groups were lower than before intervention,and the indexes of 25-OH-VD were higher than before intervention,and the indexes of fasting blood glucose,2 h postprandial blood glucose and fasting insulin in study group were lower than control group,and the indexes of 25-OH-VD were higher than control group,with statistical significance(P<0.05).The incidence of adverse outcomes was 6.52%in the study group and 26.09%in the control group,the difference was statistically significant(P<0.05).The ratio of cesarean section and vaginal midwife was 41.30%in the study group and 65.22%in the control group,and the difference was statistically significant(P<0.05).Conclusion Diet,exercise and vitamin D supplementation in gestational diabetes patients can improve blood glucose,reduce the incidence of adverse maternal and infant outcomes,and to a certain extent reduce the risk of delivery and neonatal risk.