个性化饮食干预对妊娠期缺铁性贫血及母婴结局的效果研究

Effect of Individualized Diet Intervention on Iron Deficiency Anemia During Pregnancy and Maternal and Infant Outcomes

目的:探究适用于缺铁性贫血孕妇的营养学个性化饮食干预方案,评估其对患者症状和母婴结局的改善情况。方法:120例确诊为缺铁性贫血的孕妇,随机分为对照组(60例)和干预组(60例),分别在研究开始时和干预4 w后进行1次膳食调查并采集空腹静脉血测定血红蛋白和红细胞计数;对照组不施加主动的营养学干预,为干预组提供系统的个性化膳食指导和食谱定制。结果:干预前对照组宏量营养素供能比:碳水化合物64.25%、蛋白质10.15%、脂质25.59%、铁摄入量(5.9±1.1)mg;干预组宏量营养素供能比:碳水化合物66.17%、蛋白质11.66%、脂质22.17%、铁摄入量(6.2±1.7)mg,两组间各指标均无显著统计学差异(P>0.05)。干预后对照组宏量营养素供能比:碳水化合物60.33%、蛋白质13.97%、脂质25.70%、铁摄入量(13.4±3.1)mg。与干预前对照组相比,仅铁元素摄入量有所提高,差异有统计学意义(P<0.01)。干预后干预组碳水化合物59.74%、蛋白质21.83%、脂质18.43%、铁摄入量(27.5±6.6)mg。与对照组相比,干预组蛋白质摄入量和铁摄入量均有提高,差异显著(P<0.01)。与对照组相比,干预组血红蛋白和红细胞计数指标均提高,差异显著(P<0.01)。与对照组相比,干预组妊娠期高血压发生率降低差异显著(P=0.01),妊娠不良结局发生率无显著差异(P>0.05)。结论:妊娠期个性化饮食干预有助于改善缺铁性贫血孕妇贫血相关指标,对妊娠期高血压发病风险有保护作用。

【Objective】To explore the nutrition personalized diet intervention program for pregnant women with iron deficiency anemia,and to evaluate the improvement of the patient’s symptoms and maternal and infant outcomes.【Method】Totally 120 pregnant women diagnosed with iron deficiency anemia were randomly divided into a control group(60 cases)and an intervention group(60 cases).A dietary survey was conducted at the beginning of the study and 4 weeks after the intervention,and fasting venous blood was collected for measuring hemoglobin and red blood cell count.The control group was not given active nutritional intervention,but the intervention group was provided with systematic personalized diet guidance and formula customization.【Result】Before the intervention,the macronutrient energy supply ratio of the control group were carbohydrates 64.25%,protein 10.15%,lipids 25.59%,iron intake(5.9±1.1)mg;intervention group were carbohydrates 66.17%,protein 11.66%,lipids 22.17%,iron intake(6.2±1.7)mg,and there was no significant difference in indicators between the two groups(P>0.05).After the intervention,the macronutrient supply ratio of the control group were carbohydrates60.33%,protein 13.97%,lipids 25.70%,iron intake(13.4±3.1)mg,and compared with the control group before intervention,only iron intake had improvement,which was statistically significant(P<0.01).The intervention group were carbohydrates 59.74%,protein 21.83%,lipids 18.43%,iron intake(27.5±6.6)mg,protein intake compared with control group.Both iron intake and iron intake increased,with significant differences(P<0.01).Compared with the control group,the hemoglobin and red blood cell count indexes of the intervention group increased after receiving the personalized diet intervention,and the difference was significant(P<0.01).Compared with the control group,the incidence of hypertension during pregnancy in the intervention group decreased significantly(P=0.01),and the incidence of adverse pregnancy outcomes had no significant difference(P>0.05).【Conclusion】Personalized diet intervention during pregnancy can help to improve anemia-related indicators of iron-deficiency anemia pregnant women and have protective effect on the risk of hypertension during pregnancy.