医学营养联合运动疗法对GDM孕妇产后结局影响

Effect of medical nutrition therapy combined with exercise therapy on OGTT 42 days postpartum and perinatal outcome of GDM pregnant women

目的:探讨医学营养治疗联合运动疗法对改善妊娠期糖尿病(Gestational Diabetes Mellitus,GDM)孕妇产后42d口服葡萄糖耐量测试(Oral glucose tolerance test,OGTT)结果与围产儿结局的作用。方法:选择本院2020年1月至12月收治GDM者80例,按照随机数表法分组,分为采用常规管理的对照组(n=40)与采用医学营养治疗联合运动疗法干预的研究组(n=40),比较两组产前与产后42d时OGTT中1h、2h血糖水平的差异,并统计两组不良围产儿结局进行比较。结果:产后42d研究组OGTT1h、OGTT2h血糖水平分别为(7.86±0.60)mmol/L、(7.03±0.41)mmol/L,均小于对照组;研究组体质量指数、孕早期增重量、孕中期增重量、孕晚期增重量均小于对照组;研究组产妇并发症发生率低于对照组;研究组不良围产儿结局发生率为12.50%,低于对照组35.00%,差异有统计学意义(P<0.05)。结论:对GDM孕妇采用医学营养治疗联合运动疗法干预能够有效改善产妇产后血糖水平以及孕期体质量增长情况,可降低产妇与围产儿不良结局风险。

Objective:To explore the effect of medical nutrition therapy combined with exercise therapy on improving the 42-d postpartum oral glucose tolerance test(OGTT)and perinatal outcome of pregnant women with Gestational Diabetes Mellitus(GDM).Methods:Select 80 cases of GDM patients admitted to this hospital from January to December 2020,group them according to the random number table method,and divide them into control group(n=40)with routine management and study group(n=40)with medical nutrition therapy combined with exercise therapy.Compare the difference of the 1h and 2h blood glucose levels in the OGTT between the two groups before and on the 42d postpartum,and compare the adverse perinatal outcomes of the two groups.Results:The blood glucose levels at OGTT1h and OGTT2h in the study group were(7.86±0.60)mmol/L and(7.03±0.41)mmol/L,respectively,which were lower than those in the control group at 42D postpartum.The body mass index,weight gain in the first trimester,weight gain in the second trimester and weight gain in the third trimester in the study group were lower than those in the control group.The incidence of maternal complications in study group was lower than that in control group.The incidence of adverse perinatal outcomes in the study group was 12.50%,lower than 35.00%in the control group(P<0.05).Conclusion:The intervention of medical nutrition therapy combined with exercise therapy for pregnant women with GDM can effectively improve postpartum blood glucose level and weight gain during pregnancy,and reduce the risk of adverse outcomes of puerpera and perinatal babies.