益生菌在超重及肥胖孕妇中的应用效果

Effect of probiotics in overweight and obese pregnant women

目的探讨超重或肥胖孕妇使用益生菌对妊娠糖尿病发病率、肠道菌群及妊娠结局的影响。方法选取肥胖或超重孕妇112例为研究对象,通过随机抽样的方法分为对照组与观察组,每组56例。观察组自孕20周开始至分娩每天口服益生菌3次,对照组则口服安慰剂胶囊。观察2组妊娠糖尿病发生率、血糖与妊娠期肠道菌群变化、妊娠结局(早产、妊娠高血压、剖宫产、胎盘早剥、胎膜早破等)及新生儿结局(出生体质量、巨大儿、头围、新生儿低血糖及出生3~5 d总胆红素等)。结果妊娠28周时,观察组患妊娠糖尿病的孕妇4例,少于对照组的14例,观察组餐后2 h血糖水平(102.9±20.7)mg/dL,低于对照组的(116.4±25.6)mg/dL,差异有统计学意义(P<0.05);肠道菌群分析结果显示,治疗后观察组孕妇的乳酸杆菌(8.03±1.01)CFU/g、双歧杆菌(8.43±1.28)CFU/g及肠球菌(11.46±1.22)CFU/g均高于对照组[(7.61±0.88)、(7.24±1.24)、(10.36±1.13)CFU/g],差异有统计学意义(P<0.05)。观察组的早产数少于对照组,差异有统计学意义(P<0.05)。观察组出生3~5 d后的总胆红素低于对照组,差异有统计学意义(P<0.05)。结论益生菌对超重或肥胖孕妇的血糖及肠道菌群调节可有效降低妊娠糖尿病的发生率,预防婴儿高胆红素血症的发生。

Objective To investigate the effect of probiotics on the incidence of gestational diabetes mellitus,intestinal flora and pregnancy outcomes in overweight or obese pregnant women.Methods A total of 112 overweight or obese pregnant women were selected as research objects,and they were divided into control group(n=56)and observation group(n=56)by random sampling method.The observation group received probiotics three times a day from 20 weeks of gestation to delivery,while the control group received placebo capsules.The incidence of gestational diabetes,changes in blood glucose and intestinal microflora during pregnancy,pregnancy outcomes(premature delivery,gestational hypertension,cesarean section,placental abruption,premature rupture of membranes,etc.)and neonatal outcomes(body weight,macrosomia,head circumference,neonatal hypoglycemia and total bilirubin after 3 to 5 days of birth)were observed in both groups.Results At 28 weeks,the number of pregnant women with gestational diabetes in the observation group was significantly less than that in the control group(4 cases versus 14 cases,P<0.05),and the 2 h postprandial blood glucose level in the observation group was significantly lower than that in the control group[(102.9±20.7)mg/dL versus(116.4±25.6)mg/dL,P<0.05].Intestinal microflora analysis showed that lactobacillus,bifidobacteria and enterococcus in the observation group were(8.03±1.01)CFU/g,(8.43±1.28)CFU/g and(11.46±1.22)CFU/g,which were significantly higher than(7.61±0.88)CFU/g,(7.24±1.24)CFU/g,(10.36±1.13)CFU/g in the control group after treatment(P<0.05).The number of premature delivery in the observation group was significantly less than that in the control group(P<0.05).The total bilirubin level in the observation group was significantly lower than that in the control group 3 to 5 days after birth(P<0.05).Conclusion Probiotics can effectively reduce the incidence of gestational diabetes mellitus and prevent the occurrence of hyperbilirubinemia in infants by regulating blood glucose and intestinal flora in overweight or obese pregnant women.