醫學營養治療對妊娠糖尿病患者和胎兒體重的影響

Effect of medical nutrition therapy on gestational diabetes mellitus patients and infant birth weight

目的回顧分析患妊娠糖尿病(gestational diabetes mellitus,GDM)的孕婦進行醫學營養治療後(medical nutrition therapy,MNT)體重增加情况與胎兒出生體重之間的關係,評估GDM患者最合適的體重增加範圍。方法營養師給予GDM患者個人化的飲食治療並記錄相關數據。孕期體重增加與美國醫學研究中心的指引對比,胎兒平均體重與相同胎齡的第50個百份位對比。結果孕婦體重增加達標率為42.5%。低和高BMI組體重增加欠理想。低BMI組胎兒平均出生體重為3.10±0.10kg,明顯低於指標3.4kg(P=0.01)。未見巨大兒。分娩孕週平均為38.8±0.72週,沒有早產兒。結論MNT可保障胎兒為正常體重兒,減少巨大兒發生。BMI<18.5kg/m^(2)的GDM孕婦在飲食控制上更具挑戰性。GDM孕期體重增加指標仍有待研究。

Objective To assess the appropriate weight gain range amongst gestational diabetes mellitus(GDM)patients who received medical nutrition therapy(MNT)of the relationship between maternal weight gain of GDM patients and their infants’birth weight.Methods Dietitians provided individualized nutrition counseling for GDM patients,followed by the collection of relevant data.Patients’gestational weight gain data and their infants’birth weight data were compared with the guideline of the Institute of Medicine and with the 50th percentile of the standard weight for the same gestational age respectively.Results The target range of gestational weight gain has reached the level of 42.5%.The low and high BMI groups have unexpected weigh gain.Low BMI group has the lowest average infant birth weight of 3.10±0.10kg,which is significantly lower than the indicator of 3.4kg(P=0.01),and no fetal macrosomia was found.The average week of confinement is 38.8±0.72 weeks,and no preterm infant was found.Conclusion Medical nutrition therapy ensures infant to be born at a normal birth weight and reduces the occurrence of fetal macrosomia.Diet control is more challenging in GDM patients with BMI<18.5 kg/m^(2).Further studies are suggested to establish GDM weight gain indicator.