孕期体质量管理对孕前体质量超重及肥胖孕妇妊娠结局的影响

Effect of gestational weight management on pregnancy outcomes of women with overweight or obesity before pregnancy

目的探讨孕期体质量管理对孕前体质量超重及肥胖孕妇妊娠结局的影响。方法抽取2020年4月至2022年8月漯河市妇幼保健院收治的孕前体质量超重及肥胖孕妇92例,按随机数字表法分为观察组与对照组,每组46例。对照组采用常规管理措施,观察组采用孕期体质量管理。比较两组体质量情况(孕晚期总增重、增重达标率)、血糖水平、胰岛功能、分娩方式及新生儿结局。结果观察组孕晚期总增重少于对照组,增重达标率高于对照组(P<0.05)。管理后,观察组空腹血糖、餐后2 h血糖水平低于对照组(P<0.05)。管理后,观察组空腹胰岛素、胰岛素抵抗指数低于对照组(P<0.05)。观察组剖宫产率(10.87%,5/46)低于对照组(28.26%,13/46),阴道分娩率(69.57%,32/46)高于对照组(47.83%,22/46),P<0.05。观察组正常儿娩出率(89.13%,41/46)高于对照组(65.22%,30/46),巨大儿娩出率(4.35%,2/46)低于对照组(23.91%,11/46),P<0.05。结论孕前体质量超重及肥胖孕妇应用孕期体质量管理,可控制体质量,改善血糖水平和胰岛功能,降低巨大儿发生率,提高阴道分娩率,改善妊娠结局。

Objective To analyze the effect of weight management during pregnancy on pregnancy outcomes of women with overweight or obesity before pregnancy.Methods A total of 92 pregnant women with overweight and obesity before pregnancy treated in the Luohe Maternal and Child Health Hospital from April 2020 to August 2022 were selected,and they were divided into observation group and control group according to the random number table method,with 46 cases in each group.The control group was intervented by routine management measures,while the observation group was intervented by gestational weight management.Body weight(total weight gain in the third trimester,the rate of weight gain reaching the standard),blood glucose levels,islet function,delivery mode and neonatal outcomes were compared between the two groups.Results The total weight gain in the third trimester of pregnancy in the observation group was lower than that in the control group,and the rate of weight gain reaching the standard was higher than that in the control group(P<0.05).After management,levels of fasting blood glucose and 2 h postprandial blood glucose in the observation group were lower than those in the control group(P<0.05).After management,fasting insulin and insulin resistance index in the observation group were lower than those in the control group(P<0.05).The cesarean section rate of the observation group was 10.87%(5/46),lower than 28.26%(13/46)of the control group,and the vaginal delivery rate of the observation group was 69.57%(32/46),higher than 47.83%(22/46)of the control group(P<0.05).The delivery rate of normal infants in the observation group was 89.13%(41/46),which was higher than 65.22%(30/46)in the control group,and the delivery rate of macrosomia in the observation group was 4.35%(2/46),which was lower than 23.91%(11/46)in the control group(P<0.05).Conclusions Weight management during pregnancy for women with overweight and obesity before pregnancy can control weight,improve blood glucose level and islet function,reduce the incidence of macrosomia,increase the rate of vaginal delivery and improve pregnancy outcomes.