GDM孕妇孕中期应用个体化饮食干预联合锻炼指导的效果及妊娠结局研究

The effect and pregnancy outcomes of GDM pregnant women applying individualized dietary intervention combined with exercise guidance in the second trimester

目的观察妊娠期糖尿病(GDM)孕妇孕中期应用个体化饮食干预联合锻炼指导的效果及对妊娠结局的影响。方法前瞻性选取2021年1-12月在北京市垂杨柳医院进行孕期保健并住院分娩的200例GDM孕妇为对象,并根据随机数字表法分为两组。常规组采用常规饮食及锻炼指导,而个体化组采用个体化饮食干预联合锻炼指导。比较两组孕妇糖脂指标、血清胱抑素C(Cys-C)、同型半胱氨酸(Hcy)、营养指标、妊娠结局及自我护理能力测定量表(ESCA)评分、负性情绪评分的差异。结果干预后,两组血糖指标、Cys-C、Hcy及个体化组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均较开始干预前下降,两组营养指标及对照组高度脂蛋白胆固醇(HDL-C)较开始干预前升高,个体化组血糖指标、Cys-C、Hcy、TC、甘油三酯(TG)、LDL-C均低于常规组,血清白蛋白、HDL-C均高于常规组(P<0.05)。结论GDM孕妇孕中期应用个体化饮食干预联合锻炼指导可有效地控制血糖和血脂,提高孕妇的自护能力,减少不良情绪的产生,改善孕妇的营养指标和妊娠结局。

Objective To investigate the effect of individualized dietary intervention combined with exercise guidance in the second trimester of pregnant women with gestational diabetes mellitus(GDM)and its effect on pregnancy outcomes.Methods 200 pregnant women with GDM who received health care during pregnancy and delivered in Beijing Chuiyangliu Hospital from January to December 2021 were prospectively selected,and divided into two groups according to random number table.The routine group was given routine diet and exercise guidance,while the individualized group was given individualized diet intervention and exercise guidance.The differences of glycolipid index,serum cystatin C(Cys-C),homocysteine(Hcy),nutritional index,pregnancy outcome,ESCA score and negative emotion score between the two groups were compared.Results After the intervention,the blood glucose index,Cys-C,Hcy and total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)in the individualized group were lower compared with those before the intervention.The nutritional index and high lipoprotein cholesterol(HDL-C)in the control group were higher compared with those before the intervention.The blood glucose index,Cys-C,Hcy,TC,triglyceride(TG)and LDL-C in the individualized group were lower than those in the conventional group,and the serum albumin and HDL-C were higher than those in the conventional group(P<0.05).Conclusion The application of individualized diet intervention combined with exercise guidance in the second trimester of GDM pregnancy can effectively control blood glucose and blood lipid,improve the ability of self-care of pregnant women,reduce the generation of bad emotions,and improve nutritional indicators and pregnancy outcomes.