产程饮食管理对妊娠期糖尿病产妇分娩结局的影响

Effects of dietary management during labor process on pregnancy outcome of pregnant women with gestational diabetes mellitus

目的探讨产程饮食管理对妊娠期糖尿病产妇分娩结局的影响。方法回顾性分析温州市人民医院2022年1—12月住院分娩的妊娠期糖尿病产妇122例的临床资料,根据饮食管理方法分为观察组、对照组各61例,对照组采用常规饮食管理,观察组采用产程饮食管理。比较两组产程指标和分娩结局。结果观察组产程中摄入能量[(75.36±9.54)kcal/h]显著高于对照组[(57.23±8.12)kcal/h],产程中最高血糖[(6.74±0.99)mmol/L]、高血糖比例[4.92%(3/61)]及胰岛素使用比例[3.28%(2/61)]显著低于对照组[(7.72±1.05)mmol/L,40.98%(25/61),21.31%(13/61)]差异均有统计学意义(t=-11.30、5.30,χ^(2)=22.43、9.20,均P<0.05);观察组第一产程时间[(418.66±114.26)min]、活跃期时间[(281.37±129.65)min]、第二产程时间[(38.14±17.25)min]均显著短于对照组[(519.93±132.45)min、(358.69±153.26)min、(51.37±18.62)min](t=4.52、3.00、4.07,均P<0.05);观察组新生儿低血糖发生率为1.64%(1/61),显著低于对照组的16.39%(10/61)(χ^(2)=6.39,P<0.05)。结论产程饮食管理可有效改善妊娠期糖尿病产妇血糖水平及母儿分娩结局。

Objective To investigate the effects of dietary management during labor process on pregnancy outcome of pregnant women with gestational diabetes mellitus.Methods A retrospective analysis was conducted on the clinical data of 122 pregnant women with gestational diabetes mellitus who delivered at the Wenzhou People's Hospital between January and December 2022.Based on their dietary management methods,these patients were divided into an observation group and a control group,with 61 cases in each group.The control group underwent routine dietary management,whereas the observation group received dietary management during labor process.The labor process indicators and delivery outcomes between the two groups were compared.Results The energy intake in the observation group was(75.36±9.54)kcal/h,which was significantly higher than(57.23±8.12)kcal/h in the control group(t=-11.30,P<0.05).Furthermore,the highest blood glucose levels,hyperglycemia ratios,and proportions of insulin usage in the observation group were(6.74±0.99)mmol/L,4.92%(3/61),and 3.28%(2/61),respectively,which were significantly lower than those in the control group[(7.72±1.05)mmol/L,40.98%(25/61),21.31%(13/61),t=5.30,χ^(2)=22.43,9.20,all P<0.05].Additionally,the observation group had significantly shorter first stage labor time[(418.66±114.26)minutes],active stage time[(281.37±129.65)minutes],and second stage labor time[38.14±17.25)minutes]compared with the control group[(519.93±132.45)minutes,(358.69±153.26)minutes,(51.37±18.62)minutes,t=4.52,3.00,4.07,all P<0.05].The incidence of neonatal hypoglycemia in the observation group was 1.64%(1/61),which was significantly lower than 16.39%(10/61)in the control group(χ^(2)=6.39,P<0.05).Conclusion Dietary management during the labor process can effectively improve the blood sugar level of pregnant women with gestational diabetes mellitus,as well as enhance the maternal and fetal outcomes.