孕前体重指数对妊娠期糖尿病患者妊娠结局的影响

Relationship between Pre-pregnancy BMI and Blood Glucose,Gestational Weight Gain,Dietary Nutrition and Pregnancy Outcome in GDM Patients

目的探讨妊娠糖尿病(GDM)患者孕前体质指数(BMI)与血糖、孕期增重、孕期膳食营养及妊娠结局的关系。方法选取2016年2月-2017年1月在医院治疗的GDM患者128例,根据孕前BMI分为低体质量组(n=16)、正常体质组(n=58)、超重组(n=32)和肥胖组(n=22),采用24h膳食回顾调查法和食物频度法分析患者孕中期营养摄入,采用口服葡萄糖耐量试验(OGTT)检测血糖水平,同时调查孕期增重及妊娠结局。结果超重组和肥胖组空腹血糖分别为(5.67±0.32)mmol和(5.7±0.35)mmol/L,餐后1小时血糖分别为(10.62±0.98)mmol/L和(10.65±0.97)mmol/L,均明显高于低体重质量组合正常体质量组(P<0.05);各组患者总能量、总蛋白、总脂肪、总碳水化合物摄入水平比较无统计学意义(P>0.05);各组患者孕期增重水平比较差异无统计学意义(P>0.05);超重组合肥胖组剖宫产比例分别为68.75%和77.27%,明显高于低体质量组(P<0.5);超重组合肥胖组胎儿窘迫比例分别为25%和27.27%,明显高于正常体质量组(P<0.05)。结论 GDM患者孕前BMI与孕期血糖及妊娠结局有一定关系。故孕前应控制BMI水平,加强孕前健康教育。

Objectives To investigate the relationship between pre-pregnancy body mass index(BMI) and blood glucose, gestational weight gain, dietary nutrition during pregnancy and pregnancy outcome in gestational diabetes mellitus(GDM) patients. Methods 128 cases of GDM patients in our hospital from February 2016 to January 2017 were divided into low weight group(n=16), normal weight group(n=58), overweight group(n=32) and obesity group(n=22) according to pre-pregnancy BMI,the 24 h diet review method and food frequency method were used to analyze the nutritional intake in the second trimester, and the glucose tolerance test(OGTT) was used to detect the blood glucose level, investigated the weight gain during pregnancy and the pregnancy outcome. Results Overweight and obesity group fasting blood glucose were(5.67±0.32) mmol/L and(5.70±0.35) mmol/L, 1h postprandial blood glucose were(10.62± 0.98) mmol/L and(10.65±0.97) mmol/L, were significantly higher than those in low weight group and normal weight group(P < 0.05);The total energy, total protein, total fat and total carbohydrate intake in each group were not statistically significant(P>0.05);The level of weight gain in each group were not statistically significant(P>0.05);The overweight and obesity group cesarean section rates were 68.75% and 77.27%, significantly higher than the low weight group(P<0.05);The overweight and obesity group fetal distress rates were 25.00% and 27.27%, significantly higher than that in normal weight group(P<0.05). Conclusions GDM patients pre-pregnancy BMI had a certain relationship with pregnancy blood glucose and pregnancy outcomes, so pre-pregnancy should control the level of BMI, strengthen pre pregnancy nutrition health education.