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目的探讨孕期热量个体化供给与控制孕期母婴体重、降低孕期并发症,改善妊娠结局的关系。方法选取2009年1-12月在济南市妇幼保健院进行常规产前检查,有控制体重意愿并在该院分娩的单胎初产妇1010人作为研究组,同时选取同期无控制体重意愿的1270人作为对照组,根据孕前或孕12周前体重指数(BMI)不同分为正常体重组、超重组、肥胖组3组。研究组中3组热量供给分别为36～40、33～35.9、30～32.9kcal·kg/日,同时利用孕期营养个体化专家指导系统PNM1.0,适时调整热量及各种营养素供给。对照组热量供给不限制。指导孕妇进行轻体力劳动。结果 3组孕妇的孕期体重增加、BMI增加及巨大儿、妊娠期糖尿病(GDM)、相对头盆不称及医学指征剖宫产率,研究组均低于对照组,差异有统计学意义(P<0.01)。结论对孕前不同BMI孕妇给予不同的热量供给,对控制孕期增重、降低巨大儿及GDM的发生率临床效果满意,进而降低难产及剖宫产率。
Objective To explore the relationship between individualized pregnancy heat supply and weight control during pregnancy, reduce pregnancy complications and improve pregnancy outcome. Methods A total of 1010 singleton primiparous women who wished to control their weight and gave birth at this hospital were selected as the study group from January 2009 to January 2009 in Jinan MCH hospital. At the same time, 1270 As a control group, according to body mass index (BMI) before pregnancy or 12 weeks pregnant were divided into normal weight group, overweight group, obesity group. In the study group, the heat supply of three groups was 36-40, 33-35.9, and 30-32.9 kcal · kg / day, respectively. At the same time, PNM1.0 was used to guide the individual nutrition during pregnancy to timely adjust the calories and various nutrient supplies. Control group heat supply is not limited. Guide pregnant women to do light manual labor. Results The weight gain, BMI, gestational diabetes mellitus (GDM), relative cephalopelvic disparity and cesarean section rate in pregnant women in the three groups during pregnancy were lower in the study group than in the control group (the difference was statistically significant ( P <0.01). Conclusion Different pregnant women with different BMI before pregnancy have different heat supply, which is satisfactory to control the incidence of pregnancy-induced weight gain and reduce the incidence of GDM and GDM, and then reduce the rate of labor and cesarean section.