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目的探讨营养干预对妊娠期糖尿病孕妇孕期体重以及妊娠结局的影响。方法选取2011年1月-2016年1月该院门诊收治的273例孕24周后经糖耐量检测确诊为妊娠期糖尿病的孕妇为研究对象,按照随机数字表法分为两组,观察组136例,对照组137例。对照组给予常规干预,观察组在常规干预的基础上给予个体化的营养干预,比较两组孕妇干预前后体重增长情况及妊娠结局。结果观察组孕36周、分娩前的体重均低于对照组(t=-3.051、-4.168,P=0.003、<0.001);观察组孕24周~孕36周、孕36周~分娩前的增重、孕24周~分娩前总增重均少于对照组(t=-46.089、-29.291、-87.106,P<0.001)。观察组妊娠期高血压疾病、胎膜早破、羊水过多以及剖宫产的发生率低于对照组(χ~2=6.759、7.452、12.610、5.089,P=0.009、0.006、0.001、0.024),观察组新生儿呼吸窘迫综合征、巨大儿、早产儿、低体重儿的发生率低于对照组(χ~2=4.588、6.759、8.558、5.657,P=0.032、0.009、0.003、0.017)。结论营养干预有助于控制妊娠期糖尿病孕妇的体重增加,减少不良妊娠结局的发生,值得临床推广应用。
Objective To investigate the effect of nutritional intervention on gestational weight and pregnancy outcome of pregnant women with gestational diabetes mellitus. Methods From January 2011 to January 2016, 273 pregnant women diagnosed as gestational diabetes mellitus with gestational diabetes mellitus were enrolled in this study. 273 pregnant women were divided into two groups according to the random number table. The observation group 136 Cases, control group of 137 cases. The control group was given routine intervention. The observation group was given individualized nutrition intervention on the basis of routine intervention. The weight gain and pregnancy outcome were compared between the two groups before and after intervention. Results The weight of the observation group before pregnancy was lower than that of the control group (t = -3.051, -4.168, P = 0.003, <0.001). The observation group was pregnant 24 weeks to 36 weeks pregnant and 36 weeks pregnant before delivery Weight gain, 24 weeks pregnant ~ total weight gain before delivery were less than the control group (t = -46.089, -29.291, -87.106, P <0.001). The incidence of gestational hypertension, premature rupture of membranes, polyhydramnios and cesarean section in observation group were lower than those in control group (χ ~ 2 = 6.759,7.452,12.610,5.089, P = 0.009,0.006,0.001,0.024) . The incidence of neonatal respiratory distress syndrome in observation group was lower than that in control group (χ ~ 2 = 4.588,6.759,8.558,5.657, P = 0.032,0.009,0.003,0.017) in macrosomia, preterm and low birth weight infants. Conclusion Nutritional intervention can help to control the weight gain of pregnant women with gestational diabetes and reduce the incidence of adverse pregnancy outcomes, which is worthy of clinical application.