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目的探讨孕期系统化营养干预对改善母婴不良妊娠结局的影响,为孕妇提供更科学、可行的孕期个体化膳食指导。方法采用回顾性队列研究,分析2012年1月-2013年8月在该院定期产前检查(产检)并结束分娩的孕妇2 169例,比较营养干预组(干预组)1 079例与对照组1 090例孕妇母婴不良妊娠结局的差异。结果 (1)干预组与对照组在年龄、身高、孕前体质量、孕次及产次基线水平差异无统计学意义(均P>0.05)。(2)孕妇妊娠结局:干预组剖宫产率、妊娠期糖尿病(GDM)、妊娠期高血压疾病发生率低于对照组,分别为(37.53%vs.49.54%)、(12.88%vs.17.06%)、(10.75%vs.17.61%),差异有统计学意义(χ~2=31.79、7.44、20.97,均P<0.01)。(3)新生儿结局:新生儿体质量两组差异无统计学意义[(3 352.06±466.49)g vs.(3354.12±422.14)g,t=0.12,P>0.05],但干预组低出生体质量儿、巨大儿及早产发生率低于对照组(1.48%vs.4.40%,5.38%vs.8.44%),(8.80%vs.13.58%),差异有统计学意义(χ~2=26.01、12.42,均P<0.01)。结论孕期系统化营养干预,可以降低妊娠合并症发病率,降低剖宫产率,有效改善母婴不良妊娠结局,提高新生儿的出生质量。
Objective To investigate the effect of systematic nutritional intervention during pregnancy on the improvement of adverse pregnancy outcomes in pregnant women and infants and to provide pregnant women with more scientific and feasible dietary guidance during pregnancy. Methods A retrospective cohort study was conducted to analyze 2 169 pregnant women who had scheduled antenatal examination (check-up) and delivered at the hospital between January 2012 and August 2013 and 1079 nutritional intervention groups (intervention group) and control group Difference of adverse pregnancy outcomes among 1 090 pregnant women and their mothers. Results (1) There was no significant difference in the baseline, body mass, pregnancy time and delivery among intervention group and control group (all P> 0.05). (2) The pregnancy outcome of pregnant women: The incidence of cesarean section, gestational diabetes mellitus (GDM) and gestational hypertension in intervention group were lower than those in control group (37.53% vs.49.54%, 12.88% vs.17.06 %), (10.75% vs.17.61%), the difference was statistically significant (χ ~ 2 = 31.79,7.44,20.97, all P <0.01). (3) Neonatal outcome: There was no significant difference in neonatal weight between the two groups [(3 352.06 ± 466.49) g vs. (3354.12 ± 422.14) g, t = 0.12, P> 0.05] The incidences of quality malnutrition, macrosomia and preterm birth were lower in the control group (1.48% vs.4.40%, 5.38% vs.8.44%, vs 8.80% vs.13.58%, respectively) (χ ~ 2 = 26.01, 12.42, all P <0.01). Conclusion Systematic nutritional intervention during pregnancy can reduce the incidence of pregnancy complications, reduce the rate of cesarean section, effectively improve maternal and child adverse pregnancy outcomes and improve the quality of newborn birth.