孕期规范化综合营养干预对妊娠期糖尿病孕妇妊娠结局的改善作用观察

摘要

Objective To explore the effect of standardized comprehensive nutrition intervention during pregnancy on pregnant women with gestational diabetes mellitus.Method199 cases of women with gestational diabetes mellitus (GDM) during pregnancy who carried out pregnancy tests in Our Hospital were selected. The data of pregnancy tests and production was all complete and standardized comprehensive nutrition intervention was provided for the whole pregnant women. All pregnant women had completed twice nutrition classroom mission. Besides, face to face personal nutritionintervention was performed 1 to 3 times according to the situation of pregnancy. Based on whether participate in face to face personal nutritionintervention or not, all pregnant women were divided to observation group and control group.Result The percentages of adverse pregnancy outcomes of mothers (pregnancy-induced hypertension, polyhydramnios, postpartum hemorrhage, cesarean section, premature birth, premature rupture of membranes, and forceps delivery) in the observation group were all lower than that of the control group, and among all the outcomes, the percentage of polyhydramnios(7.0％ vs 21.2％), premature rupture of membranes(14.0％ vs 38.8％) and forceps delivery(0 vs 8.2％) in the observation group were significantly lower than that of the control group(P<0.05). The percentages of adverse pregnancy outcomes of infants (macrosomia, intrauterine distress, and neonatal asphyxia) in the observation group were also lower than that of the control group, with significantly lower percentages of macrosomia in the former group than that in the latter group(P<0.05).Conclusion Face to face personal nutritionintervention may have a certain improvement effect on pregnancy outcomes.%目的 探讨孕期规范化综合营养干预对妊娠期糖尿病孕妇妊娠结局的改善作用.方法 选取2016年10月1日至2017年9月30日在本院进行孕期产检并诊断妊娠期糖尿病的199例孕妇作为研究对象.采用规范化综合营养干预手段进行营养指导.所有研究对象均完成2次营养课堂宣教,在此基础上根据产检孕周情况,进行一对一个体化营养干预1～3次.根据是否参加一对一个体化营养干预进行分组,参加至少1次个体化营养干预者作为观察组,未参加个体化营养干预者作对照组,比较分析两组妊娠结局的不同.结果 观察组不良妊娠结局(妊高征、羊水过多、产后出血、剖宫产、早产、胎膜早破、产钳助产)发生率低于对照组,其中羊水过多发生率(7.0％vs 21.2％)、胎膜早破发生率(14.0％vs 38.8％)和产钳助产发生率(0 vs 8.2％)三项比较差异有显著性(P<0.05);观察组新生儿不良结局(巨大儿、胎儿宫内窘迫和新生儿窒息)发生率低于对照组,其中巨大儿发生率(7.0％vs 21.2％)比较差异有显著性(P<0.05).结论 孕期规范化综合营养干预对妊娠期糖尿病孕妇妊娠结局具有一定的改善作用.