目的 研究妊娠早中期个体化医学营养管理降低妊娠期糖尿病发生率的作用.方法 根据是否采取个体化医学营养将早中期空腹血糖高的孕妇100例随机分为对照组和管理组,每组50例.比较2组孕妇在体重、血糖、并发症、妊娠结局的差异.结果 妊娠早中期接受个体化医学营养管理的孕妇的体重和血糖水平较对照组低(P<0.05).对照组孕妇发生羊水过多,羊水污染,胎膜早破,产后出血的比例分别为12.0%、10.0%、20.0%、32.0%;妊娠早中期开始实行个体化医学营养管理的孕妇以上指标的比例分别为2.0%、4.0%、6.0%、12.0%.对照组的孕妇妊娠结局发生胎儿窘迫、剖宫产、早产、新生儿窒息、巨大儿的比例分别为16.0%、50.0%、8.0%、4.0%、14.0%;妊娠早中期开始实行个体化医学营养管理的孕妇妊娠结局发生以上情况的比例分别为4.0%、30.0%、0、0、4.0%,差异均有统计学意义(P<0.05).结论 妊娠早中期个体化医学营养管理对降低妊娠期糖尿病发生率有明显作用.%Objective To investigate the effects of individualized medical nutrition management at early metaphase of pregnancy on the incidence of gestational diabetes mellitus.Methods One hundred pregnant women with gestational diabetes mellitus at early metaphase of pregnancy who were admitted and treated in our hospital from January 2015 to December 2016 were enrolled in the study,according to whether they received individual medical nutrition intervention or not,the 100 pregnant women were randomly divided into control group (n=50) and intervention group (n=50). The differences of body weight, blood glucose,complications and pregnancy outcome were observed and compared between the two groups. Results The body weight and blood glucose levels in intervention group were significantly lower than those in control group(P<0.05),and the incidence rates of polyhydramnios, amniotic fluid pollution, premature rupture of membranes, postpartum hemorrhage in control group were 12.0%, 10.0%, 20. 0%, 32. 0%,respectively,however,which in intervention group were 2. 0%, 4.0%,6. 0%,12. 0%,respectively. Moreover the incidence rates of fetal distress, cesarean section, premature birth, neonatal asphyxia,macrosomia were 16.0%,50.0%,8.0%,4.0%,14.0%,respectively in control group,however,which in intervention groups were 4.0%,30.0%,0,0,4.0%,respectively,there were significant differences between two groups (P<0.05). Conclusion The individualized medical nutrition management at early metaphase of pregnancy has obvious effects in reducing incidence rate of gestational diabetes mellitus.
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