孕妇妊娠压力状况及其影响因素分析

目的分析孕妇妊娠压力状况,并探讨其影响因素,为制定有针对性的缓解孕妇压力方案提供有力依据。方法选取2014年1~6月于我院产科门诊就诊的孕妇为研究对象,通过妊娠压力量表对妊娠孕妇进行问卷调查,并进行统计学处理。结果孕妇妊娠压力得分为(65.19±13.64)分,得分指标为67.2%,属于中等水平压力,其中得分最高的为"确保母子安全和健康引发的压力感"。家庭人均月收入、流产经历及妊娠合并症为影响孕妇心理压力的主要因素。结论孕妇妊娠期间均存在一定的心理压力,其主要压力源为"确保母子安全和健康引发的压力感",造成此压力源的主要原因为对妊娠和分娩认识的不足。家庭人均月收入、妊娠合并症及流产经历是造成孕妇妊娠压力的主要因素。     

二胎孕妇妊娠压力及其影响因素分析

目的 探讨二胎孕妇妊娠压力现状及其影响因素。方法 于2016年7-8月,应用妊娠压力量表、家庭关怀度指数（APGAR）和自制调查问卷对便利抽样的331名二胎孕妇进行调查。结果 结果 二胎孕妇妊娠压力总均分（0.75±0.48）分,妊娠有压力者占21.8%;单因素分析显示,第一胎高危妊娠（χ²=9.479、P=0.002）、婆媳关系（χ²=18.243、P=0.000）、夫妻关系（χ²=24.160、P=0.000）、怀孕态度（χ²=31.560、P=0.000）、生二胎原因（χ²=29.835、P=0.000）、第二胎高危妊娠（χ²=4.992、P=0.025）、家庭功能（χ²=62.002、P=0.000）等因素与二胎孕妇妊娠压力发生率有关;logistic回归分析显示,二胎孕妇妊娠压力与夫妻关系、生二胎原因、第二胎高危妊娠和家庭功能有关。结论 夫妻关系差、家庭功能障碍、第二胎高危妊娠、在父母压力下生二胎等因素是导致二胎孕妇妊娠压力的主要因素。     

饮食运动干预联合胰岛素对妊娠期糖尿病孕妇妊娠结局的影响

目的 研究饮食运动干预联合胰岛素对妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇妊娠结局的影响。方法 选择2016年5月-2020年5月我院的GDM孕妇100例,根据干预方式的不同将其分为对照组和实验组,各50例。对照组采用常规干预及胰岛素治疗,实验组在对照组的基础上联合饮食运动干预。对比两组的血糖控制情况、不良妊娠结局。结果 干预后实验组的FPG、2hPG、HbA1c低于对照组(P<0.05);实验组的不良妊娠结局总发生率低于对照组的(P<0.05)。结论 饮食运动干预联合胰岛素相比单纯的胰岛素治疗能够有效控制GDM孕妇的血糖水平,降低不良妊娠结局的发生。     

个体化孕期饮食指导对妊娠结局的影响

妊娠糖尿病（gestational diabetes mellitus，GDM）是指在妊娠期首次发现或发生的糖代谢异常，但不排除异常在妊娠前即已存在。GDM对妊娠、胎儿和新生儿有较大的负面影响，易造成羊水过多、妊高症、巨大儿、畸胎和死胎等。现阶段大多数孕妇的营养宣教缺乏针对个体的饮食指导，随着生活水平的提高、科学合理的营养知识的相对匮乏，导致GDM的发病率逐年上升。     

个体化孕期饮食指导对妊娠结局的影响

妊娠糖尿病(gestational diabetes mellitus,GDM)是指在妊娠期首次发现或发生的糖代谢异常,但不排除异常在妊娠前即已存在.GDM对妊娠、胎儿和新生儿有较大的负面影响,易造成羊水过多、妊高症、巨大儿、畸胎和死胎等.     

孕期合理饮食对妊娠结局的影响

目的:探讨孕期合理饮食对妊娠结局的影响。方法:选择2002年1月～2005年1月在本院门诊就诊的早孕者,根据孕前体重指数(BMI)分为3组,低体重组:BMI<19,理想体重组:19≤BMI≤22,高体重组:BMI>22,每组按随机原则又分为观察组、对照组,观察组在整个孕期指导合理饮食,对照组在整个孕期不予任何饮食指导。结果:观察组孕期平均体重增长、阴道分娩平均总产程、平均产后出血量分别为(12.09±3.37)kg、(6.82±2.56)h、(368±127)ml,对照组分别为(14.59±3.55)kg、(7.73±3.37)h、(413±138)ml,两组比较有非常显著性差异(P<0.01),观察组的巨大儿发生率、剖宫产率、新生儿窒息率分别为6.42%、25.06%、2.64%,对照组分别为10.52%、35.01%、3.72%,两组比较有非常显著性差异或显著性差异(P<0.01或P<0.05)。结论:孕期合理饮食有助于控制孕期体重过度增长,使总产程缩短,产后出血量减少,巨大儿的发生率、剖宫产率、新生儿窒息率明显降低。     

饮食和生活方式的咨询指导对孕妇体重指数及妊娠结局的影响

目的探讨系统性饮食和生活方式的咨询指导对孕妇体重指数(body mass index,BMI)及妊娠结局的影响。方法安徽医科大学第一附属医院产科门诊建档的孕妇280例,随机双盲分为接受常规产前检查的对照组(137例)和接受系统性饮食和生活方式咨询指导的实验组(143例),观察产前干预措施对孕妇孕期BMI、美国医学研究会(the institute of medicine,IOM)指南遵从率、妊娠结局等影响。结果与对照组相比,实验组孕妇自孕28~38周的BMI降低;实验组的孕妇总体IOM遵从率和组内正常体重孕妇(BMI<25)IOM遵从率均有明显提高,超重孕妇(BMI:25~)和肥胖孕妇(BMI≥30)的IOM遵从率有一定的提高,但差异无统计学意义(均有P>0.05);实验组孕妇的不良妊娠结局、妊娠期高血压疾病(hypertensive disorder complicating pregnancy,HDCP)、妊娠期糖尿病(gestational diabetes mellitus,GDM)的发生率均有不同程度地下降。结论系统性饮食和生活方式的咨询指导比常规产前检查更能有效...     

孕妇饮食调养食谱——妊娠止呕

粟米丸子 【原料】 粟米粉200克,精盐适量。     

孕妇孕晚期生殖道GBS感染对胎膜早破、妊娠结局影响

目的：院内妊娠晚期孕妇生殖道B族链球菌(GBS)感染情况调查并探究对胎膜早破、妊娠结局的影响。方法：选取2021年6月-2023年7月于本院定期产前检查的妊娠晚期孕妇3970例GBS感染检测,根据感染情况分为感染组和非感染组,比较两组胎膜早破发生率及妊娠不良结局。结果：3970例孕妇中103例GBS感染,感染率2.6%,纳入感染组,非感染孕妇中随机选取103例纳入非感染组;感染组年龄≤30岁组感染率(68.0%)高于>30～35岁组及>35岁组,感染组胎膜早破发生率(18.5%)高于非感染组(4.9%),绒毛膜羊膜炎(6.8%)、新生儿肺炎(13.6%)、胎儿生长发育迟缓(8.7%)、新生儿感染(7.8%)、胎儿宫内窘迫(9.7%)发生率均高于非感染组(0、4.9%、1.0%、1.0%、1.9%)(均P<0.05);两组产妇分娩期发热、新生儿黄疸发生率未见差异(P>0.05)。结论：孕晚期孕妇发生GBS感染增加胎膜早破及不良妊娠结局发生风险,临床应及时采取措施治疗干预。     

妊娠期糖尿病饮食控制对妊娠结局的影响

目的:研究饮食控制对妊娠期糖尿病妊娠结局的影响。方法:比较饮食控制组与对照组、饮食控制组与未治疗组的病理妊娠、胎婴儿患病率的差别。结果:饮食控制组的病理妊娠发生率和胎婴儿患病率与对照组比较差异无显著性,饮食控制组的病理妊娠发生率和胎婴儿患病率均显著低于未治疗组(P<0.01)。结论:严格按标准控制饮食对妊娠期糖尿病十分重要。     

妊娠期糖尿病与孕妇饮食及生活方式的病例-对照研究

目的探讨与妊娠期糖尿病(GDM)相关的饮食和生活方式。方法采用1∶2病例-对照研究,选取450例孕妇作为研究对象,包括150例确诊为GDM的孕妇和300例正常孕妇,用问卷调查其一般情况、妊娠情况及饮食生活情况等,并进行t检验和条件Logistic回归分析。结果两组妇女平均每日总能量、蛋白质、脂肪和碳水化合物的摄入量差异均有统计学意义(P≤0.01)。经单因素条件Logistic回归分析共有23个变量与GDM的发生有关,最终进入多因素Logistic回归模型的有7个变量,其中危险因素6个,包括血压高(OR=28.50)、不良孕产史(OR=3.10)、孕前肥胖(OR=2.80)、过量摄入水果(OR=2.40)、糖尿病家族史(OR=1.86)及喜欢吃甜食(OR=1.68);1个保护因素为进食白肉频率较高(OR=0.62)。结论多种饮食生活方式不合理与GDM发病有关;对孕妇应积极开展营养教育,合理选择食物,调整饮食结构,以减少GDM的发病率。     

The Association between Dietary Patterns and Pre-Pregnancy BMI with Gestational Weight Gain: The “Born in Shenyang” Cohort

The reported associations of maternal dietary patterns during pregnancy with gestational weight gain are inconsistent, especially among the less studied Asian Chinese populations. In a prospective pre-birth cohort study conducted in northern China, we determined the associations between maternal dietary patterns and the probability of excess gestational weight gain (EGWG) among 1026 pregnant women. We used 3-day food diaries to assess maternal diet and performed principal component analysis to identify dietary patterns. Maternal adherence to a traditional pattern, which was characterized by a higher intake of tubers, vegetables, fruits, red meat, and rice, was associated with a higher probability of EGWG (quartile 3 vs. quartile 1, odds ratio [OR] = 1.62, 95% confidence interval [CI] = 1.10−2.38). This risk association was more pronounced among women who were overweight/obese before pregnancy (quartile 4 vs. quartile 1, OR = 5.17, 95% CI = 1.45–18.46; p for interaction < 0.01). Maternal adherence to a high protein pattern, which was characterized by a higher intake of fried foods, beans and bean products, dairy products, and fruits, was associated with a lower risk of EGWG (quartile 3 vs. quartile 1, OR = 0.56, 95% CI, 0.39−0.81). The protective association was more pronounced among non-overweight/obese women (p for interaction < 0.01). These findings may help to develop interventions and better define target populations for EGWG prevention.     

Maternal stress during pregnancy and gestational duration: A cohort study from the Danish National Birth Cohort

Background

Preterm birth is one of the most important contributors to neonatal mortality and morbidity. Experiencing stress during pregnancy may increase the risk of adverse birth outcomes, including preterm birth. This association has been observed in previous studies, but differences in measures used limit comparability.

Objective

The objective of the study was to investigate the association between two measures of maternal stress during pregnancy, life stress and emotional distress, and gestation duration.

Methods

Women recruited in the Danish National Birth Cohort from 1996 to 2002, who provided information on their stress level during pregnancy and expecting a singleton baby, were included in the study. We assessed the associations between the level of life stress and emotional distress in quartiles, both collected at 31 weeks of pregnancy on average, and the rate of giving birth using Cox regression within intervals of the gestational period.

Results

A total of 80,991 pregnancies were included. Women reporting moderate or high levels of life stress vs no stress had a higher rate of giving birth earlier within all intervals of gestational age (e.g. high level: 27–33 weeks: hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.04, 1.84; 34–36 weeks: 1.10, 95% CI 0.97, 1.25; 37–38 weeks: 1.21, 95% CI 1.15, 1.28). These associations between life stress and preterm birth were mainly driven by pregnancy worries. For emotional distress, a high level of distress was associated with shorter length of gestation in the preterm (27–33 weeks: 1.38, 95% CI 1.02, 1.86; 34–36 weeks: 1.05, 95% CI 0.91, 1.19) and early term (1.11, 95% CI 1.04, 1.17) intervals.

Conclusions

Emotional distress and life stress were shown to be associated with gestational age at birth, with pregnancy-related stress being the single stressor driving the association. This suggests that reverse causality may, at least in parts, explain the earlier findings of stress as a risk factor for preterm birth.     

Pre-Gestational Consumption of Ultra-Processed Foods and Risk of Gestational Diabetes in a Mediterranean Cohort. The SUN Project

We aimed to investigate the relationship between the pre-gestational consumption of ultra-processed foods (UPF) and the risk of gestational diabetes (GDM). We carried out a prospective study among 3730 Spanish women of the SUN cohort who reported at least one pregnancy after baseline recruitment. Cases of GDM were identified among women with a confirmed diagnosis of GDM. UPF consumption was assessed through a validated, semi-quantitative food frequency questionnaire and the frequency of UPF consumption was categorized in tertiles. We identified 186 cases of GDM. In the pooled sample, we did not observe a significant association of UPF with the risk of GDM. When we stratified by age, the multivariate OR for the third tertile of UPF consumption compared with the lowest one was 2.05 (95% CI 1.03, 4.07) in women aged ≥30 years at baseline (P_trend = 0.041). The association remained significant in a sensitivity analysis after changing many of our assumptions and adjusting for additional confounders. No association between a higher UPF consumption and GDM risk was observed in women aged 18–29 years. The pre-gestational UPF consumption may be a risk factor for GDM, especially in women aged 30 years or more. Confirmatory studies are needed to validate these findings.     

孕期个性化营养指导对妊娠期糖尿病患者妊娠结局的影响

目的探讨孕期个性化营养指导对妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇妊娠结局的影响。方法将2010年10月至2013年5月佛山市顺德区妇幼保健院产科收治的138例GDM患者随机分为观察组和对照组,每组各69例,观察组给予个性化营养指导;对照组给予常规GDM营养宣教。比较两组患者的体质量增长速率、空腹血糖(fasting blood glucose,FBG)、餐后血糖(postprandial blood glucose,PBG)、并发症及妊娠结局。结果实施营养指导后,观察组患者的体质量增长速率显著低于对照组(P0.05);PBG、FBG水平优于对照组(P0.05);羊水过多、胎膜早破、产后出血、巨大儿、早产、剖宫产、胎儿宫内窘迫发生率均低于对照组(P0.05)。结论个性化营养指导有利于维持GDM患者围产期的血糖处于正常水平,改善妊娠结局。     

A Priori and a Posteriori Dietary Patterns during Pregnancy and Gestational Weight Gain: The Generation R Study

Abnormal gestational weight gain (GWG) is associated with adverse pregnancy outcomes. We examined whether dietary patterns are associated with GWG. Participants included 3374 pregnant women from a population-based cohort in the Netherlands. Dietary intake during pregnancy was assessed with food-frequency questionnaires. Three a posteriori-derived dietary patterns were identified using principal component analysis: a “Vegetable, oil and fish”, a “Nuts, high-fiber cereals and soy”, and a “Margarine, sugar and snacks” pattern. The a priori-defined dietary pattern was based on national dietary recommendations. Weight was repeatedly measured around 13, 20 and 30 weeks of pregnancy; pre-pregnancy and maximum weight were self-reported. Normal weight women with high adherence to the “Vegetable, oil and fish” pattern had higher early-pregnancy GWG than those with low adherence (43 g/week (95% CI 16; 69) for highest vs. lowest quartile (Q)). Adherence to the “Margarine, sugar and snacks” pattern was associated with a higher prevalence of excessive GWG (OR 1.45 (95% CI 1.06; 1.99) Q4 vs. Q1). Normal weight women with higher scores on the “Nuts, high-fiber cereals and soy” pattern had more moderate GWG than women with lower scores (−0.01 (95% CI −0.02; −0.00) per SD). The a priori-defined pattern was not associated with GWG. To conclude, specific dietary patterns may play a role in early pregnancy but are not consistently associated with GWG.