食品交换份法营养干预对妊娠期糖尿病孕妇妊娠结局的影响

[目的]探讨食品交换份的营养干预方法对妊娠期糖尿病孕妇的作用,为今后妊娠期糖尿病营养指导,减少母婴并发症提供参考依据。[方法]选取在宁波市江北区妇幼保健院做常规产前检查,于孕24~28周确诊为单胎妊娠期糖尿病的农村孕妇198例,其中自愿接受个体化食品交换份干预指导的123例为干预组,未进行系统营养干预的75例为对照组,比较两组孕妇母婴并发症和妊娠结局等情况。[结果]干预组孕妇经过个体化营养指导及食品交换份干预后,空腹血糖和餐后2 h血糖均较治疗前明显下降,差异有统计学意义(P<0.05)。干预组羊水过多、巨大儿和新生儿窒息的发生率均低于对照组,差异有统计学意义(P<0.05),但两组胎膜早破、早产、剖宫产和低出生体重儿的发生率差异均无统计学意义(P>0.05)。[结论]对妊娠期糖尿病孕妇及时进行食品交换份的个体化营养指导可降低母婴并发症,改善妊娠结局。

Food exchange portion in nutrition intervention of gestational diabetes mellitus

[ Objective] To ascertain the effect of food exchange portion in nutrition intervention on gestational diabetes mellitus （GDM ）, and provide a theoretical basis for nutrition guidance on GDM and reduction of maternal and neonatal complications. F Methods ] A total of 198 singleton pregnancy women diagnosed with GDM at 24th to 28th pregnant week were selected in Jiangbei District of Ningbo City. Among them,123 patients voluntarily accepted individualized nutrition guidance and were included in the intervention group,while the control group consisted of 75 patients without systematic nutrition intervention. Then the two groups of pregnant women were compared in their maternal complications and pregnancy outcomes. [ Results ] Through individualized nutrition guidance and intervention of food exchange portion, fasting glucose and postprandial blood glucose dropped significandy after the treatment in the pregnant women of the intervention group as compared with those in control group. Such differences between the two groups had statistical significance （ P 〈 0.05 ）. Pregnancy complications in intervention group such as polyhydramnios, birth rate of macrosomia and neonatal asphyxia were lower than those in control group. Such differences were statistically significant （ P 〈 0. 05 ）. But the differences between the two groups in premature rupture of membranes, preterm birth, Caesarean section and the incidence of low birth weight did not have statistical significance （ P 〉 0.05 ）. [ Conclusion ] Timely individualized nutrition of food exchange portion guidance for GDM pregnant women can reduce maternal and neonatal complications and improve pregnancy outcomes.