妊娠期营养干预降低巨大儿出生率的观察

目的:探讨妊娠早、中晚期营养干预对降低巨大儿出生率的影响。方法:随机选择在该院建卡的孕妇分成早孕组、中晚孕组,其中自愿接受早孕期(孕12周内)营养干预的271人为干预组A,中晚孕期(孕24~32周)自愿接受营养干预的207人为干预组B,未接受孕期营养干预的256人为对照组,对干预组进行孕期营养指导、干预和随访,比较干预组和对照组巨大儿出生率等妊娠结局。结果:干预组A巨大儿出生率为5.90%,干预组B巨大儿出生率为8.21%,对照组巨大儿出生率为12.11%,干预组A与对照组之间巨大儿出生率有显著性差异(P<0.05),干预组B与对照组之间巨大儿出生率无显著性差异(P>0.05),且干预组A中妊高征、剖宫产、胎儿宫内窘迫的发生率明显低于对照组(P<0.05);干预组B中剖宫产、产后出血的发生率明显低于对照组(P<0.05),但胎膜早破的发生率明显高于对照组(P<0.05),各组间GDM/GIGT的发生率无明显差异。结论:孕早期营养干预可明显降低巨大儿的出生率。

Effects of nutrition interference on the natality of macrosomia of pregnant women

Objective:To study the effects of nutrition interference on the natality of macrosomia of pregnant women in early and intermediate/later period of pregnancy.Methods:Total of 733 pregnant women were selected randomly from the population registered and received management of pregnant period in this hospital and divided into three groups: Group A (n=271) and B (n=207) were given the interferences from early and intermediate/later pregnant periods respectively through follow-up visits periodically; Gourp C (n=256) with no nutrition interference was as control. The pregnancy outcomes of different groups were recorded and analyzed.Results:The natalities of macrosomia in group A,B and C were 6.3%,8.4% and 12.0% respectively and there was significant difference between group A and B (P<0.05).Besides,the incidences of pregnancy-induced hypertension syndrome,cesarean delivery rate,intrauterine fetal distress in group A were less than that in group C (P<0.05) and the incidences of cesarean delivery rate and postpartum hemorrhage in group B were less than that in group C (P<0.05),but the cases of premature rupture of fetal membranes in group B was high than that in group C (P>0.05).However,there were no significant differences on the incidences of GDM/GIGT between these groups.Conclusion:Nutrition interference initiating at the early period of pregnancy could obviously reduce the incidence of macrosomia.