超重及肥胖孕妇的营养代谢状况

目的:使用营养代谢分析的方法,了解正常孕妇和超重及肥胖孕妇的营养状况。方法:随机选取妊娠26周以上的孕妇178人,依据孕前体重指数(BMI=Kg/m2)分3组,利用人体代谢分析仪(间接测热法)测量孕妇基础代谢所消耗的能量(BEE),通过膳食调查了解孕妇的实际摄入量,对正常、超重和肥胖孕妇的营养状况进行分析、比较,观察超重及肥胖孕妇的营养代谢特点,同时将此方法得出的结论与血中营养素的含量进行比较。结果:①肥胖及超重孕妇存在以高胆固醇为主的高脂血症,同时其低密度脂蛋白也高于正常孕妇(P<0.01)。与正常组相比,超重及肥胖组甘油三脂有所增高,高密度脂蛋白有所降低,但差异无显著性。②肥胖妇女的基础能量消耗(BEE)和全日总能量消耗(TEE)均高于正常孕妇,差异有统计学意义(P<0.01)。③肥胖孕妇的碳水化合物和蛋白质的摄入量明显高于正常孕妇,差异有统计学意义(P<0.05)。但其脂肪的摄入量低于正常孕妇,从而造成营养的失衡。④无论正常孕妇还是超重及肥胖孕妇均存在钙、铁、锌、VitB1、VitB2、叶酸、Vi-tA的摄入量不足。其中超重及肥胖孕妇在镁、VitB1、VitB2、VitA的实际摄入量与理想摄入量的差值上,即缺余值上与正常体重孕妇相比存在统计学意义(P<0.05)。结论:我国孕妇的营养摄入存在不平衡现象,而超重及肥胖孕妇的问题更为突出。个性化的监测及营养指导,对超重及肥胖孕妇减少不良妊娠合并症和妊娠结局可能起到积极的作用。

The Analysis of Nutritive Status in Overweight and Obesity Pregnant Women

Objective:To investigate the nutrition condition at normal and overweight pregnant women by metabolic analysis method.Methods:178 pregnant women exceed 26 gestational weeks were divided randomly into three groups. Basic Energy Expenditure (BEE) was estimated by "body metabolic analysis" instrument (Indirect Calorimetric), the actual intake was estimated by dietary survey, at the same time, the result from the method were compared with blood level of nutrient elements.Results:①Hyperlipaemia (exclusive higher level of TC) are observed in overweight and fat pregnancies. Meanwhile LDL in the second and third group higher than in the first group, there was the significant difference (P<0.01).Therefore there was higher TG and lower HDL in fat and overweight women, statistical discrepancy was no significant difference;②There were significant correlation of BEE and TEE between fat pregnancies and normal pregnancies (P<0.01);③Carbohydrate and protein of fat women was distinctly higher than women with normal BMI pregnancies (P<0.05), but the fat intake was lower than normal group. The result in these were induced dystrophy;④Normal, overweight and fat pregnancies had all inadequate daily intake of calcium, iron, zinc, vitaminB1, vitaminB2, folic acid and vitamin A. Meantime, there was statistical difference between overweight, fat pregnancies and normal women in lacking numerical value of magnesium, vitaminB1,vitaminB2,vitamin A(P<0.05).Conclusion:In China, unbalance of nutrition intake exists in pregnant women, it exhibits outstandingly in women with overweight and fat pregnancies. To monitor the nutrition status of a pregnant women and give individual suggestion on nutrition intake help to reduce the pregnant adverse badness of complication and poor outcome.