孕早期生活方式干预对妊娠期糖尿病高危孕妇妊娠结局的影响

目的 探讨孕早期饮食和运动管理对妊娠期糖尿病（GDM）高危孕妇妊娠结局的影响。方法 选择2015年3月 - 2016年3月在南通大学第二附属医院接受产检和分娩的171例GDM高危孕妇，随机分为研究组和对照组。研究组接受饮食和运动全程规范化管理，对照组行常规产检，比较2组妊娠期并发症的发生率以及妊娠结局。结果 （1）研究组羊水过多和GDM发生率低于对照组，差异具有统计学意义（所有P＜0.05）；（2）研究组剖宫产率以及产后出血、胎儿宫内窘迫发生率显著低于对照组，差异具有统计学意义（所有P＜0.05）；（3）研究组新生儿高胆红素血症、巨大儿发生率显著低于对照组，差异具有统计学意义（所有P＜0.05）；（4）研究组孕妇产后糖代谢异常和新生儿肥胖的发生率均低于对照组，但差异均无统计学意义（所有P＞0.05）。结论 孕早期饮食和运动干预可降低 GDM的发病率，减低剖宫产率以及产后出血、胎儿宫内窘迫等并发症的发生率，对预防巨大儿、新生儿高胆红素血症等不良妊娠结局具有积极意义。

Effect of early lifestyle intervention on pregnancy outcome for high-risk pregnant women with gestational diabetes mellitus

Objective The aim of this study was to investigate the effect of diet and exercise management on pregnancy outcome for high-risk pregnant women with gestational diabetes mellitus(GDM). Methods From March of 2015 to March of 2016, 171 pregnant women with risk factors of GDM were randomly assigned to test group and control group, and all of them underwent prenatal examinations and a delivery in Second Affiliated Hospital of Nantong University. Pregnant women in the test group accepted the standardized management of diet and exercise, and others in the control group received routine birth examinations. Both the incidence of complications and pregnancy outcomes were compared between two groups. Results (1) The incidences of hydramnios and GDM in the test group were significantly lower than those in the control group(all P<0.05). (2) The rates of cesarean section, postpartum hemorrhage and fetal distress in the test group were significantly lower than those in the control group (all P<0.05). (3) The incidences of neonatal hyperbilirubinemia and macrosomia in the test group were significantly lower than those in the control group (all P<0.05). (4) The incidences of postpartum abnormal glucose metabolism and neonatal obesity in the test group were lower than those in the control group, while the differences were not statistically significant(all P＞0.05). Conclusion The interventions of diet and exercise in early pregnancy can cut down the incidence of GDM and complications such as postpartum hemorrhage, fetal distress, and reduce cesarean section rate. It is positively and significantly related to prevention of adverse pregnancy outcomes, including macrosomia and neonatal hyperbilirubinemia.