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医学营养治疗对交界性糖耐量受损孕妇孕期并发症及母婴结局的影响
胡峥;王曼;朱昊平;胡国敏;
0
(上海市闵行区中心医院; 上海美华妇儿医院; 上海市闵行区妇幼保健院)
摘要:
目的:评价医学营养治疗对交界性糖耐量受损(BGGI)孕妇母婴结局及其孕期并发症的影响。方法:纳入2013年7月至2016年12月上海市闵行区中心医院和上海市闵行区妇幼保健院诊断为BGGI的孕妇,随机分为干预组和非干预组各1200例,并选择同期1200例正常孕妇作为对照组。干预方法为医学营养和运动治疗。比较各组的母婴结局和血糖变化。结果:最终干预组、非干预组和对照组分别纳入1158例、1162例和1187例孕妇。与非干预组比较,干预组剖宫产、产后出血、妊娠期高血压疾病、妊娠期糖尿病(GDM)、胎膜早破、巨大儿、胎儿生长受限(FGR)及胎儿窘迫的发生率以及新生儿体质量更低,Apgar评分更高,差异均有统计学意义(P<0.05);干预组与对照组GDM发生率、新生儿体质量及Apgar评分比较,差异均有统计学意义(P<0.05)。干预组产后1天和产后6周的空腹血糖(FPG)、餐后2小时血糖(2h PG)和糖化血红蛋白(Hb A1c)明显低于非干预组,差异均有统计学意义(P<0.05)。结论:医学营养治疗能明显降低BGGI孕妇的妊娠期并发症发生率,改善母婴结局。
关键词:  交界性糖耐量受损  妊娠期糖尿病  妊娠结局  血糖
DOI:
基金项目:
Influence of Medical Nutrition Therapy on the Outcomes and Complications of Fetuses and Pregnant Women in Treating for Borderline Gestational Glucose Intolerance
HU Zheng;WANG Man;ZHU Haoping
(Shanghai Minhang District Central Hospital;Shanghai Meihua Children’s Hospital)
Abstract:
Objective: To evaluate the influence of medical nutrition therapy on the outcomes and complications of fetuses and pregnant women in treating for borderline gestational glucose intolerance( BGGI). Methods: Pregnant women who were diagnosed as BGGI in Shanghai minhang district central hospital and Shanghai minhang district maternal and child health care in July 2013 to December 2016 were randomly divided into intervention group( n =1200) and non-intervention group( n = 1200).And 1200 normal pregnant women were selected as control group.Intervention methods were medical nutrition and exercise. The outcomes and complications of fetuses and pregnant women and postpartum follow-up blood sugar changes were investigated.Results: 1158,1162 and 1187 pregnant women were eventually enrolled in intervention group,non-intervention group and control group respectively.Compared with non-intervention group,lower incidences( P<0. 05) of cesarean section,postpartum hemorrhage,gestational hypertension,GDM,premature rupture of membranes,macrosomia,intrauterine growth restriction,intrauterine distress and low birth weight were determined in intervention group,as well as higher APGAR score( P<0. 05).There were significant differences in incidences of GDM,neonatal weight and apgar socre compared between the intervention group and control group( P <0. 05). The levels of FPG,2 h PG and Hb A1 c in intervention group were significantly lower than those of non-intervention group after 1 d and 6 weeks of delivery( P<0. 05).Conclusions: Medical nutrition therapy could obviously reduce pregnancy complications of pregnant women with BGGI and improve outcomes of fetuses and pregnant women. 更多
Key words:  Borderlinegestationalglucoseintolerance  Gestationaldiabetes  Pregnancyoutcome  Bloodsugar

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