杨蓓,魏华莉,李小娟
YANG Bei,WEI Huali,LI Xiaojuan

• 1:应急总医院妇产科
• 2:应急总医院病案科

摘要(Abstract)：

目的:探究妊娠期糖尿病(GDM)的危险因素及膳食营养干预效果。方法:选取246例孕妇作为研究对象,其中124例非GDM孕妇作为非GDM组,122例GDM孕妇作为GDM组,比较2组患者年龄、文化程度、产次、糖尿病家族史、孕前BMI、体育锻炼、收入水平及孕早期血红蛋白等资料,对有差异的指标采用Logistic回归分析GDM发生的危险因素;再将GDM孕妇均分为观察组与对照组,对照组根据宣教内容自主择食,观察组给予膳食营养干预,比较2组母婴结局(剖宫产、早产、羊水过多、巨大儿、胎儿窘迫及产褥感染)。结果:GDM发病与孕妇孕前BMI、年龄、孕早期血红蛋白、体育锻炼及糖尿病家族史有关,差异有统计学意义(P <0. 05),而与文化程度、产次及收入水平无关,差异无统计学意义(P> 0. 05); Logistic回归分析结果显示,孕妇年龄、糖尿病家族史、孕前BMI及孕早期血红蛋白水平是GDM发病的危险因素(P <0. 05),而体育锻炼则是GDM发病的保护因素(P <0. 05);膳食营养干预后,观察组巨大儿、早产及胎儿窘迫发生率低于对照组,差异有统计学意义(P <0. 05),2组孕妇羊水过多、剖宫产率及产褥感染发生率比较,差异无统计学意义(P> 0. 05)。结论:孕妇孕前BMI、年龄、孕早期血红蛋白及糖尿病家族史是GDM发病的危险因素,体育锻炼是GDM的保护因素,对GDM孕妇进行膳食营养干预可一定程度改善母婴结局。
Objective: To explore risk factors of patients with gestational diabetes mellitus( GDM and the effect of dietary nutrition intervention on clinical outcomes. Methods: A total of 246 pregnant women were recruited as study subjects,including 124 non-GDM patients and 122 GDM patients.Maternal age,education level,the number of birth,family history of diabetes,pre-pregnancy body mass index( BMI),physical exercise,income level and early pregnancy hemoglobin were compared between GDM and non-GDM patients. The risk factor analysis of GDM were performed on differential indexes between GDM and non-GDM patients using Logistic regression. In addition,GDM patients were randomly divided into observation group( n = 61) and control group( n = 61). The observation group was given dietary nutrition intervention,while the control group not. The maternal and infant outcomes( cesarean section,premature delivery,polyhydramnios,macrosomia,fetal distress and puerperal infection) were compared between observation and control groups. Results: The incidence of GDM was significantly associated with the BMI,age,hemoglobin,physical exercise,family history of diabetes of pregnant women before pregnancy( P < 0. 05),but not with gestational age,education level,frequency,income level and dietary habits( P > 0. 05). Logistic regression analysis revealed that maternal age,family history of diabetes,pre-pregnancy BMI,and hemoglobin levels were all risk factors for GDM( P < 0. 05),while physical exercise was a protective factor( P < 0. 05). After dietary nutrition intervention,the incidence of giant infants,premature delivery and fetal distress were lower in the observation group than those in the control group( P < 0. 05). Moreover,there was no significant differences in polyhydramnios,cesarean section rate and incidence of puerperal infection between two groups( P > 0. 05). Conclusion: Pre-pregnancy BMI,maternal age,early pregnancy hemoglobin and family history of diabetes are risk factors for the development of GDM. Physical exercise is a protective factor for GDM. In addition,dietary nutrition intervention can improve mother and infant outcomes to a certain extent.

关键词(KeyWords)： 孕妇;妊娠期糖尿病;流行病学特点;膳食营养干预措施
pregnant women;gestational diabetes mellitus(GDM);epidemiological characteristics;dietary nutrition intervention

Abstract:

Keywords:

基金项目(Foundation): 北京市科技计划项目(Z121107001012033)

作者(Author): 杨蓓,魏华莉,李小娟
YANG Bei,WEI Huali,LI Xiaojuan

DOI: 10.19367/j.cnki.2096-8388.2020.09.010

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