摘要：

目的·探討個體化營養(yǎng)示范餐對超重及肥胖孕婦的孕期體質(zhì)量管理和妊娠糖尿病（gestational diabetes mellitus，GDM）預防的效果。方法·將2017年6月—2019年1月在上海健康醫(yī)學院附屬第六人民醫(yī)院東院建卡并已知情同意的超重及肥胖孕婦隨機分為干預組和對照組各100例，對照組進行孕期營養(yǎng)課堂集體健康教育，干預組在此基礎上進行營養(yǎng)示范餐等個體化的營養(yǎng)干預。比較分析2組孕婦孕13~16、17~20、21~24周的體質(zhì)量增長情況和GDM的發(fā)病率。結(jié)果·孕13~24周干預組增加的體質(zhì)量小于對照組（t=4.207，P=0.000）。2組體質(zhì)量增長值的差異在不同孕周不同，孕17~20周時2組的差別最大（F=3.483，P=0.034）。干預組GDM發(fā)病率（16.5%）低于對照組（38.5%）（χ2=11.773，P=0.001）。結(jié)論·個體化營養(yǎng)示范餐的干預有助于超重及肥胖孕婦維持適宜的孕期體質(zhì)量增長并降低GDM發(fā)病率。

關鍵詞: 超重, 肥胖, 示范餐, 個體化營養(yǎng)干預, 孕期體質(zhì)量增長, 妊娠糖尿病

Abstract:

Objective·To explore the effect of individualized nutritional standard meal intervention on weight management and prevention of gestational diabetes mellitus (GDM) in overweight and obese pregnant women.Methods·Overweight and obese pregnant women who had established files in Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences from June 2017 to January 2019 with informed consent were randomly divided into intervention group and control group, with 100 cases in each group. The control group received collective health education in nutrition class during pregnancy, and the intervention group received individualized nutrition intervention such as nutritional standard meal on this basis. The weight gains at 13?16, 17?20 and 21?24 weeks of gestation and the incidence of GDM were compared between the two groups.Results·The weight gain of the intervention group was lower than that of the control group at 13?24 weeks of gestation (t=4.207, P=0.000). The variation of weight gain between the two groups was the greatest at 17?20 weeks of gestation (F=3.483, P=0.034). The incidence of GDM in the intervention group (16.5%) was lower than that in the control group (38.5%) (χ2=11.773, P=0.001).Conclusion·The intervention of individualized nutrition standard meal for overweight and obese pregnant women can help maintain appropriate gestational weight gain and reduce the incidence of GDM.

Key words: overweight, obese, standard meal, individualized nutritional intervention, gestational weight gain, gestational diabetes mellitus (GDM)

中圖分類號: 

R459.3

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