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目的探讨昆明市产妇孕期营养干预和代谢性危险因素对妊娠结局的影响。方法以昆明市妇幼保健院营养科2014年1月-2016年3月接受的营养咨询、常规体检的孕妇作为研究对象,回顾性分析将采用新妊娠期糖尿病诊断标准确诊患有妊娠期糖尿病(gestational diabetes mellitus,GDM)的孕妇,根据是否进行营养干预分为研究组和对照组,研究组孕妇采用了营养干预,比较两组孕妇妊娠结局差异,将巨大儿列为代谢性危险因素Logistics逐步回归分析各项指标和巨大儿发生风险的关系。结果研究组新生儿出生体重为(3 256.00±30.00)g,对照组为(3 487.00±35.00)g;研究组巨大儿的发生率为4.57%,孕妇高血压的发生率为11.36%,对照组分别为11.71%和21.71%,两组比较,差异有统计学意义(P<0.05);两组患者在孕中晚期体重增长量、FBS含量、TG含量以及CHOL含量等方面比较,差异有统计学意义(P<0.05);孕20周时体重和是否患有GDM与有无代谢性因素无关(P>0.05)。结论采取营养干预可有效降低高危孕妇妊娠不良结局的发生率,通过膳食管理对孕妇的体重进行有效的控制可以降低巨大儿的发生风险,该干预值得在孕期推广使用。
Objective To investigate the effect of pregnant women’s nutritional intervention and metabolic risk factors on pregnancy outcome in Kunming. Methods The pregnant women who received nutritional counseling and routine physical examination from January 2014 to March 2016 in Kunming Maternal and Child Health Hospital Nutritional Section were retrospectively analyzed. The diagnostic criteria of gestational diabetes mellitus using gestational diabetes mellitus were retrospectively analyzed. diabetes mellitus, GDM) pregnant women, according to whether the nutritional intervention is divided into study group and control group, the study group adopted nutritional interventions pregnant women, pregnancy differences between the two groups were compared, the giant children as metabolic risk factors Logistics stepwise regression analysis The relationship between the indicators and the risk of huge children. Results The birth weight of newborns in study group was (3 256.00 ± 30.00) g and that in control group was (3 487.00 ± 35.00) g. The incidence of huge children in study group was 4.57% and the incidence of hypertension in pregnant women was 11.36% (11.71% and 21.71% respectively). There was significant difference between the two groups (P <0.05). The difference of weight gain, FBS content, TG content and CHOL content between the two groups in the second trimester was statistically significant (P <0.05). At 20 weeks’ gestation, there was no correlation between body weight and whether there was GDM with or without metabolic factors (P> 0.05). Conclusion Nutritional intervention can effectively reduce the incidence of adverse pregnancy outcomes in high-risk pregnant women. The effective control of pregnant women’s weight through dietary management can reduce the risk of macrosomia, and the intervention is worth promoting during pregnancy.