摘要： 目的·探讨个体化营养示范餐对超重及肥胖孕妇的孕期体质量管理和妊娠糖尿病（gestational diabetes mellitus，GDM）预防的效果。方法·将2017年6月—2019年1月在上海健康医学院附属第六人民医院东院建卡并已知情同意的超重及肥胖孕妇随机分为干预组和对照组各100例，对照组进行孕期营养课堂集体健康教育，干预组在此基础上进行营养示范餐等个体化的营养干预。比较分析2组孕妇孕13~16、17~20、21~24周的体质量增长情况和GDM的发病率。结果·孕13~24周干预组增加的体质量小于对照组（
t=4.207，
P=0.000）。2组体质量增长值的差异在不同孕周不同，孕17~20周时2组的差别最大（
F=3.483，
P=0.034）。干预组GDM发病率（16.5%）低于对照组（38.5%）（
χ2=11.773，
P=0.001）。结论·个体化营养示范餐的干预有助于超重及肥胖孕妇维持适宜的孕期体质量增长并降低GDM发病率。
关键词: 超重, 肥胖, 示范餐, 个体化营养干预, 孕期体质量增长, 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) PDF全文下载地址:
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