个体化营养示范餐对超重及肥胖孕妇妊娠糖尿病的预防效果

doi:10.3969/j.issn.1674-8115.2021.03.013

上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (3): 360-365.doi: 10.3969/j.issn.1674-8115.2021.03.013

个体化营养示范餐对超重及肥胖孕妇妊娠糖尿病的预防效果

屠越华¹^,²(), 王筱金³, 王炳顺³()

^1.上海交通大学公共卫生学院，上海 200025
^2.上海健康医学院附属第六人民医院东院临床营养科，上海 201306
^3.上海交通大学医学院临床研究中心生物统计教研室，上海 200025

收稿日期:2020-01-09 出版日期:2021-03-28 发布日期:2021-04-06
通讯作者: 王炳顺 E-mail:tuyuehua19880105@126.com;wangbingshun@sjtu.edu.cn
作者简介:屠越华（1988—），女，主管技师，硕士生；电子信箱：tuyuehua19880105@126.com。
基金资助:
上海健康医学院附属第六人民医院东院科学研究基金(2015004)

Effects of individualized nutritional standard meal intervention on the prevention of gestational diabetes in overweight and obese pregnant women

Yue-hua TU¹^,²(), Xiao-jin WANG³, Bing-shun WANG³()

^1.School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
^2.Department of Clinical Nutrition, Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201306, China
^3.Department of Biostatistics, Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received:2020-01-09 Online:2021-03-28 Published:2021-04-06
Contact: Bing-shun WANG E-mail:tuyuehua19880105@126.com;wangbingshun@sjtu.edu.cn
Supported by:
Science Research Foundation of Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences(2015004)

摘要/Abstract

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)

中图分类号:

R459.3

屠越华, 王筱金, 王炳顺. 个体化营养示范餐对超重及肥胖孕妇妊娠糖尿病的预防效果[J]. 上海交通大学学报(医学版), 2021, 41(3): 360-365.

Yue-hua TU, Xiao-jin WANG, Bing-shun WANG. Effects of individualized nutritional standard meal intervention on the prevention of gestational diabetes in overweight and obese pregnant women[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(3): 360-365.

图/表 6

参考文献 22

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Item	Intervention group (N=97）	Control group (N=96）	t/χ² value	P value
Age/year	29.92±4.19	29.80±4.61	-0.182	0.856
Deliver time/n （%）			0.449	0.503
First-born	28 (28.9）	32 (33.3）
Second-born	69 (71.1）	64 (66.7）
Pre-pregnancy BMI/（kg·m^-2）	26.10±1.95	26.37±2.10	0.934	0.351
Weight classification before pregnancy/n （%）			0.163	0.686
Pre-pregnancy overweight	80 (82.5）	77 (80.2）
Pre-pregnancy obesity	17 (17.5）	19 (19.8）
Weight gain in the first 12 weeks of pregnancy/kg	1.63±0.87	1.70±0.97	0.498	0.619
Fasting plasma glucose/（mmol·L^-1）	4.74±0.36	4.77±0.34	0.495	0.621

Item	Intervention group (N=97）	Control group (N=96）	t/χ² value	P value
Age/year	29.92±4.19	29.80±4.61	-0.182	0.856
Deliver time/n （%）			0.449	0.503
First-born	28 (28.9）	32 (33.3）
Second-born	69 (71.1）	64 (66.7）
Pre-pregnancy BMI/（kg·m^-2）	26.10±1.95	26.37±2.10	0.934	0.351
Weight classification before pregnancy/n （%）			0.163	0.686
Pre-pregnancy overweight	80 (82.5）	77 (80.2）
Pre-pregnancy obesity	17 (17.5）	19 (19.8）
Weight gain in the first 12 weeks of pregnancy/kg	1.63±0.87	1.70±0.97	0.498	0.619
Fasting plasma glucose/（mmol·L^-1）	4.74±0.36	4.77±0.34	0.495	0.621

Classification of weight gain	Intervention group （N=97）	Control group （N=96）	Z value	P value
Insufficient weight gain	10 （10.3）	2 （2.1）	-2.983	0.003
Appropriate weight gain	48 （49.5）	37 （38.5）
Excessive weight gain	39 （40.2）	57 （59.4）

Classification of weight gain	Intervention group （N=97）	Control group （N=96）	Z value	P value
Insufficient weight gain	10 （10.3）	2 （2.1）	-2.983	0.003
Appropriate weight gain	48 （49.5）	37 （38.5）
Excessive weight gain	39 （40.2）	57 （59.4）

Time	Intervention group （N=97）	Control group （N=96）	t value	P value
0 h	4.59±0.34	4.68±0.47	1.609	0.110
1 h	7.41±1.32	8.23±2.09	3.267	0.001
2 h	6.70±1.11	7.14±1.55	2.272	0.024

个体化营养示范餐对超重及肥胖孕妇妊娠糖尿病的预防效果

Effects of individualized nutritional standard meal intervention on the prevention of gestational diabetes in overweight and obese pregnant women

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