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

doi:10.3969/j.issn.1674-8115.2021.03.013

Abstract

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)

CLC Number:

R459.3

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.

Figures/Tables 6

TrendMD

References 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