首页|精准营养管理对妊娠期增重过快者体重控制和妊娠结局的影响

精准营养管理对妊娠期增重过快者体重控制和妊娠结局的影响

Effects of precision nutrition management on body weight control and pregnancy outcome among pregnant women with rapid weight gain

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目的 探讨精准营养管理对妊娠期体重增加(GWG)过快者体重增速和妊娠结局的影响.方法 选取2022年7月至2023年5月于该院规律产检且GWG过快的121例孕妇为研究对象,采用随机数字表法分为观察组(n=58)和对照组(n=63).两组均接受常规产前检查保健和健康宣教,观察组同时接受精准营养干预4周,其中以低血糖生成指数型营养配方粉30 g代替1次加餐.调查观察组干预前和干预期的膳食情况及身体活动水平,收集两组入组前基线信息、干预后体重、分娩体重和妊娠母儿结局.结果 与干预前比较,干预期观察组全谷物和杂豆类[0(0,30.0)g/d vs.0(0,2.5)g/d]、鱼虾类[65.0(0,130.0)g/d vs.0(0,100.0)g/d]、蔬菜类[(310.5±98.9)g/d vs.(248.2±117.9)g/d]、铁[20.30(18.70,23.90)mg/d vs.18.75(14.80,22.80)mg/d]摄入量及每周活动时间[350(280,420)min vs.210(150,280)min]增加,水果类[179.0(145.0,238.0)g/d vs.200.0(179.0,366.0)g/d]、总能量[1702(1608,1837)kcal/d vs.2055(1848,2327)kcal/d]、饱和脂肪酸[11.50(8.20,15.80)g/d vs.15.75(12.30,19.00)g/d]摄入量及脂肪热量比例[(31.71±5.22)%vs.(35.12±6.17)%]减少,差异有统计学意义(P<0.05).与对照组比较,观察组干预期[0.45(0.29,0.63)kg/周vs.0.63(0.50,0.88)kg/周]、干预后4周每周体重增长[0.50(0.34,0.64)kg/周vs.0.70(0.50,0.93)kg/周]、GWG过快比例(60.3%vs.77.8%)更低,差异有统计学意义(P<0.05).与对照组比较,观察组妊娠期合并贫血(15.5%vs.31.7%)、巨大儿(5.2%vs.17.2%)、分娩不良结局(1.7%vs.12.7%)发生率及新生儿出生体重[(3292.2±420.9)g vs.(3497.6±454.7)g]更低,顺产产程更短[5.17(3.33,9.15)h vs.10.00(6.37,18.00)h],差异有统计学意义(P<0.05).结论 精准营养管理可以有效控制GWG过快孕妇孕期体重增速.
Objective To investigate the effect of precision nutrition management on the weight gain and pregnancy outcome in the patients with rapid gestational weight gain (GWG).Methods A total of 121 pregnant women with regular antenatal check-up and rapid GWG in this hospital from July 2022 to May 2023 were selected as the study subjects and divided into the observation group (n=58) and control group (n=63) by the random number table method.The two groups all received the conventional antenatal check-up,health-care and health education.The observation group simultaneously received the precision nutrition intervention for 4 weeks,in which one extra meal was replaced with 30 g of low glycaemic index nutritional formula pow-der.The diet situation and physical activity levels in the observation group were investigated before interven-tion and during the intervention period.The baseline information,post-intervention body weight,delivery body weight and pregnant maternal and neonate outcomes were collected in the two groups.Results Compared with before intervention,whole grains and miscellaneous beans[0(0,30.0)g/d vs.0(0,2.5)g/d],fish and shrimp[65.0(0,130.0)g/d vs.0(0,100.0)g/d],vegetables[(310.5±98.9)g/d vs.(248.2±117.9)g/d],iron[20.30(18.70,23.90)mg/d vs.18.75(14.80,22.80)mg/d]intake and weekly activity time[350(280,420) min vs.210(150,280)min]during the intervention period in the observation group were increased,fruits[179.0(145.0,238.0)g/d vs.200.0(179.0,366.0)g/d],total energy[1702(1608,1837)kcal/d vs.2055 (1848,2327)kcal/d],saturated fatty acids[11.50(8.20,15.80)g/d vs.15.75(12.30,19.00)g/d]intake and proportion of fat calories[(31.71±5.22)% vs.(35.12±6.17)%]were decreased,the differences were statis-tically significant (P<0.05).Compared with the control group,the intervention period[0.45(0.29,0.63)kg/week vs.0.63(0.50,0.88)kg/week]and the weekly weight gain in 4 weeks after the intervention[0.50 (0.34,0.64)kg/week vs.0.70(0.50,0.93)kg/week],GWG excess ratio (60.3% vs.77.8%) in the observa-tion group were lower,and the differences were statistically significant (P<0.05).Compared with the control group,complicating anemia during pregnancy (15.5% vs.31.7%),macrosomia (5.2% vs.17.2%),incidence rate of adverse delivery outcomes (1.7% vs.12.7%) and neonatal birth weight[(3292.2±420.9)g vs. (3497.6±454.7)g]in the observation group were lower,and the natural labor process was shorter[5.17 (3.33,9.15)h vs.10.00(6.37,18.00)h],the differences were statistically significant (P<0.05).Conclusion Preci-sion nutrition management could effectively control rapid GWG and the increasing velocity of gestational weight.

precision nutritionpregnancyweight gainbody weight controlpregnancy outcome

钱钻子、李利、梁馨予、陈正琼、应德美、王建

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陆军军医大学第二附属医院营养科,重庆 400037

陆军军医大学第二附属医院妇产科,重庆 400037

精准营养 妊娠 体重增长 体重控制 妊娠结局

重庆英才创新创业领军人才项目

CQYC20220303514

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(8)
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