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

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