目的 探讨基于跨理论模型的多学科管理对高龄孕妇妊娠期糖尿病(gestational diabetes mellitus,GDM)的预防效果.方法 选取在长沙市某三级综合医院产检的高龄孕妇130例,随机分为对照组和观察组各65例.对照组实施常规孕产保健管理,观察组在常规孕产保健基础上实施基于跨理论模型的多学科管理.比较两组干预前和干预12周后的血清 25(OH)D 水平、孕妇膳食指南依从性指数(Chinese Dietary Guidelines Compliance Index for Pregnant Women,CDGCI-PW)评分、体质指数(body messive index,BMI)、GDM发生率及糖耐量试验血糖水平.结果 对照组和观察组分别有63和64例孕妇完成了本研究.干预后,观察组血清25(OH)D水平及CDGCI-PW评分高于对照组(P＜0.05),而BMI、血糖水平及GDM发生率低于对照组(P＜0.05).结论 基于跨理论模型的多学科管理可改善高龄孕妇的膳食依从性和维生素D营养状况,有利于合理控制孕期体重和血糖水平,从而降低GDM发生率.
Prevention of gestational diabetes mellitus in elderly pregnant women by multidisciplinary management based on the transtheoretical model
Objective To explore the prevention effect of multidisciplinary management based on the transtheoretical model on gestational diabetes mellitus(GDM)in elderly pregnant women.Methods One hundred and thirty elderly pregnant women undergoing prenatal checkups in a tertiary general hospital in Changsha City were selected to randomly divide into the control group and the observation group(each n=65).The control group implemented routine maternity care management,while the observation group adopted the transtheoretical model-based multidisciplinary management on the basis of routine maternity care.The serum 25(OH)D level,the score of the Chinese Dietary Guidelines Compliance Index for Pregnant Women(CDGCI-PW),body mass index(BM1),the incidence rate of GDM and the blood glucose level of glucose tolerance test were compared between the two groups before the intervention and 12 weeks after the intervention.Results Sixty three pregnant women in the control group and 64 pregnant women in the observation group completed this study.After the intervention,the serum 25(OH)D level and the score of CDGCI-PW in the observation group were higher than those in the control group(both P＜0.05),while BMI,the blood glucose level and the incidence rate of GDM in the observation group were lower than those in the control group(both P＜0.05).Conclusion Multidisciplinary management based on the transtheoretical model can improve the elderly pregnant women's dietary compliance and nutritional status of vitamin D,which is conducive to reasonable control of pregnancy weight and blood sugar level and thus reducing the incidence rate of GDM.
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