刘海燕 张国荣 刘新荣 等

[摘要] 目的 觀察孕期营养改善和监测对妊娠结局的影响。 方法 选取2010年1月～2013年1月在秦皇岛市妇幼保健院营养科接受孕期营养指导的416名孕妇，采用随机数字表法分为研究组和对照组，每组各208例。研究组接受孕期营养监测，对照组不接受孕期营养监测。分析比较两组营养素的摄入情况及妊娠结局。 结果 研究组孕妇孕晚期谷类、蔬菜、水果、蛋类、肉类、奶类、豆类、脂肪的适宜摄入率均明显高于对照组，差异均有高度统计学意义（P < 0.01）；除维生素B2及锌外，研究组孕妇能量、蛋白质、维生素A、维生素B1、维生素B2、维生素C、钙、铁、锌的摄入量均低于对照组，差异均有高度统计学意义（P < 0.01）；对照组的巨大儿发生率明显高于研究组（P < 0.05）；研究组孕妇孕晚期发生贫血24例（11.54%），对照组发生贫血30例（14.42%），两组比较差异无统计学意义（P > 0.05）；而研究组的妊娠期高血压发生率（0.48%）明显低于对照组（3.85%）（P < 0.05）。 结论 孕期的能量、营养素的过度摄入可能会导致出生体重儿、巨大儿、妊娠期高血压、妊娠期糖尿病等不良妊娠结局，有效改善孕妇的营养状况有利于减少不良妊娠结局的发生。

[关键词] 孕期营养；监测；妊娠结局；影响

[中图分类号] R714 [文献标识码] A [文章编号] 1673-7210（2016）02（b）-0091-04

Effect of pregnancy nutrition improving and monitoring for pregnancy outcomes

LIU Haiyan1 ZHANG Guorong2 LIU Xinrong3 ZHANG Jing1

1.Department of Obstetrical， Maternity and Child Care Centers of Qinhuangdao， Hebei Province， Qinhuangdao 066000， China； 2.Department of Obstetrics and Gynecology， Orthopaedic Hospital of Qinhuangdao， Hebei Province， Qinhuangdao 066001， China； 3.Department of Obstetrics and Gynecology， Maternity and Child Care Centers of Lulong County， Hebei Province， Lulong 066400， China

[Abstract] Objective To investigate the effect of pregnancy nutrition improving and monitoring for pregnancy outcomes. Methods 416 pregnant women from January 2010 to January 2013 given nutrition guidance during pregnancy in Nutritional Department of Maternity and Child Care Centers of Qinhuangdao were selected， and they were divided into two groups by random number table， study group and control group， with 208 cases in each group. The study group was given nutrion monitoring during pregency， and the control group without any nutrion monitoring. Nutrients intake and pregnancy outcome of two groups were analyzed and compared. Results Intake rate of grains， vegetables， fruits， eggs， meat， milk， beans and fat of pregnant women in the study group was significantly higher than those of the control group， the differences were statistically significant （P < 0.01）； except for vitamin B2 and zinc， nutrient intake of energy， protein， vitamin A， vitamin B1， vitamin B2， vitamin C， calcium， iron， zinc in the study group were lower than that of the control group， the differences were statistically significant （P < 0.01）； the incidence of a huge children was significantly higher than that of the study group （P < 0.05）； 24 pregnant women in the study group happened anemia （11.54%）， 30 pregnant women in the control group happened anemia （14.42%） （P > 0.05）； the incidence of pregnancy-induced hypertension in the study group （0.48%） was significantly lower than the control group （3.85 %） （P < 0.05）. Conclusion Unreasonable nutrient intake of energy and during pregnancy may develop adverse pregnancy outcomes， such as gestational hypertension， GDM. Effective improvement of the nutritional status of pregnant women maternal can reduce the incidence of adverse pregnancy outcomes.

[Key words] Pregnancy nutrition； Monitoring； Pregnancy outcomes； Effect

近年来，人民生活水平不断提高，孕期营养问题越来越受到重视，但营养知识的缺乏使孕妇盲目补充营养，造成饮食结构不合理、营养过剩等严重影响母婴的健康。孕妇营养物质比例失调可致严重母婴并发症[1]。营养摄入过多会使孕妇肥胖、易患糖尿病、妊娠高血压疾病、胎儿过大等，难产发生率也明显升高。而营养摄入过少易患妊娠贫血、流产、早产、胎儿宫内生长受限、胎死宫内等。现代流行病学研究指出：孕期营养状况的监测检查并根据结果进行纠正、调整，以使孕妇的营养摄入符合《中国营养膳食指南》推荐水平，对降低高危妊娠具有重要的意义[2-4]，但目前在国内外相关报道较少。目前越来越多的学者同时认为，为孕妇制订科学的营养分析和饮食方案，从而对孕妇进行合理的营养指导，可保证孕妇和胎儿健康[5]。……