甘智芬 冯浩 黄金娟

【摘要】 目的：探讨饮食运动指导对孕前超重肥胖孕妇妊娠期糖尿病的预防效果。方法：选取2017年1月-2018年6月本院产科70例孕前超重肥胖孕妇，按照随机数字表法将其分为观察组和对照组，各35例。对照组实施常规孕期检查，观察组实施饮食运动指导，比较两组妊娠期糖尿病发生率、血糖指标、血脂指标、分娩方式、产后出血情况、妊娠不良结局、新生儿Apgar评分。结果：观察组妊娠期糖尿病发生率为2.86%，低于对照组的17.14%（P<0.05）;观察组干预后空腹血糖、餐后2 h血糖、总胆固醇、甘油三酯均低于对照组（P<0.05）;观察组阴道自然分娩率、新生儿Apgar评分均高于对照组，剖宫产率、产后出血量、产后出血率、妊娠不良结局发生率均少于对照组，差异均有统计学意义（P<0.05）。结论：饮食运动指导可有效降低孕前超重肥胖孕妇妊娠期糖尿病的发生率，有利于改善妊娠结局。

【关键词】 产科; 妊娠期糖尿病; 饮食; 运动; 预防

【Abstract】 Objective：To explore the preventive effect of diet and exercise guidance on gestational diabetes mellitus in pregnant overweight and obese pregnant women.Method：A total of 70 pregnant women with overweight and obesity from January 2017 to June 2018 were selected.According to the random number table method，they were divided into observation group and control group，35 cases in each group.The control group was given routine pregnancy examination，while observation group was given diet and exercise guidance.The incidence of gestational diabetes mellitus，blood glucose index，blood lipid index，delivery mode，postpartum hemorrhage，adverse pregnancy outcome and Apgar score of newborns between two groups were compared.Result：The incidence of gestational diabetes mellitus in observation group was 2.86%，lower than 17.14% of control group（P<0.05）.The fasting blood sugar，2 h postprandial blood sugar，total cholesterol and triglyceride in observation group were lower than those of control group（P<0.05）.The natural vaginal delivery rate and Apgar score of newborns in observation group were higher than those of control group，while the cesarean section rate，postpartum hemorrhage，postpartum hemorrhage rate and adverse pregnancy outcomes were less than those of control group，the differences were statistically significant（P<0.05）.Conclusion：Diet and exercise guidance can effectively reduce the incidence of gestational diabetes mellitus in pregnant overweight and obese pregnant women，and is conducive to improving pregnancy outcomes.

【Key words】 Obstetrics; Gestational diabetes mellitus; Diet; Exercise; Prevention

First-authors address：Jian Maternal and Child Health Hospital，Jian 343000，China

doi：10.3969/j.issn.1674-4985.2019.17.042

妊娠期糖尿病是一種常见的妊娠期合并症，具有较高的发病率，易增加妊娠风险，对母婴结局较为不利，故临床需对妊娠期糖尿病予以积极预防，尤其是糖尿病风险较高的孕前超重及肥胖孕妇[1-3]。本研究针对70例孕前超重肥胖孕妇展开研究，分别实施常规孕期检查、饮食运动指导，以探讨饮食运动指导对孕前超重肥胖孕妇妊娠期糖尿病的预防效果。现报道如下。

1 资料与方法

1.1 一般资料 选取2017年1月-2018年6月本院产科70例孕前超重肥胖孕妇进行前瞻性研究，纳入标准：BMI≥24 kg/m2即超重，BMI≥28 kg/m2即肥胖;单胎妊娠;神志清醒。排除标准：存在其他合并症;中途脱落研究或失访。按照随机数字表法将其分为观察组和对照组，各35例。研究对象均对本研究知情同意，且经伦理学委员会批准。

1.2 方法 （1）对照组实施常规孕期检查，定期对其血糖水平进行监测。（2）观察组在对照组基础上实施饮食运动指导，具体如下，①饮食指导：向……