低血糖负荷膳食干预孕妇孕期增重的研究

发布时间：2018-01-25 13:33

本文关键词： 血糖负荷血糖生成指数 IOM标准孕期增重新生儿出生体重　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的通过对孕妇孕期实施低血糖负荷膳食的干预,了解孕妇孕期膳食摄入情况,记录孕妇各孕期体重的变化,计算孕妇的孕期增重,观察低血糖负荷膳食是否能降低孕期增重过多现象的发生。方法本研究采用流行病学随机化干预试验,以安徽省某妇幼保健院孕妇为研究对象,建立孕期干预组和对照组,其中干预组97例,对照94例。干预组中按孕前BMI值和孕期增重等级对其进行分级管理,主要干预内容为低血糖负荷膳食,干预的结点为孩子出生,对照组不施加本项目的干预措施。采用孕期基本信息调查表获取孕妇的人口学信息等基线数据,干预的同时,在各孕期使用连续3日24h膳食记录表记录孕妇的膳食摄入量。孕期产检的过程中连续监测孕妇的体重以及血糖和血脂的变化,孕妇分娩时及时记录新生儿的出生体重、性别等信息,比较两组孕妇孕期增重的不同、血糖血脂的变化及出生结局的不同来探讨低血糖负荷膳食干预的效果。结果(1)孕妇的基本信息:干预组与对照组孕妇年龄分布(25.63±2.58岁,25.62±2.62岁,P0.05)无差异,身高(159.09±4.16cm,159.04±4.20cm,P0.05)、体重(54.04±7.85kg,51.00±7.20kg,P0.05)分布也均无差异,按照我国的BMI分级标准划分,两组孕前体重正常、超重的孕妇分布P0.05,无差异。(2)孕期低GL膳食干预的效果:干预组与对照组孕妇相比较,孕中期膳食GL值(142.02±49.41,170.54±64.73,P0.05),膳食GI值(56.98±11.08,62.63±14.26,P0.05),膳食总能量(1441.40±407.17kcal,1715.78±517.99 kcal,P0.05),蛋白质摄入量(60.15±10.71g,52.34±11.79g,P0.05),脂肪摄入量(39.20±17.66g,50.82±23.34g,P0.05),碳水化合物摄入量(206.52±63.36g,255.03±84.92g,P0.05);孕晚期膳食GL值(146.35±48.15,163.65±59.96,P0.05),膳食GI值(57.53±8.95,61.62±13.10,P0.05),膳食总能量(1489.22±375.79kcal,1782.98±491.43kcal,P0.05),蛋白质摄入量(61.65±8.29g,52.95±11.34g,P0.05),脂肪摄入量(40.75±13.08g,53.59±19.09g,P0.05),碳水化合物摄入量(213.50±60.95g,264.88±86.25g,P0.05),差异均有统计学意义。(3)低GL膳食干预对孕期增重的影响:干预组与对照组孕妇孕期增重(13.61±3.76kg,15.13±3.15 kg,P0.05),其中干预组孕期增重超过IOM标准20人,对照组孕期增重超过IOM标准35人,P0.05,存在统计学差异;孕中期增重(3.32±1.69 kg,4.13±1.86 kg,P0.05),孕晚期增重(2.77±1.80 kg,3.56±1.31 kg,P0.05)。(4)低GL膳食干预对新生儿出生结局的影响:干预组与对照组新生儿出生体重(3186.70±350.05 g,3205.38±516.12 g,P0.05),身长(49.82±0.99 cm,50.02±0.80cm,P0.05);不良出生结局:干预组发现1例巨大儿,对照组有3例巨大儿,大于胎龄儿干预组出现7例,对照组出现13例,小于胎龄儿两组均有11例,干预组早产3例,对照组早产2例,差异均无统计学意义。结论本研究通过对普通孕妇进行孕期低GL膳食干预,改善孕期饮食结构、营养状态,减轻了孕期体重的增加量,新生儿的出生体重、身长得到略微降低,对母婴健康有长远的指导意义。
[Abstract]:Objective to investigate the dietary intake during pregnancy and to record the changes of weight during pregnancy and calculate the weight gain of pregnant women through the intervention of low-glycemic loaded diet during pregnancy. Objective: to observe whether hypoglycemic load diet can reduce the occurrence of excessive weight gain during pregnancy. Methods A randomized epidemiological intervention trial was used to study pregnant women in a maternal and child health care hospital in Anhui province. The intervention group and control group were established, 97 cases in the intervention group and 94 cases in the control group. The intervention group was divided into two groups according to the BMI value before pregnancy and the weight gain grade during pregnancy. The main intervention content was low glycemic load diet. The node of intervention is the birth of the child, the control group does not impose the intervention measures of this project. The basic information questionnaire of pregnancy was used to obtain the baseline data of demographic information of pregnant women, while the intervention was at the same time. The dietary intake of pregnant women was recorded by 24 hours diet record on 3rd. The changes of body weight, blood glucose and blood lipid were continuously monitored during pregnancy. The birth weight and sex of the newborns were recorded in time when the pregnant women gave birth, and the difference of weight gain during pregnancy between the two groups was compared. Results the basic information of pregnant women: the age distribution of pregnant women in intervention group and control group was 25.63 卤2.58 years old. There was no difference (P 0.05) in 25.62 卤2.62 years old, and the height was 159.09 卤4.16 cm, 159.04 卤4.20 cm (P0.05). There was no difference in the distribution of body weight (54.04 卤7.85 kg / L, 51.00 卤7.20 kg / kg P0.05). According to the BMI classification standard of China, the body weight of the two groups was normal before pregnancy. The effect of low GL diet intervention during pregnancy: the GL value of the intervention group was 142.02 卤49.41 in the second trimester compared with the control group. The value of dietary GI was 56.98 卤11.08 卤62.63 卤14.26 (P 0.05). Total dietary energy was 1441.40 卤407.17kcaln 1715.78 卤517.99kcalP0.05). The protein intake was 60.15 卤10.71 g / g, and the fat intake was 39.20 卤17.66 g. The carbohydrate intake was 206.52 卤63.36g / L, 255.03 卤84.92g / g, respectively. In the third trimester of pregnancy, the GL value of diet was 146.35 卤48.15 卤163.65 卤59.96 (P 0.05), and the dietary GI value was 57.53 卤8.95. The total dietary energy was 1489.22 卤375.79kcal (1782.98 卤491.43kcalP0.05). The protein intake was 61.65 卤8.29g / g, and the fat intake was 40.75 卤13.08g. The carbohydrate intake was 213.50 卤60.95g / g, 264.88 卤86.25g / g, respectively. The effect of low GL dietary intervention on pregnancy weight gain: pregnant women in intervention group and control group gained 13.61 卤3.76 kg / L 15.13 卤3.15 kg / kg during pregnancy. P0.05, in which the pregnant weight gain of 20 patients in the intervention group exceeded the IOM standard, while in the control group, the weight gain during pregnancy exceeded the IOM standard in 35 patients (P0.05), and there was statistical difference between the two groups. In the second trimester, the weight gain was 3.32 卤1.69 kg / d 4.13 卤1.86 kg / kg P0.05A and 2.77 卤1.80 kg / kg in the second trimester of pregnancy. 3.56 卤1.31 kg. Effect of low GL dietary intervention on neonatal outcome: neonatal birth weight of intervention group and control group was 3186.70 卤350.05 g. 3205.38 卤516.12 g / g P0.05U, 49.82 卤0.99 cm-1 / 50.02 卤0.80cm / kg P0.05A; Bad birth outcome: one macrosomia was found in the intervention group, 3 in the control group, 7 in the intervention group, 13 in the control group and 11 in both groups. There were 3 cases of premature delivery in intervention group and 2 cases in control group, there was no significant difference between them. Conclusion this study can improve diet structure and nutritional status of pregnant women by low GL diet intervention during pregnancy. It reduces the weight gain during pregnancy and the birth weight and body length of the newborn, which has a long-term guiding significance for maternal and child health.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R715.3

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