膳食对妊娠期缺铁性贫血的影响调查及个体化营养干预方案对妊娠期铁缺乏的效果研究

发布时间：2018-06-22 11:17

本文选题：妊娠期 + 缺铁性贫血　；参考：《天津医科大学》2016年硕士论文

【摘要】：目的:(1)通过对患有妊娠期缺铁性贫血的孕妇和正常孕妇的孕期膳食摄入进行调查比较,探讨妊娠期膳食对妊娠期缺铁性贫血的影响。(2)通过研究个体化营养干预方案的实施效果,探索有效的治疗孕妇缺铁性贫血的营养干预模式。方法:(1)采用回顾性病例对照研究方法,对105例妊娠期缺铁性贫血孕妇(病例组)和同期同所医院正常妊娠的105例正常孕妇(对照组)进行孕期膳食摄入频率问卷调查,调查内容为孕妇妊娠期间摄入膳食的频率和摄入量。问卷分为常规膳食和特殊膳食两部分。通过比较两组孕妇妊娠期食物摄入的频率,采用单因素分析和多因素logistic回归分析,筛选出与妊娠期缺铁性贫血发生相关的膳食因素。(2)采用随机对照试验方法,将患有妊娠期铁缺乏的孕妇随机分为干预组(35例)采用孕妇个体化营养干预方案,对照组(35例)采用常规健康教育方法。个体化营养干预方案包括营养档案的建立、膳食调查与监测和开具营养处方等。效果评估指标时间分别为孕12周、孕20周、孕28周和孕36周,评估指标为分别比较两组孕妇日均铁摄入量、血红蛋白和血清铁蛋白、平均红细胞体积、妊娠结局和分娩结局指标。结果:(1)在妊娠期膳食摄入频率方面,病例组和对照组孕妇孕期摄入水果类、谷薯类、油脂类和蔬菜类的频率差异没有统计学意义(P0.05);病例组孕期血制品、动物内脏、肉禽鱼类、钙、铁、维生素补充剂的摄入频率与对照组相比,低于对照组孕妇。病例组摄入刺激性饮品、干果类、豆类、奶类及奶制品的频率与对照组相比,高于对照组孕妇,差异有统计学意义(P0.05)。单因素logistic回归分析初步筛选出8项相关因素。进一步进行多因素条件logistic回归分析结果显示,妊娠期经常摄入血制品、肉禽鱼类、动物内脏、钙补充剂、维生素补充剂、铁补充剂可能为妊娠期缺铁性贫血的保护性因素;而妊娠期缺铁性贫血的危险因素可能为经常摄入刺激性饮品、奶类及奶制品。(2)干预后对两组孕妇的相关指标进行比较,结果显示干预组的铁摄入量、血红蛋白、平均红细胞体积和血清铁蛋白指标均优于对照组,二者差异有统计学意义(P0.05)。对照组与干预组相比,干预结束后比较两组孕妇妊娠期铁缺乏患病率,差异具有统计学意义(P0.05)。两组孕妇妊娠结局比较,结果显示两组妊娠期铁缺乏孕妇分娩后分析孕期体重增重方面,干预组相比对照组更优,差异有统计学意义(P0.05)。对两组孕妇其他妊娠期并发症和分娩并发症的发生率进行比较,干预组与对照组相比,妊娠期糖尿病的发病率较低,差异有统计学意义(P0.05)。两组孕妇在其他妊娠期合并症和不良妊娠结局方面比较,差异无统计学意义(P0.05)。结论:(1)妊娠期增加肉禽鱼类、血制品、动物内脏、钙、铁、维生素补充剂的摄入可以有效预防或减少妊娠期缺铁性贫血的发生。而孕期刺激性饮品、牛奶及奶制品的摄入频次过多可能会增加妊娠期缺铁性贫血发生的风险。(2)孕妇个体化营养干预方案对治疗妊娠期妇女铁缺乏有较好的干预效果,在改善妊娠结局方面,妊娠期个体化营养干预方案对孕期合理增重有较好影响,在预防其他妊娠期并发症方面无显著效果。
[Abstract]:Objective: (1) to explore the effect of pregnancy diet on iron deficiency anemia during pregnancy by comparing the dietary intake of pregnant women with pregnant women with iron deficiency anemia and normal pregnant women. (2) through the study of the implementation effect of individualized nutrition intervention program, the effective treatment mode for the treatment of iron deficiency anemia in pregnant women was explored. (1) a retrospective case control study was used to investigate the frequency and intake of dietary intake of 105 pregnant women with iron deficiency anemia (case group) and 105 normal pregnant women (control group) during the same period of normal pregnancy (control group). The questionnaire was divided into regular diet and special diet. The two part of the special diet. By comparing the frequency of the food intake in the two groups of pregnant women, using single factor analysis and multiple factor Logistic regression analysis, the dietary factors related to the occurrence of iron deficiency anemia in pregnancy were selected. (2) a randomized controlled trial was used to randomly divide pregnant women with iron deficiency into the intervention group (35 cases) to adopt pregnancy. In the control group, the control group (35 cases) adopted the routine health education method. The individualized nutrition intervention program included the establishment of nutritional archives, the dietary survey and monitoring and the prescriptions of nutrition. The evaluation indexes were 12 weeks of pregnancy, 20 weeks of pregnancy, 28 weeks of pregnancy and 36 weeks of pregnancy. The evaluation indexes were compared to the average daily iron rate in the two groups of pregnant women. Intake, hemoglobin and serum ferritin, mean red cell volume, pregnancy outcome and delivery outcome indicators. Results: (1) there was no statistical difference in the frequency of intake of fruits, Cereals, Oils and vegetables during pregnancy in pregnant women and control groups (P0.05). The frequency of intake of viscera, fowl fish, calcium, iron, vitamin supplement was lower than that of the control group. The frequency of intake of stimulant drinks, dried fruit, legumes, milk and dairy products in the case group was higher than that of the control group, the difference was statistically significant (P0.05). The single factor Logistic regression analysis was a preliminary screening of 8 items. Related factors. Further multivariate conditional logistic regression analysis showed that frequent intake of blood products during pregnancy, meat fowl fish, animal viscera, calcium supplements, vitamin supplements, and iron supplements may be protective factors for iron deficiency anemia in pregnancy, and the risk factors for iron deficiency anemia in pregnancy may be regular intake of stimulation. Sexual drinks, milk and dairy products. (2) compared to the related indexes of two groups of pregnant women after the intervention, the results showed that the iron intake, hemoglobin, mean red blood cell volume and serum ferritin were superior to the control group in the intervention group, and the difference between the two groups was statistically significant (P0.05). Compared with the intervention group, the control group compared the two groups of pregnant women after the intervention. The incidence of iron deficiency during pregnancy was statistically significant (P0.05). The results of pregnancy outcome in two groups of pregnant women showed that the two groups of pregnant women with iron deficiency were better than the control group after childbirth analysis. The difference was statistically significant (P0.05). Other pregnancy complications and childbirth complications in the two groups of pregnant women were found. Compared with the control group, the incidence of gestational diabetes was lower than the control group, the difference was statistically significant (P0.05). There was no significant difference between the two groups of pregnant women in other pregnancy complications and bad pregnancy outcomes (P0.05). Conclusion: (1) the increase of meat fishes, blood products, animal viscera, calcium, iron, and vitamin D during pregnancy. The intake of vegetative supplements can effectively prevent or reduce the incidence of iron deficiency anemia during pregnancy. The risk of iron deficiency anemia in pregnancy may be increased by excessive intake of milk and milk and milk products during pregnancy. (2) the individualized nutrition intervention program of pregnant women has a better effect on the treatment of iron deficiency in pregnant women. In terms of improving pregnancy outcome, the individualized nutrition intervention program during pregnancy has a good effect on reasonable weight gain during pregnancy, and there is no significant effect in preventing complications of other pregnancy.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R714.254

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