孕期骨营养监测对孕产妇骨健康的影响 - 南京医科大学学报.docVIP

孕期骨营养监测对孕产妇骨健康的影响 钱芳1，2潘维君2尹晓兰2 陶玲玲2 冯晴1 （1南京医科大学公共卫生学院食品卫生系，江苏，南京，210029；2马鞍山市妇幼保健院妇女保健科，安徽，马鞍山，243000） 【摘要】 目的：探讨孕期骨营养监测指导对孕产妇骨健康的影响。方法：将472名孕妇根据早孕建册日期随机分成干预组和对照组，两组在年龄、BMI、孕周、文化程度、职业、家庭人均月收入等方面的差异均无统计学意义（p0.05）。干预组从孕20周左右至产后42天接受骨营养监测指导，包括定期超声骨密度检测、24小时膳食调查及指导，科学补钙指导以及常规孕产期保健指导。对照组接受常规孕产期保健，定期监测超声骨密度。结果：（1）干预组（-0.83±0.56）和对照组（0.77±0.51）在孕中期的骨密度T值均比孕早期低，差异具有统计学意义（p0.001），两组孕中期的骨密度差异无统计学意义（t=-1.08，p=0.129）。（2）干预组孕晚期骨密度T值（-0.68±0.73）较对照组（-1.03±0.57）高，差异有统计学意义（t=4.49，p0.001）；干预组产后42天骨密度T值（-0.68±0.94）较对照组（-1.32±0.81）高，差异具有统计学意义（t=7.9，P0.001）。对照组的骨密度在孕期及产褥期呈下降趋势，而干预组未呈现明显的下降趋势，差异具有统计学意义（P0.001）。（3）干预组难产发生率（11.4%）低于对照组，差异有统计学意义。结论：孕产期进行骨营养监测指导可有效改善孕产妇骨健康状况。 【关键词】孕产期 骨健康 骨营养监测 骨营养指导 【Abstract】objective：To investigate the influence of nutrition during pregnancy on maternal bone under the monitoring of bone health. Methods：472 pregnant women in early pregnancy are divided into intervention group and control group according to the date of the first attendance. There were no statistically significant differences in age、BMI、gestational weeks、education、occupation、income per monthly between two groups（p0.05）.The intervention group received routine prenatal care guide and regular bone nutrition monitoring and guidance from 20 weeks of gestation to 42 days postpartum, Including regular ultrasonic bone density detection, 24 hour dietary survey and calcium nutritional guidance. The control group received routine prenatal care and regular monitoring of ultrasonic bone density. Result：(1) The bone mineral density of the second trimester（-0.83±0.56） is lower than the early pregnancy（-0.42±0.39） in intervention group,and is also the control group. The two groups was not statistically significant differences in BMD during second trimester of pregnancy（t=-1.08，p=0.129）.(2) The bone mineral density of the intervention group during late pregnancy (-0.68 ± 0.73) is higher than the control group (-1.03 ± 0.57) . The difference was statistically significant（t=4.49，p0.001）. The bone mineral d