个体化孕期体重管理对妊娠结局影响.docVIP

个体化孕期体重管理对妊娠结局影响 　　[摘要] 目的：探讨孕期个体化体重管理的可行性及其对妊娠结局的影响。方法：随机将2010年2月~2011年1月在我院产科门诊定期产检的正常单胎头位初产妇640例分为研究组（320例）和对照组（320例），研究组接受个体化体重管理，包括制订孕期增重目标、均衡饮食及适量运动等，对照组接受常规产科检查。结果：研究组和对照组平均孕期增重分别为（12.5±2.7） kg和（15.9±4.8） kg，差异有统计学意义（P 　　[关键词] 妊娠；体重增长；人体质量指数；妊娠结局 　　[中图分类号] R17 [文献标识码] B [文章编号] 1673-7210（2011）06（c）-176-03 　　 　　The impact on management of individual pregnancy weight gain to the pregnancy outcome 　　ZHONG Liruo, LIU Biyun, LI Yan 　　Department of Obstetrics and Gynecology, the Peoples Hospital of Shenzhen City, the Second Clinical Hospital of Jinan University, Guangdong Province, Shenzhen 518020, China 　　[Abstract] Objective: To evaluate the possibility on management of individual pregnancy weight gain and its impact to the pregnancy outcome. Methods: 640 primiparas with single fetal and fetal position which was head presentation were enrolled and divided into two groups randomly. The study group (320 cases) received education on management of individual pregnancy weight gain, and the control group (320 cases) received regular physical examination only. Various basic clinical characteristics including body mass index (BMI) and gestational weight gain were collected and maternal and neonatal outcomes were recorded. Results: The mean gestational weight gain was (12.5±2.7) kg in the study group which was lower than that in the control group (15.9±4.8) kg (P0.05), the incidences of macrosomia, gestational diabetes mellitus, cesarean section in the study group were 8.3%, 2.8% and 49.8% significantly which were less than those in the control group (19.9%, 8.4% and 62.5%) (P28 为肥胖。实验组根据孕前或孕12周前BMI所在的范围，确定孕期增重的大致范围，即按照2009年美国IOM推荐的单胎孕妇孕期增重标准[3]：低体重组增重12.5~18.0 kg，正常体重组增重11.5~16.0 kg，超重组增重7.0~11.5 kg，肥胖组增重5.0~9.0 kg，从而制订孕期增重阶段目标和终极目标。 　　1.2.2 实施方法 对研究组孕妇进行个体化体重干预，包括均衡的膳食营养、良好的生活方式及适量的运动。具体方法如下：①对研究组孕妇详细介绍异常孕期增重对母婴健康的危害。②个体化膳食营养指导：结合膳食调查并利用专业围产营养管理软件，计算出孕妇各种营养素的需求情况，进而做出个体化的调整。③指导实验组孕妇多活动，尽可能完成正常的工作并参加一些有益的体育活动，如散步和轻体力家务劳动。④每周在家或至本院产科门诊监测体重，每人均定时定称，根据每次