妊娠糖尿病患者膳食调查及分娩巨大儿的影响因素.docVIP

·1614 · · 专 题 研 究 · 妊娠糖尿病患者膳食调查及分娩巨大儿的影响因素 丁冰杰，王佳，毕研霞，洪忠新 【摘要】 目的 探讨妊娠糖尿病 (GDM) 患者膳食情况及分娩巨大儿的危险因素。方法 选择2013年1— 12 月在首都医科大学附属北京友谊医院营养门诊就诊的GDM 患者157例，根据其分娩新生儿的出生体质量，将其分为巨 大儿组(新生儿体质量≥4000 g,n=17) 与正常体质量儿组(新生儿体质量为2500 g～4000g,n=140)。 记录患 者身高、孕前体质量及分娩体质量等资料。采用24h 膳食回顾调查法调查两组患者饮食摄人量。采用多因素Logistic 回归分析 GDM 患者分娩巨大儿的影响因素。 结果 两组年龄、妊娠早中期增重、孕期增重、糖尿病家族史、妊娠早中 期增重超标比例比较，差异均无统计学意义 (P0.05); 两组身高、孕前体质量、孕前体质指数 (BMI)、 分娩体质 量、孕晚期增重、孕前超重、孕期增重过多、上班情况比较，差异均有统计学意义 (P0.05)。 两组患者水果、蔬 菜、食用油摄入量比较，差异有统计学意义 (P0.05)。 多因素 Logistic 回归分析显示，孕前超重、孕期增重过多是 CDM 患者分娩巨大儿的影响因素(P0.05)。 结论 GDM 患者存在膳食摄入不合理情况，其分娩巨大儿的危险因素 是孕前超重和孕期增重过多，应对孕前超重孕妇尽早进行膳食干预和运动干预控制孕期增重，从而减少巨大儿的出生。 【关键词】 糖尿病，妊娠；巨大胎儿；膳食；体重增长 【中图分类号】 R714.256 【文献标识码】 A doi:10.3969/j.issn.1007-9572.2015.14.004 丁冰杰，王佳，毕研霞，等.妊娠糖尿病患者膳食调查及分娩巨大儿的影响因素 [J]. 中国全科医学，2015,18 (14):1614- 1617.[] Ding BJ, Wang J, Bi YX,et al. Dietary survey of patients with gestational diabetes mellitus and risk factors for macrosomia [J]. Chinese General Practice,2015,18(14):1614- 1617. Dietary Survey of Patients With Gestational Diabetes Mellitus and Risk Factors for Macrosomia DING Bing -jie,WANG Jia,BI Yan - xia, et al. Department of Nutrition,Beijing Friendship Hospital, Capital Medical University,Beijing 100050,China 【Abstract】 Objective To investigate the dietary condition of patients with gestational diabetes mellitus(GDM)and risk factors for macrosomia. Methods A total of 157 cases of GDM patients who received treatment in Beijing Friendship Hospital from January 2013 to December 2013 were included in the study. According to the birth weight of neonates, the subjects were divided into two groups:macrosomia group (n=17, birth weight≥4000 g)and normal neonate weight group (n=140, 2500 g birth weight 4000 g). Height and body weights before pregnancy and at delivery were recorded. A 24 h dietary recall was used to investigate the daily food intake of the two groups. Mulvariate Logistic regression analysis was conducted to determine influencing fa