中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
14期
1614-1617
,共4页
丁冰杰%王佳%毕研霞%洪忠新
丁冰傑%王佳%畢研霞%洪忠新
정빙걸%왕가%필연하%홍충신
糖尿病,妊娠%巨大胎儿%膳食%体重增长
糖尿病,妊娠%巨大胎兒%膳食%體重增長
당뇨병,임신%거대태인%선식%체중증장
Diabetes,gestational%Fetal macrosomia%Diet%Weight gain
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 ～＜4000 g，n ＝140）。记录患者身高、孕前体质量及分娩体质量等资料。采用24 h 膳食回顾调查法调查两组患者饮食摄入量。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（P ＞0.05）；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（P ＜0.05）。两组患者水果、蔬菜、食用油摄入量比较，差异有统计学意义（P ＜0.05）。多因素 Logistic 回归分析显示，孕前超重、孕期增重过多是GDM 患者分娩巨大儿的影响因素（P ＜0.05）。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。
目的：探討妊娠糖尿病（GDM）患者膳食情況及分娩巨大兒的危險因素。方法選擇2013年1—12月在首都醫科大學附屬北京友誼醫院營養門診就診的 GDM 患者157例，根據其分娩新生兒的齣生體質量，將其分為巨大兒組（新生兒體質量≥4000 g，n ＝17）與正常體質量兒組（新生兒體質量為2500 g ～＜4000 g，n ＝140）。記錄患者身高、孕前體質量及分娩體質量等資料。採用24 h 膳食迴顧調查法調查兩組患者飲食攝入量。採用多因素 Logistic迴歸分析 GDM 患者分娩巨大兒的影響因素。結果兩組年齡、妊娠早中期增重、孕期增重、糖尿病傢族史、妊娠早中期增重超標比例比較，差異均無統計學意義（P ＞0.05）；兩組身高、孕前體質量、孕前體質指數（BMI）、分娩體質量、孕晚期增重、孕前超重、孕期增重過多、上班情況比較，差異均有統計學意義（P ＜0.05）。兩組患者水果、蔬菜、食用油攝入量比較，差異有統計學意義（P ＜0.05）。多因素 Logistic 迴歸分析顯示，孕前超重、孕期增重過多是GDM 患者分娩巨大兒的影響因素（P ＜0.05）。結論 GDM 患者存在膳食攝入不閤理情況，其分娩巨大兒的危險因素是孕前超重和孕期增重過多，應對孕前超重孕婦儘早進行膳食榦預和運動榦預控製孕期增重，從而減少巨大兒的齣生。
목적：탐토임신당뇨병（GDM）환자선식정황급분면거대인적위험인소。방법선택2013년1—12월재수도의과대학부속북경우의의원영양문진취진적 GDM 환자157례，근거기분면신생인적출생체질량，장기분위거대인조（신생인체질량≥4000 g，n ＝17）여정상체질량인조（신생인체질량위2500 g ～＜4000 g，n ＝140）。기록환자신고、잉전체질량급분면체질량등자료。채용24 h 선식회고조사법조사량조환자음식섭입량。채용다인소 Logistic회귀분석 GDM 환자분면거대인적영향인소。결과량조년령、임신조중기증중、잉기증중、당뇨병가족사、임신조중기증중초표비례비교，차이균무통계학의의（P ＞0.05）；량조신고、잉전체질량、잉전체질지수（BMI）、분면체질량、잉만기증중、잉전초중、잉기증중과다、상반정황비교，차이균유통계학의의（P ＜0.05）。량조환자수과、소채、식용유섭입량비교，차이유통계학의의（P ＜0.05）。다인소 Logistic 회귀분석현시，잉전초중、잉기증중과다시GDM 환자분면거대인적영향인소（P ＜0.05）。결론 GDM 환자존재선식섭입불합리정황，기분면거대인적위험인소시잉전초중화잉기증중과다，응대잉전초중잉부진조진행선식간예화운동간예공제잉기증중，종이감소거대인적출생。
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≥4 000 g)and normal neonate weight group(n = 140, 2 500 g birth weight < 4 000 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 factors for macrosomia. Results There were no statistically significant differences(P > 0. 05)between two groups in age,early - to - mid pregnancy over weight gain,pregnancy weight gain,family history of diabetes mellitus and rate of early- to - mid pregnancy weight gain exceeding standard. There were statistically significant differences(P < 0. 05) between the two groups in height,pre - pregnancy weight,pre - pregnancy BMI,height,weight at delivery,late pregnancy weight gain, pre - pregnancy weight,excessive pregnancy weight gain,being at work or not. There were statistically significant differences (P < 0. 05) between the two groups in the intake of vegetables,fruits and cooking oil. The multivariate Logistic regression analysis showed that pre - pregnancy overweight and excessive pregnancy weight gain were risk factors ( P < 0. 05 ) for macrosomia. Conclusion Dietary intake is not reasonable in GDM patients,pre - pregnancy overweight and pregnancy excessive weight gain are risk factors for macrosomia delivered. Diet and sport intervention should be conducted on overweight pregnant women in order to reduce the occurrence of macrosomia.
