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孕早期超重/肥胖孕妇个体化远程营养健康干预的效果评价

Effect evaluation of individualized remote nutritional health interventions for overweight/obese women in early pregnancy

  • 摘要:
    目的 评价个体化远程营养健康管理模式对孕早期超重/肥胖孕妇孕期全程管理的干预效果。
    方法 选择2019年6月 — 2020年9月在广东省深圳市妇幼保健院产科门诊首次就诊并确诊为孕前超重/肥胖的单胎孕早期妊娠妇女200例为研究对象,将其随机分为对照组100例和干预组100例。对照组孕妇采取常规营养健康指导,干预组孕妇在常规营养健康指导的基础上运用微医平台进行个体化远程营养健康管理模式全程管理至分娩。分析两组孕妇孕期体重增长情况和妊娠结局管理效果。
    结果 干预组孕妇孕期增重正常的发生率(77.89%)高于对照组(60.42%),增重过度的发生率(13.68%)低于对照组(28.13%)。干预组孕前超重孕妇的分娩前体重(76.96 ± 5.34)kg和孕期增重(9.90 ± 2.32)kg低于对照组的分娩前体重(79.03 ± 5.97)kg和孕期增重(11.73 ± 4.03)kg,干预组孕前肥胖孕妇的孕期增重(8.09 ± 2.31)kg低于对照组的孕期增重(10.74 ± 3.70)kg,差异均具有统计学意义(均P < 0.05)。干预组孕妇剖宫产率(43.16%)、妊娠期糖尿病(9.47%)、子痫前期(2.11%)、羊水过多(3.16%)和早产(2.11%)的发生率均低于对照组,差异均具有统计学意义(均P < 0.05);干预组孕期增重不足的发生率、妊娠期高血压、胎膜早破和产后出血的发生率与对照组相比差异均无统计学意义(均P < 0.05)。干预组围产儿低出生体重儿的发生率(2.11%)低于对照组(9.38%),差异具有统计学意义(P < 0.05);干预组胎儿宫内窘迫、胎儿宫内生长受限、巨大儿、新生儿窒息的发生率与对照组相比差异均无统计学意义(均P > 0.05)。
    结论 个体化远程营养健康管理模式对控制孕期增重有效,有助于改善孕前超重和肥胖孕妇的不良妊娠结局。

     

    Abstract:
    Objective To evaluate the intervention effect of individualized remote nutrition and health management model on overweight/obese women in early pregnancy.
    Methods A total of 200 women with single early pregnancy, who were diagnosed as pre-pregnancy overweight or obese in the obstetrics department of Shenzhen Maternal and Child Health Hospital from June 2019 to September 2020, were recruited as study subjects. They were randomly assigned to control group (100 cases) and intervention group (100 cases). The control group received routine nutrition and health guidance. The intervention group received individualized remote nutrition and health guidance through‘We Doctor’platform plus routine care for the whole process of pregnancy and delivery. Weight gain during pregnancy and pregnancy outcome were compared between two groups.
    Results The reasonable incidence of pregnancy weight gain in the intervention group (77.89%) was higher than that in the control group (60.42%), while the incidence of excessive weight gain(13.68%) was lower than that in the control group (28.13%). Weight before delivery (76.96 ± 5.34 kg) and weight gain during pregnancy (9.90 ± 2.32 kg) of pre-pregnancy overweight pregnant women in the intervention group were lower than those (79.03 ± 5.97 kg and 11.73 ± 4.03 kg, respectively) in the control group. Weight gain during pregnancy of pre-pregnancy obese pregnant women in the intervention group (8.09 ± 2.31 kg) was lower than that in the control group (10.74 ± 3.70 kg), the difference was statistically significant (P < 0.05). The rate of cesarean section (43.16%), the incidences of gestational diabetes mellitus (9.47%), preeclampsia (2.11%), polyhydramnios (3.16%) and preterm delivery (2.11%) in the intervention group were lower than those in the control group (9.38%) (P < 0.05). There was no significant difference in the incidences of underweight gain, hypertension, premature rupture of membranes and postpartum hemorrhage during pregnancy between 2 groups (all P > 0.05). The incidence of low birth weight of perinatal infant (2.11%) was lower in the intervention group than that in the control group (P < 0.05). There was no statistically significant difference in the incidences of fetal distress, fetal intrauterine growth restriction, macrosomia and neonatal asphyxia between 2 groups (all P > 0.05).
    Conclusion The individualized remote nutrition and health management model is effective in controlling weight gain during pregnancy, and it also helps to improve adverse pregnancy outcomes of overweight and obese pre-pregnant women.

     

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