摘要
目的:评估有组织、规律的饮食和生活方式咨询可否预防孕期体重增加超标。方法:设立随机对照试验,随机抽取200例孕妇作为研究对象,114例为干预组,需要通过严格的饮食和生活方式咨询;86例为对照组,接受产前常规指导。主要观察两组孕妇孕期体重增加量以及对美国医学会(IOM)指南遵从率的差异;并观察两组孕妇分娩方式、新生儿体重、剖宫产率、巨大儿、妊娠期糖尿病、妊娠期高血压疾病发生率的不同。结果:干预组孕期体重增加量为13.1±5.7kg,明显少于对照组的16.2±7.0kg,差异有统计学意义(P<0.05);因产程没有进展而施行剖宫产的比例,对照组为45.9%,明显高于干预组的21.6%,差异有统计学意义(P<0.05);初产妇孕期体重增加量为16.5±6.6kg,明显多于经产妇的12.5±5.8kg,差异有统计学意义(P<0.01);两组的IOM指南遵从率、新生儿体重、巨大儿、妊娠期糖尿病、妊娠期高血压疾病发生率无明显的统计学差异。结论:有组织规律的饮食和生活方式咨询比常规产前指导更能有效的预防孕期体重增加超标,超重和肥胖孕妇比正常体重孕妇更不易遵从IOM指南,孕期体重符合IOM指南标准的最佳条件是孕前体重指数正常。
Objective：To estimate whether an organized,consistent program of dietary and lifestyle counseling prevents excessive weight gain in pregnancy.Methods：This randomized controlled trial assigned 200 women to receive either an organized,consistent program of intensive dietary and lifestyle counseling or routine prenatal care（lifestyle counseling 114,routine prenatal care 86）.The primary study outcome was the difference between two groups of patients whose gestational weight gain and adherence to the Institute of Medicine（IOM） guidelines.Secondary outcomes included mode of delivery,rate of cesarean delivery,neonatal weight,the incidence of macrosomia of deliver,gestational diabetes mellitus and pregnancy hypertension.Results：The lifestyle counseling group gained significantly less weight than did the routine prenatal care group[（13.1±5.7）kg compared with（16.2±7.0）kg,P0.05）].The routine prenatal care group had significantly more cesarean deliveries due to ＂failure to progress＂（routine prenatal care 45.9% compared with lifestyle counseling 21.6%,P0.05）.Nulliparous women gained significantly more weight than did parous women[（16.5±6.6）kg compared with（12.5±5.8）kg,P0.01].No statistically significant differences were noted between the groups in adherence to IOM guidelines,neonatal weight,the incidence of macrosomia of deliver,gestational diabetes mellitus and pregnancy hypertension.Conclusion：An organized,consistent program of dietary and lifestyle counseling can reduce weight gain in pregnancy than routine prenatal care.The most predictive factor of IOM adherence is having a normal prepregnancy body mass index.
出处
《现代妇产科进展》
CSCD
北大核心
2010年第5期358-361,共4页
Progress in Obstetrics and Gynecology
关键词
妊娠
膳食
生活方式
咨询
体重增长
Pregnancy
Diet
Life style
Counseling
Weight gain
