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系统评价;妊娠期糖尿病的营养治疗

Systematic review; Nutritional therapy in gestational diabetes mellitus.

作者信息

Thomaz de Lima Helaine, Lopes Rosado Eliane, Ribeiro Neves Paulo Augusto, Corrêa Monteiro Machado Raphaela, Mello de Oliveira Larissa, Saunders Cláudia

机构信息

Research Group on Maternal and Child Health (Grupo de Pesquisa em Saúde Materna e Infantil - GPSMI). Instituto de Nutrição Josué de Castro/Universidade Federal do Rio de Janeiro (UFRJ)..

Instituto de Nutrição Josué de Castro/UFRJ..

出版信息

Nutr Hosp. 2013 Nov 1;28(6):1806-14.

Abstract

INTRODUCTION

Several methods of dietetic counseling can be used in the nutritional therapy in gestational diabetes mellitus (GDM). The main methods are the traditional method (TM) and the carbohydrate counting (CCM).

OBJECTIVE

Presenting a systematic review of the literature on the impact of nutritional therapy in GDM, through TM and CCM, evaluating the results for maternal and child health.

METHODS

We searched databases PubMed, Scopus, Web of Science, Lilacs and CAPES Digital Bank of Thesis. The methodological quality of all the studies included was made using the Jadad score.

RESULTS AND CONCLUSION

We have found five studies that evaluated the effects of nutritional therapy, through the TM, on the maternal and child health. None study evaluating the CCM was detected in pregnant women with GDM Nutritional therapy given during antenatal care was effective in reducing pregnancy complications (preeclampsia, excessive gestational weight gain, necessity for cesarean delivery, for insulin therapy and for shoulder dystocia), perinatal complications (macrosomia, neonatal hypoglycemia, and birth weight) and also in better glycemic control. The use of nutritional therapy should be highlighted within the antenatal care for pregnant women with GDM, giving the satisfactory results on metabolic control and on pregnancy outcomes. Studies examining the CCM to GDM patients should be conducted to show its effects on maternal and child health.

摘要

引言

妊娠糖尿病(GDM)营养治疗中可采用多种饮食咨询方法。主要方法有传统方法(TM)和碳水化合物计数法(CCM)。

目的

通过TM和CCM对GDM营养治疗影响的文献进行系统综述,评估母婴健康结果。

方法

我们检索了PubMed、Scopus、科学网、Lilacs和CAPES数字论文库等数据库。使用Jadad评分对纳入的所有研究的方法学质量进行评估。

结果与结论

我们发现五项研究评估了通过TM进行营养治疗对母婴健康的影响。在患有GDM的孕妇中未检测到评估CCM的研究。产前护理期间进行的营养治疗在减少妊娠并发症(先兆子痫、孕期体重过度增加、剖宫产必要性、胰岛素治疗必要性和肩难产)、围产期并发症(巨大儿、新生儿低血糖和出生体重)以及更好地控制血糖方面是有效的。对于患有GDM的孕妇,应在产前护理中强调营养治疗的使用,因为其在代谢控制和妊娠结局方面取得了令人满意的结果。应开展针对GDM患者的CCM研究,以显示其对母婴健康的影响。

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