妊娠期间生活方式干预的效果 - 芬兰妊娠糖尿病预防试验（RADIEL）的结果。
Effect of a lifestyle intervention during pregnancy-findings from the Finnish gestational diabetes prevention trial (RADIEL).
机构信息
Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Unit of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
出版信息
J Perinatol. 2018 Sep;38(9):1157-1164. doi: 10.1038/s41372-018-0178-8. Epub 2018 Jul 24.
OBJECTIVE
To assess the effect of lifestyle counseling on perinatal outcomes among women at high risk for gestational diabetes.
STUDY DESIGN
A total of 492 women with obesity and/or prior gestational diabetes were allocated to intervention (four sessions of lifestyle counseling, n = 249) or usual care (n = 243) before 20 weeks' gestation.
RESULT
Lifestyle indicators, gestational weight gain, or obstetric and perinatal outcomes did not differ between the two groups. An oral glucose tolerance test in the first half of pregnancy was pathological in 37.7% (n = 87/144) of intervention and 36.5% (n = 72/197) of control group women (p = 0.81). The total incidence of gestational diabetes diagnosed in the first or second half of pregnancy was 44.8% (107/239) in the intervention and 48.1% (111/231) in the control group (p = 0.48).
CONCLUSIONS
The high prevalence of impaired glucose metabolism was observed already in early pregnancy, which may have contributed to the lack of effect of the intervention.
目的
评估生活方式咨询对患有妊娠期糖尿病高危因素的女性围产期结局的影响。
研究设计
共有 492 名肥胖和/或既往患有妊娠期糖尿病的女性在妊娠 20 周前被分配到干预组（生活方式咨询 4 次，n=249）或常规护理组（n=243）。
结果
两组的生活方式指标、妊娠体重增加或产科和围产期结局无差异。妊娠前半期的口服葡萄糖耐量试验在干预组中 37.7%（n=87/144）和对照组中 36.5%（n=72/197）的女性呈病理性（p=0.81）。在妊娠第 1 或第 2 半期诊断的妊娠期糖尿病总发病率在干预组中为 44.8%（107/239），在对照组中为 48.1%（111/231）（p=0.48）。
结论
妊娠早期已经观察到葡萄糖代谢受损的高患病率，这可能导致干预措施无效。
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