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降低接受体外受精 (IVF) 的女性在怀孕期间接受营养和健康饮食实践培训后的主要母婴并发症。

Decreasing the main maternal and fetal complications in women undergoing fertilization (IVF) trained by nutrition and healthy eating practices during pregnancy.

机构信息

Department of Midwifery, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.

Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

出版信息

J Matern Fetal Neonatal Med. 2021 Jun;34(12):1855-1867. doi: 10.1080/14767058.2019.1651267. Epub 2019 Aug 20.

Abstract

PURPOSE

fertilization (IVF) can lead to undesirable consequences for pregnant women and their newborns. Reducing the adverse maternal (mainly, gestational diabetes mellitus (GDM) and preeclampsia (PE)), and fetal outcomes in IVF-pregnant women (IVF-PW) was aimed with the correct training of nutrition principles during pregnancy.

MATERIALS AND METHODS

A quasi-experimental clinical trial with 170 IVF-PW in intervention and control groups was conducted. The subjects before the dietary intervention completed questionnaires of nutritional and lifestyle and 24-h food recall. The intervention group was trained with the diet modification programs from early (12-16 weeks) to late (week 34) pregnancy in six weekly, 15-20-min sessions. The GDM diagnosis was based on 75-g OGTT and FBS tests, respectively, in 24-28 weeks' gestation. Other adverse maternal (e.g. PE, cesarean delivery, and preterm delivery (<37 weeks)), and fetal (e.g. intrauterine growth retardation (IUGR), birth weight, and fetal viability) outcomes were also monitored. The dataset was assessed using both inferential and descriptive statistics.

RESULTS

A diet modification program with an increased intake of lactose, fiber, and some minerals (e.g. magnesium and zinc) and vitamins (e.g. B3 and B5) in conjunction with a lower intake rate of glucose and lipid could control the prevalence of adverse maternal and neonatal outcomes in IVF-PW. Although the GDM reduction in the two intervention (8.2%) and control (20.0%) groups was statistically insignificant, there was a significant difference in PE prevalence at a lower rate (39.0%) in the intervention group than the control. No significant difference in cesarean delivery (94.1-95.2%), and preterm delivery (45.9%) between the two groups was found. The IUGR (24.7-25.9%), birth weight (2.791-2.820 kg), and fetal viability (95.3-97.6%) also did not change significantly after the healthy eating practices during pregnancy.

CONCLUSIONS

Diet-based interventions in IVF-PW during pregnancy were efficient in improving the outcomes for both mother and baby.

摘要

目的

体外受精(IVF)可能会给孕妇及其新生儿带来不良后果。本研究旨在通过在怀孕期间正确教授营养原则,减少 IVF 孕妇(IVF-PW)的不良母婴(主要是妊娠糖尿病(GDM)和子痫前期(PE))和胎儿结局。

材料和方法

对 170 名 IVF-PW 进行了准实验性临床试验,分为干预组和对照组。在进行饮食干预之前,所有受试者均完成了营养和生活方式问卷以及 24 小时食物回忆。干预组在妊娠早期(12-16 周)和晚期(第 34 周)进行六次、每次 15-20 分钟的饮食修改方案培训。GDM 的诊断基于妊娠 24-28 周时的 75g OGTT 和 FBS 检查。还监测了其他不良母婴(如 PE、剖宫产和早产(<37 周))和胎儿结局(如宫内生长迟缓(IUGR)、出生体重和胎儿存活率)。使用推断统计和描述性统计评估数据集。

结果

与低糖和脂质摄入率相结合,增加乳糖、纤维和一些矿物质(如镁和锌)以及维生素(如 B3 和 B5)的饮食修改方案可以控制 IVF-PW 中不良母婴和新生儿结局的发生率。虽然两组干预组(8.2%)和对照组(20.0%)的 GDM 降低率无统计学意义,但干预组的 PE 发生率较低(39.0%)。两组间剖宫产(94.1-95.2%)和早产(45.9%)率无显著差异。两组间 IUGR(24.7-25.9%)、出生体重(2.791-2.820kg)和胎儿存活率(95.3-97.6%)也无显著变化。

结论

在 IVF-PW 怀孕期间进行基于饮食的干预措施在改善母婴结局方面是有效的。

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