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剖宫产术前 2 小时口服富含碳水化合物的补充剂对产妇和新生儿围手术期结局的影响:一项随机临床试验。

The impact of oral carbohydrate-rich supplement taken two hours before caesarean delivery on maternal and neonatal perioperative outcomes -- a randomized clinical trial.

机构信息

Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, SAR, China.

Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301, Yanchangzhong Road, Shanghai, 200072, China.

出版信息

BMC Pregnancy Childbirth. 2021 Oct 7;21(1):682. doi: 10.1186/s12884-021-04155-z.

Abstract

BACKGROUND

To evaluate the impact of oral carbohydrate-rich (Ch-R) supplement taken 2 hours before an elective caesarean delivery (CD) on maternal and neonatal perioperative outcomes.

METHODS

Ninety pregnant women undergoing elective CD were randomized into the Ch-R group, placebo group and fasting group equally. Participants' blood was drawn at three time points, before intervention, immediately after and 1 day after the surgery to measure maternal and neonatal biochemical indices. Meanwhile women's perioperative symptoms and signs were recorded.

RESULTS

Eighty-eight pregnant women were finally included in the study. Women who had drunk Ch-R supplement had lower postoperative insulin level (β = - 3.50, 95% CI - 5.45 to - 1.56), as well as postoperative HOMA-IR index (β = - 0.74, 95% CI - 1.15 to - 0.34), compared with women who had fasted. Additionally, neonates of mothers who were allocated in the Ch-R group also had a higher glucose level, compared with neonates of mothers in the fasting group (β = 0.40, CI 0.17 to 0.62).

CONCLUSION

Oral Ch-R solution administered 2 hours before an elective CD may not only alleviate maternal postoperative insulin resistance, but also comfort women's preoperative thirst and hunger, compared to fasting. Additionally, it may increase neonatal glucose level as well.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR2000033163 . Data of Registration: 2020-5-22.

摘要

背景

评估择期剖宫产术前 2 小时口服富含碳水化合物(Ch-R)的补充剂对产妇和新生儿围手术期结局的影响。

方法

90 例行择期剖宫产的孕妇随机分为 Ch-R 组、安慰剂组和禁食组。在术前、术后即刻和术后 1 天抽取 3 个时间点的参与者血液,以测量产妇和新生儿的生化指标。同时记录女性围手术期的症状和体征。

结果

最终有 88 名孕妇纳入研究。与禁食组相比,口服 Ch-R 补充剂的女性术后胰岛素水平较低(β=−3.50,95%CI−5.45 至−1.56),HOMA-IR 指数也较低(β=−0.74,95%CI−1.15 至−0.34)。此外,与禁食组的母亲所生的新生儿相比,母亲被分配到 Ch-R 组的新生儿血糖水平更高(β=0.40,CI 0.17 至 0.62)。

结论

与禁食相比,择期剖宫产术前 2 小时口服 Ch-R 溶液不仅可以减轻产妇术后胰岛素抵抗,还可以缓解女性术前的口渴和饥饿感。此外,它还可能增加新生儿的血糖水平。

试验注册

中国临床试验注册中心,ChiCTR2000033163。注册数据:2020-5-22。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f33/8495981/9df9bbd3939d/12884_2021_4155_Fig1_HTML.jpg

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