Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Drs Messika, Toledano, Hadar, Shmuel, and Tauman); Sleep Disorders Center, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel (Dr Tauman).
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Drs Messika, Toledano, Hadar, Shmuel, and Tauman); Sleep Disorders Center, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel (Dr Tauman).
Am J Obstet Gynecol MFM. 2022 Sep;4(5):100660. doi: 10.1016/j.ajogmf.2022.100660. Epub 2022 May 4.
Gestational diabetes mellitus is associated with an increased risk of maternal, fetal, and neonatal morbidities. Chronobiological disorders have recently been identified as risk factors for those morbidities. The disorders include chrononutritional disorders related to meal frequency and content according to the sleep-wake cycle, sleep disorders related to sleep quality, and chrono-obesity disorders, such as abnormal weight gain because of sleep deprivation and time of eating.
This study aimed to assess whether a chrononutritional and sleep hygiene intervention can improve maternal glycemic control and reduce the proportion of large-for-gestational-age newborns among women with gestational diabetes mellitus.
This randomized controlled trial included 103 women with gestational diabetes mellitus who were carrying a singleton fetus and assigned to either the intervention group (n=33) or the control group (n=70). The intervention group was assigned to a chrononutrition and sleep hygiene program, in addition to the usual care for gestational diabetes mellitus, from the time of diabetes mellitus diagnosis to birth, whereas the control group received the usual gestational diabetes mellitus care.
The chrononutritional and sleep hygiene intervention significantly reduced the proportion of women with suboptimal glycemic control (<80% of the plasma glucose values at target), after adjustment for maternal age, prepregnancy body mass index, gravidity, history of gestational diabetes mellitus, and large for gestational age (relative risk, 0.28; 95% confidence interval, 0.18-0.81). The effect of the intervention on balancing maternal glycemic control was mainly because of the decreased carbohydrate intake in the evening interval of the day (relative risk, 0.8; 95% confidence interval, 0.64-0.99). However, the intervention had no effect on the proportion of large-for-gestational-age newborns.
The chrononutritional and sleep hygiene intervention can improve maternal glycemic control.
妊娠糖尿病与产妇、胎儿和新生儿发病率增加有关。最近发现，昼夜节律紊乱是这些疾病的危险因素之一。这些疾病包括根据睡眠-觉醒周期与进餐频率和内容有关的营养紊乱、与睡眠质量有关的睡眠障碍，以及与睡眠剥夺和进食时间有关的肥胖紊乱，如因睡眠不足和进食时间异常导致的体重增加。
本研究旨在评估营养与睡眠卫生干预是否可以改善妊娠糖尿病患者的血糖控制，降低巨大儿的比例。
这是一项随机对照试验，纳入了 103 名患有妊娠糖尿病的单胎孕妇，随机分为干预组（n=33）和对照组（n=70）。干预组除接受妊娠糖尿病常规治疗外，还接受了营养与睡眠卫生干预，从糖尿病诊断到分娩，而对照组仅接受妊娠糖尿病常规治疗。
经过调整母亲年龄、孕前体重指数、孕次、妊娠糖尿病史和巨大儿等因素后，营养与睡眠卫生干预显著降低了血糖控制不佳（目标血浆葡萄糖值<80%）的女性比例（相对风险，0.28；95%置信区间，0.18-0.81）。干预对平衡产妇血糖控制的影响主要是由于白天晚上间隔的碳水化合物摄入量减少（相对风险，0.8；95%置信区间，0.64-0.99）。然而，该干预对巨大儿的比例没有影响。
营养与睡眠卫生干预可以改善产妇的血糖控制。
