Ji L L, Yang Q B, Zhang X Y, Jin C, Li S Y, Ban L W
Department of Clinical Nutrition, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
Zhonghua Yi Xue Za Zhi. 2023 Sep 5;103(33):2614-2618. doi: 10.3760/cma.j.cn112137-20230410-00576.
To explore the effect of strengthening individualized nutrition education in the second trimester based on first trimester on blood glucose. A retrospective study was conducted on 398 pregnant women aged (31.79±3.48) (23-41) years old who underwent an oral glucose tolerance test (OGTT) from October 2021 to December 2022 at Beijing Tsinghua Changgung Hospital. They were divided into two groups according to whether the women were re-visited in second trimester or not. The routine group consisted of 205 pregnant women aged between 24 and 41 (31.49±3.36) years old who only received the first trimester nutrition education and the strengthening group consisted of 193 pregnant women aged (31.92±3.97) (23-41) years old who received both the first and second trimester nutrition education. Then according to pre pregnancy body mass index (BMI), they were divided into normal (18.5 kg/m≤BMI<24 kg/m) and overweight (24 kg/m≤BMI<28 kg/m). The OGTT blood glucose level, the positive rate of gestational diabetes (GDM) and the weight gain during pregnancy were compared between the two groups with different BMI, in order to analyze the effect of strengthening nutrition education in the second trimester of pregnancy on blood glucose. The differences between the two groups were not statistically significant in terms of the pregnant women's age, proportion of pregnant women aged≥35, proportion of pre-pregnancy BMI and overweight, parity and early pregnancy blood glucose (all >0.05). The blood glucose levels of OGTT at 0, 1, and 2 hour were (4.57±0.37), (8.41±1.70), and (7.28±1.51) mmol/L, respectively, lower than those in the routine group [(4.74±0.48), (9.44±1.55), and (8.27±1.58) mmol/L, respectively, all <0.001]. The positive rate of GDM in the strengthening group was 35.23% (68/193), which was lower than that in the routine group (91.71%, 188/205) (<0.001). After the BMI stratification, the OGTT blood glucose levels and the positive rate of GDM in the strengthening group were still lower than those in the routine group (all <0.05). The weight gain with normal BMI in the early pregnancy in routine group was higher than that in the strengthening group (=0.003), but there was no significant statistical difference in weight gain of overweight pregnant women at different gestational weeks (all >0.05). Strengthening a nutrition education about second trimester for pregnant women in the early stages of pregnancy can effectively improve blood glucose levels and reduce the positive rate of GDM.
探讨基于孕早期强化个体化营养教育对孕中期血糖的影响。对2021年10月至2022年12月在北京清华长庚医院接受口服葡萄糖耐量试验（OGTT）的398例年龄为（31.79±3.48）（23 - 41）岁的孕妇进行回顾性研究。根据孕妇在孕中期是否复诊将其分为两组。常规组由205例年龄在24至41岁（31.49±3.36）岁之间、仅接受孕早期营养教育的孕妇组成，强化组由193例年龄为（31.92±3.97）（23 - 41）岁、接受孕早期和孕中期营养教育的孕妇组成。然后根据孕前体重指数（BMI），将她们分为正常（18.5kg/m≤BMI<24kg/m）和超重（24kg/m≤BMI<28kg/m）。比较两组不同BMI孕妇的OGTT血糖水平、妊娠期糖尿病（GDM）阳性率及孕期体重增加情况，以分析孕中期强化营养教育对血糖的影响。两组孕妇在年龄、≥35岁孕妇比例、孕前BMI及超重比例、产次和孕早期血糖方面差异均无统计学意义（均>0.05）。强化组OGTT 0、1、2小时血糖水平分别为（4.57±0.37）、（8.41±1.70）、（7.28±1.51）mmol/L，低于常规组[分别为（4.74±0.48）、（9.44±1.55）、（8.27±1.58）mmol/L，均<0.001]。强化组GDM阳性率为35.23%（68/193），低于常规组（91.71%，188/205）（<0.001）。BMI分层后，强化组OGTT血糖水平及GDM阳性率仍低于常规组（均<0.05）。常规组孕早期BMI正常孕妇的体重增加高于强化组（=0.003），但超重孕妇在不同孕周的体重增加差异无统计学意义（均>0.05）。对孕早期孕妇强化孕中期营养教育可有效改善血糖水平并降低GDM阳性率。
