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生活方式干预预防妊娠糖尿病高危妇女不良妊娠结局的随机对照试验。

Lifestyle interventions to prevent adverse pregnancy outcomes in women at high risk for gestational diabetes mellitus: a randomized controlled trial.

机构信息

School of Medicine, Wuhan University of Science and Technology, Wuhan, China.

Department of Endocrinology, CR & WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.

出版信息

Front Immunol. 2023 Aug 22;14:1191184. doi: 10.3389/fimmu.2023.1191184. eCollection 2023.

Abstract

OBJECTIVE

To examine the effects of lifestyle interventions, including dietary guidance, health education and weight management, on pregnancy outcomes in women at high risk of gestational diabetes mellitus (GDM).

METHODS

Our study included 251 women at high risk of GDM and 128 randomized to lifestyle interventions (dietary guidance, health education, and weight management); One hundred and twenty-three people were randomly assigned to a control group (regular pregnancy check-ups). Counts between groups were compared using either chi-square test or Fisher's exact test.

RESULTS

Compared with the control group, the risk of GDM was reduced by 46.9% (16.4% vs 30.9%, = 0.007) and the risk of pregnancy induced hypertension (PIH) was reduced by 74.2% (2.3% vs 8.9%, = 0.034) in the intervention group. There were no significant differences in macrosomia, cesarean section, or preterm birth ( >0.05).

CONCLUSION

The lifestyle intervention in this study helped pregnant women to better understand knowledge related to pregnancy, reduce stress and anxiety, and increase intake of adequate prenatal nutrition. This intervention prevented metabolic abnormalities that may occur due to inadequate nutrient intake during pregnancy. In addition, it helped women to control weight gain, maintain appropriate weight gain during pregnancy, and reduce the risk of excessive or insufficient weight gain, ultimately lowering the incidence of GDM and PIH. This highlights the importance of early screening and intervention for high-risk pregnant women.

CLINICAL TRIAL REGISTRATION

https://www.chictr.org.cn, identifier ChiCTR2300073766.

摘要

目的

研究生活方式干预措施(包括饮食指导、健康教育和体重管理)对妊娠期糖尿病(GDM)高危妇女妊娠结局的影响。

方法

我们的研究纳入了 251 名 GDM 高危妇女,并将其中 128 名随机分为生活方式干预组(饮食指导、健康教育和体重管理);123 名被随机分配到对照组(常规妊娠检查)。采用卡方检验或 Fisher 确切概率法比较组间计数资料。

结果

与对照组相比,干预组 GDM 风险降低了 46.9%(16.4%比 30.9%, = 0.007),妊娠高血压(PIH)风险降低了 74.2%(2.3%比 8.9%, = 0.034)。巨大儿、剖宫产和早产的发生率无显著差异( >0.05)。

结论

本研究中的生活方式干预有助于孕妇更好地了解与妊娠相关的知识,减轻压力和焦虑,并增加充足的产前营养摄入。这种干预防止了由于妊娠期间营养摄入不足而可能导致的代谢异常。此外,它有助于女性控制体重增加,保持妊娠期间适当的体重增加,并降低体重增加过多或过少的风险,最终降低 GDM 和 PIH 的发生率。这凸显了对高危孕妇进行早期筛查和干预的重要性。

临床试验注册

https://www.chictr.org.cn,注册号 ChiCTR2300073766。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9fe/10477780/3aecde762ddf/fimmu-14-1191184-g001.jpg

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