《中国居民膳食营养素参考摄入量（2013版）》推荐能量对妊娠期糖尿病孕妇体重、血糖及妊娠结局的影响

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摘要目的探讨《中国居民膳食营养素参考摄入量（2013 版）》（2013 DRIS）推荐能量对妊娠期糖尿病（GDM）孕妇体重、血糖及妊娠结局的影响。方法选取2018年1月～2019年5月就诊于大连市妇幼保健院产科营养门诊并已确诊GDM 的482 例孕妇，均给予医学营养治疗（MNT），按就诊先后顺序分为试验组（248 例）和对照组（234 例）。其中试验组给予2013 DRIS 推荐能量，对照组给予《妊娠合并糖尿病诊治指南2014》推荐能量。随访至分娩，分别比较两组孕妇的体重增长、血糖水平、孕期血糖控制情况、妊娠结局、新生儿情况及分娩并发症总发生率。结果试验组孕妇的体重增长量大于对照组，干预后总蛋白及白蛋白水平均高于对照组，差异均有统计学意义（P<0.05）。两组干预后的空腹血糖、餐后2 h 血糖均低于干预前，差异有统计学意义（P<0.05）；两组孕妇干预后的空腹血糖、餐后2 h 血糖及糖化血红蛋白水平比较，差异均无统计学意义（P>0.05）。试验组孕妇的早产发生率低于对照组，差异有统计学意义（P<0.05）。试验组的低出生体重儿发生率低于对照组，差异有统计学意义（P<0.05）。两组的血糖控制合格率、尿酮体阳性率、新生儿出生体重、分娩并发症总发生率、剖宫产率、巨大儿发生率比较，差异无统计学意义（P>0.05）。结论 GDM 孕妇采用2013 DRIS 推荐能量，更有利于孕期体重合理增长、改善孕妇营养状况、降低早产及低出生体重儿发生率，而不影响血糖控制效果。

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	战芳
	王婷
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	岳晓玲

关键词 ：妊娠期糖尿病, 能量, 医学营养治疗, 《中国居民膳食营养素参考摄入量（2013 版）》, 孕期体重增长

Abstract： Objective To explore the effect of recommended energy in Chinese Dietary Reference Intakes (2013 Edition) (2013 DRIS) on the weight, blood glucose and pregnancy outcome of pregnant women with gestational diabetes mellitus (GDM). Methods A total of 482 pregnant women who were diagnosed with GDM in the Obstetric Nutrition Clinic of Dalian Maternal and Child Health Hospital from January 2018 to May 2019 were selected and were given medical nutrition therapy (MNT) both. They were divided into experimental group (n=248) and control group (n=234)according to the order of visits. In the experimental group, the recommended energy of 2013 DRIS was used, and in the control group, the recommended energy of Guidelines for Diagnosis and Treatment of Diabetes in Pregnancy 2014 was used. Follow up until delivery. Weight gain, blood glucose level, blood glucose control during pregnancy, pregnancy outcome, neonatal condition, and total incidence of delivery complications were compared between the two groups. Results The weight increase of pregnant women in the experimental group was greater than that of the control group, and the total protein and albumin levels after intervention were higher than those of the control group, with statistically significant differences (P<0.05). Fasting blood glucose and blood glucose 2 h after meal in both groups after intervention were lower than those before intervention, and the differences were statistically significant (P<0.05). There were no statistically significant differences between the two groups in fasting blood glucose, blood glucose 2 h after meal and glycosylated hemoglobin after intervention (P>0.05). The incidence of premature birth in the experimental group was lower than that in the control group, and the difference was statistically significant (P<0.05). The incidence of low birth weight infants in the experimental group was lower than that in the control group, and the difference was statistically significant (P<0.05). There were no statistically significant differences between the two groups in blood glucose control pass rate, urine ketone positive rate, newborn birth weight, total incidence of delivery complications, cesarean section rate, and incidence of macrosomia (P>0.05). Conclusion The use of energy recommended by 2013 DRIS for pregnant women with GDM is more conducive to reasonable weight gain during pregnancy, improving the nutritional status of pregnant women, reducing the incidence of preterm and low birth weight infants, without affecting the effect of blood sugar control.

Key words： Gestational diabetes mellitus Energy Medical nutrition therapy Chinese Dietary Reference Intakes (2013 Edition) Weight gain during pregnancy

基金资助:辽宁省大连市医学科学研究计划项目（1911073）

引用本文:

战芳；王婷；袁健；岳晓玲. 《中国居民膳食营养素参考摄入量（2013版）》推荐能量对妊娠期糖尿病孕妇体重、血糖及妊娠结局的影响[J]. 中国当代医药, 2021, 28(3): 137-141.
ZHAN Fang ；WANG Ting ；YUAN Jian； YUE Xiao-ling. Influence of recommended energy in Chinese Dietary Reference Intakes(2013 Edition) on the weight, blood glucose and pregnancy outcome of pregnant women with gestational diabetes mellitus. 中国当代医药, 2021, 28(3): 137-141.

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