本文關(guān)鍵詞： 血糖負(fù)荷 血糖生成指數(shù) IOM標(biāo)準(zhǔn) 孕期增重 新生兒出生體重　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的通過對孕婦孕期實施低血糖負(fù)荷膳食的干預(yù),了解孕婦孕期膳食攝入情況,記錄孕婦各孕期體重的變化,計算孕婦的孕期增重,觀察低血糖負(fù)荷膳食是否能降低孕期增重過多現(xiàn)象的發(fā)生。方法本研究采用流行病學(xué)隨機化干預(yù)試驗,以安徽省某婦幼保健院孕婦為研究對象,建立孕期干預(yù)組和對照組,其中干預(yù)組97例,對照94例。干預(yù)組中按孕前BMI值和孕期增重等級對其進行分級管理,主要干預(yù)內(nèi)容為低血糖負(fù)荷膳食,干預(yù)的結(jié)點為孩子出生,對照組不施加本項目的干預(yù)措施。采用孕期基本信息調(diào)查表獲取孕婦的人口學(xué)信息等基線數(shù)據(jù),干預(yù)的同時,在各孕期使用連續(xù)3日24h膳食記錄表記錄孕婦的膳食攝入量。孕期產(chǎn)檢的過程中連續(xù)監(jiān)測孕婦的體重以及血糖和血脂的變化,孕婦分娩時及時記錄新生兒的出生體重、性別等信息,比較兩組孕婦孕期增重的不同、血糖血脂的變化及出生結(jié)局的不同來探討低血糖負(fù)荷膳食干預(yù)的效果。結(jié)果(1)孕婦的基本信息:干預(yù)組與對照組孕婦年齡分布(25.63±2.58歲,25.62±2.62歲,P0.05)無差異,身高(159.09±4.16cm,159.04±4.20cm,P0.05)、體重(54.04±7.85kg,51.00±7.20kg,P0.05)分布也均無差異,按照我國的BMI分級標(biāo)準(zhǔn)劃分,兩組孕前體重正常、超重的孕婦分布P0.05,無差異。(2)孕期低GL膳食干預(yù)的效果:干預(yù)組與對照組孕婦相比較,孕中期膳食GL值(142.02±49.41,170.54±64.73,P0.05),膳食GI值(56.98±11.08,62.63±14.26,P0.05),膳食總能量(1441.40±407.17kcal,1715.78±517.99 kcal,P0.05),蛋白質(zhì)攝入量(60.15±10.71g,52.34±11.79g,P0.05),脂肪攝入量(39.20±17.66g,50.82±23.34g,P0.05),碳水化合物攝入量(206.52±63.36g,255.03±84.92g,P0.05);孕晚期膳食GL值(146.35±48.15,163.65±59.96,P0.05),膳食GI值(57.53±8.95,61.62±13.10,P0.05),膳食總能量(1489.22±375.79kcal,1782.98±491.43kcal,P0.05),蛋白質(zhì)攝入量(61.65±8.29g,52.95±11.34g,P0.05),脂肪攝入量(40.75±13.08g,53.59±19.09g,P0.05),碳水化合物攝入量(213.50±60.95g,264.88±86.25g,P0.05),差異均有統(tǒng)計學(xué)意義。(3)低GL膳食干預(yù)對孕期增重的影響:干預(yù)組與對照組孕婦孕期增重(13.61±3.76kg,15.13±3.15 kg,P0.05),其中干預(yù)組孕期增重超過IOM標(biāo)準(zhǔn)20人,對照組孕期增重超過IOM標(biāo)準(zhǔn)35人,P0.05,存在統(tǒng)計學(xué)差異;孕中期增重(3.32±1.69 kg,4.13±1.86 kg,P0.05),孕晚期增重(2.77±1.80 kg,3.56±1.31 kg,P0.05)。(4)低GL膳食干預(yù)對新生兒出生結(jié)局的影響:干預(yù)組與對照組新生兒出生體重(3186.70±350.05 g,3205.38±516.12 g,P0.05),身長(49.82±0.99 cm,50.02±0.80cm,P0.05);不良出生結(jié)局:干預(yù)組發(fā)現(xiàn)1例巨大兒,對照組有3例巨大兒,大于胎齡兒干預(yù)組出現(xiàn)7例,對照組出現(xiàn)13例,小于胎齡兒兩組均有11例,干預(yù)組早產(chǎn)3例,對照組早產(chǎn)2例,差異均無統(tǒng)計學(xué)意義。結(jié)論本研究通過對普通孕婦進行孕期低GL膳食干預(yù),改善孕期飲食結(jié)構(gòu)、營養(yǎng)狀態(tài),減輕了孕期體重的增加量,新生兒的出生體重、身長得到略微降低,對母嬰健康有長遠(yuǎn)的指導(dǎo)意義。
[Abstract]:Objective to investigate the dietary intake during pregnancy and to record the changes of weight during pregnancy and calculate the weight gain of pregnant women through the intervention of low-glycemic loaded diet during pregnancy. Objective: to observe whether hypoglycemic load diet can reduce the occurrence of excessive weight gain during pregnancy. Methods A randomized epidemiological intervention trial was used to study pregnant women in a maternal and child health care hospital in Anhui province. The intervention group and control group were established, 97 cases in the intervention group and 94 cases in the control group. The intervention group was divided into two groups according to the BMI value before pregnancy and the weight gain grade during pregnancy. The main intervention content was low glycemic load diet. The node of intervention is the birth of the child, the control group does not impose the intervention measures of this project. The basic information questionnaire of pregnancy was used to obtain the baseline data of demographic information of pregnant women, while the intervention was at the same time. The dietary intake of pregnant women was recorded by 24 hours diet record on 3rd. The changes of body weight, blood glucose and blood lipid were continuously monitored during pregnancy. The birth weight and sex of the newborns were recorded in time when the pregnant women gave birth, and the difference of weight gain during pregnancy between the two groups was compared. Results the basic information of pregnant women: the age distribution of pregnant women in intervention group and control group was 25.63 鹵2.58 years old. There was no difference (P 0.05) in 25.62 鹵2.62 years old, and the height was 159.09 鹵4.16 cm, 159.04 鹵4.20 cm (P0.05). There was no difference in the distribution of body weight (54.04 鹵7.85 kg / L, 51.00 鹵7.20 kg / kg P0.05). According to the BMI classification standard of China, the body weight of the two groups was normal before pregnancy. The effect of low GL diet intervention during pregnancy: the GL value of the intervention group was 142.02 鹵49.41 in the second trimester compared with the control group. The value of dietary GI was 56.98 鹵11.08 鹵62.63 鹵14.26 (P 0.05). Total dietary energy was 1441.40 鹵407.17kcaln 1715.78 鹵517.99kcalP0.05). The protein intake was 60.15 鹵10.71 g / g, and the fat intake was 39.20 鹵17.66 g. The carbohydrate intake was 206.52 鹵63.36g / L, 255.03 鹵84.92g / g, respectively. In the third trimester of pregnancy, the GL value of diet was 146.35 鹵48.15 鹵163.65 鹵59.96 (P 0.05), and the dietary GI value was 57.53 鹵8.95. The total dietary energy was 1489.22 鹵375.79kcal (1782.98 鹵491.43kcalP0.05). The protein intake was 61.65 鹵8.29g / g, and the fat intake was 40.75 鹵13.08g. The carbohydrate intake was 213.50 鹵60.95g / g, 264.88 鹵86.25g / g, respectively. The effect of low GL dietary intervention on pregnancy weight gain: pregnant women in intervention group and control group gained 13.61 鹵3.76 kg / L 15.13 鹵3.15 kg / kg during pregnancy. P0.05, in which the pregnant weight gain of 20 patients in the intervention group exceeded the IOM standard, while in the control group, the weight gain during pregnancy exceeded the IOM standard in 35 patients (P0.05), and there was statistical difference between the two groups. In the second trimester, the weight gain was 3.32 鹵1.69 kg / d 4.13 鹵1.86 kg / kg P0.05A and 2.77 鹵1.80 kg / kg in the second trimester of pregnancy. 3.56 鹵1.31 kg. Effect of low GL dietary intervention on neonatal outcome: neonatal birth weight of intervention group and control group was 3186.70 鹵350.05 g. 3205.38 鹵516.12 g / g P0.05U, 49.82 鹵0.99 cm-1 / 50.02 鹵0.80cm / kg P0.05A; Bad birth outcome: one macrosomia was found in the intervention group, 3 in the control group, 7 in the intervention group, 13 in the control group and 11 in both groups. There were 3 cases of premature delivery in intervention group and 2 cases in control group, there was no significant difference between them. Conclusion this study can improve diet structure and nutritional status of pregnant women by low GL diet intervention during pregnancy. It reduces the weight gain during pregnancy and the birth weight and body length of the newborn, which has a long-term guiding significance for maternal and child health.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R715.3

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