早期生活方式干预可降低高危人群妊娠期糖尿病发病率

蒋艳敏; 金慧; 许岚; 徐湘; 马锦琪; 朱云龙

doi:10.16016/j.1000-5404.201809197

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早期生活方式干预可降低高危人群妊娠期糖尿病发病率

临床医学 | 更新时间：2026-01-09

- 早期生活方式干预可降低高危人群妊娠期糖尿病发病率
- Early lifestyle intervention reduces incidence of gestational diabetes in high-risk population
- 第三军医大学学报 2019年41卷第6期页码：594-599
- 作者机构：
  
  1.214023 江苏无锡，南京医科大学附属无锡人民医院：内分泌科
  2.214023 江苏无锡，南京医科大学附属无锡人民医院：产科
  3.214002 江苏无锡，南京医科大学附属无锡市妇幼保健院产科
- 作者简介：
  
  [ 许岚，E-mail：xulan126@126.com XU Lan, E-mail: xulan126@126.com
- 基金信息：
  
  无锡市科技局指令性计划项目(CSE01011)
- DOI：10.16016/j.1000-5404.201809197
  中图分类号： R181.37;R473.2;R714.256
- 收稿：2018-08-28，
  
  修回：2019-01-07，
  
  纸质出版：2019-03-30
- 稿件说明：
移动端阅览
蒋艳敏, 金慧, 许岚, 等. 早期生活方式干预可降低高危人群妊娠期糖尿病发病率[J]. 第三军医大学学报, 2019,41(6):594-599.

Yanmin JIANG, Hui JIN, Lan XU, et al. Early lifestyle intervention reduces incidence of gestational diabetes in high-risk population[J]. Journal of Third Military Medical University, 2019, 41(6): 594-599.
蒋艳敏, 金慧, 许岚, 等. 早期生活方式干预可降低高危人群妊娠期糖尿病发病率[J]. 第三军医大学学报, 2019,41(6):594-599. DOI： 10.16016/j.1000-5404.201809197.

Yanmin JIANG, Hui JIN, Lan XU, et al. Early lifestyle intervention reduces incidence of gestational diabetes in high-risk population[J]. Journal of Third Military Medical University, 2019, 41(6): 594-599. DOI： 10.16016/j.1000-5404.201809197.

摘要

目的

调查无锡两家医院产科门诊随访产检的孕妇妊娠期糖尿病(gestational diabetes mellitus，GDM)的发病情况，评估早期生活方式干预对妊娠期糖尿病高危人群发病和妊娠结局的影响。

方法

采用随机对照研究设计，对2014年2月至2015年1月在无锡市人民医院、无锡市妇幼保健院门诊产检的14 141例孕妇进行问卷调查，筛选出正常对照组和GDM高危人群，并将GDM高危人群分为高危干预组和高危对照组。3组同时接受常规门诊产检，高危干预组进行运动饮食指导等生活方式干预，具体措施包括知识宣教、饮食指导、运动指导、自我血糖监测、发放饮食运动记录表、定期电话随访答疑。3组均随访至确诊GDM或妊娠终止，比较各组GDM发病率、BMI变化以及妊娠结局。

结果

① 共有14 141名孕妇参加调查，总GDM发病率为11.43%(1 617/14 141，其中部分孕妇进行生活方式干预)。②13 159名孕妇跟踪随访至GDM确诊或妊娠结束。正常对照组、高危干预组和高危对照组GDM发病率分别为9.01%，13.42%和23.28%，差异均有统计学意义(

0.01)。③GDM高危干预组中GDM孕妇产前BMI明显低于高危对照组，差异有统计学意义(

0.01)。④高危干预组早产率、先兆早产率、胎儿生长迟缓率、羊水过多、宫内窘迫、产后出血率、妊娠合并贫血等并发症的发生明显低于高危对照组(

0.01)。

结论

早期生活方式干预可显著降低GDM高危人群的产前BMI以及GDM发病率，改善妊娠结局。

Abstract

Objective

To investigate the incidence of gestational diabetes mellitus (GDM) in 2 general hospitals in Wuxi and the effect of lifestyle intervention on the occurrence of GDM and pregnancy outcomes in high-risk population.

Methods

From February

2014 to January

2015

a total of 14 141 pregnant women receiving routine antenatal care in Wuxi People's Hospital and Wuxi Maternal and Child Health Hospital were screened for high risk factors of GDM using a questionnaire. According to the results of questionnaire screening

the women were divided into normal pregnancy group (

=8 290

aged 26.36±2.13 years) and high risk for GDM group (

=4 869

aged 27.32±3.79 years). The women with high risks for GDM were randomized into lifestyle intervention group (

=3 645

aged 27.35±3.85 years) and control group (

=1 224

aged 27.29±4.12 years); in the intervention group

the women were provided with health education and guidance for diet

exercise and blood glucose control. All the women were followed up to the endpoints (an established diagnosis of GDM and the end of pregnancy)

and the incidence of GDM

changes in body mass index (BMI) and pregnancy outcomes were compared among the 3 gr

oups.

Results

The overall incidence of GDM was 11.43% in this cohort. A total of 13 159 women were followed up to the predetermined endpoints. The incidence of GDM was 9.01% in normal pregnancy group

13.42% in high-risk intervention group and 23.28% in high-risk control group

showing a significant difference among the 3 groups (

0.01). Compared with those in high-risk control group

the women in high-risk intervention group had a significantly lower BMI before delivery (

0.01) and significantly lower rates of preterm birth

threatened premature labor

fetal growth retardation

hydramnios

intrauterine distress

postpartum bleeding and pregnancy-related anemia (

0.01).

Conclusion

Early lifestyle intervention can significantly reduce BMI and the incidence of GDM in pregnant women at high risks of GDM to improve the pregnancy outcomes.

关键词

Keywords

references

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