摘要
目的:探讨知信行营养管理模式在妊娠期的应用,分析其对妊娠期糖尿病的预防和行为改善作用。方法:选取2020年1月—2020年12月临床营养科门诊就诊的1151例建档孕妇作为观察对象,重点研究其中131例诊断GDM的患者,分析研究其在知信行营养管理模式下,通过复诊频次、膳食结构改善以及妊娠结局等指标评价其知识、态度、行为的转化情况,并分析知信行营养管理模式对妊娠期糖尿病的发病影响和管理成效。结果:依据就诊次数进行分组,诊断GDM前从未进行营养指导的孕妇GDM患病率14.0%(39/278);孕早期接受营养指导的患者GDM患病率10.7%(59/553);依照建议,早孕中孕完成2次营养指导的孕妇,GDM患病率10.3%(33/320)。按照要求复诊,执行力较好患者,GDM发病率有降低的趋势,但无统计学意义,可能与样本量不足有关。此外,孕26 w的空腹血糖,接受过营养管理的孕妇均低于对照组(P=0.011),差异有统计学意义,而OGTT 1h血糖和2h血糖的差异并不明显。对诊断GDM患者进行膳食多样性评分,就诊次数提高了孕妇膳食多样性评分(P<0.05),但孕期增重和新生儿体重间的差异无统计学意义(P>0.05)。结论:知信行营养管理模式具有预防妊娠期糖尿病的作用,通过改变饮食行为和提高疾病预防意识,有效降低孕妇的空腹血糖,减少不良妊娠结局的发生,提高病人分娩满意率。
Objective To explore the application of Knowledge,Attitude and Practice nutrition management mode in pregnancy and analyze its effect on the prevention and behavior improvement of gestational diabetes mellitus.Method We choosed between January 2020and December 2020,1151 cases of clinical nutrition clinic on inputting pregnant women as research object,the key research of 131 patients with diagnosis of GDM,analysis and study on the Knowledge,Attitude and Practice nutrition management mode,through the visit frequency,diet structure improvement and pregnancy outcome indicators to evaluate the transformation of knowledge,attitude and behavior.The effects of nutritional management model on gestational diabetes were analyzed.Result The prevalence rate of GDM in pregnant women who had never received nutritional guidance before GDM diagnosis was 14.0%(39/278).The prevalence of GDM was 10.7%(59/553)in patients receiving nutritional guidance in early pregnancy.According to the recommendations,the prevalence of GDM was 10.3%(33/320)in women who completed the nutritional guidance twice during pregnancy.The incidence of GDM in patients with better execution showed a trend of decrease,but there was no statistical significance,which may be related to insufficient sample size.In addition,fasting blood glucose at 26 weeks of gestation was lower in all pregnant women who had received nutritional management than in the control group(P=0.011),the difference was statistically significant,and there was no significant difference between 1-hour OGTT blood glucose and 2h blood glucose.Dietary diversity score of GDM patients showed that the number of visits increased the dietary diversity score of pregnant women(P<0.05),but there was no significant difference between weight gain during pregnancy and newborn weight(P>0.05).Conclusion Knowledge,Attitude and Practice management mode can prevent gestational diabetes,effectively reduce fasting blood glucose of pregnant women,reduce the occurrence of adverse pregnancy outcomes,and improve the sa
作者
金超
林兵
李世阳
张欣悦
杨勤兵
JIN Chao;LIN Bing;LI Shi-yang;ZHANG Xin-yue;YANG Qin-bing(Department of Clinical Nutrition,Beijing Tsinghua Changgung Hospital,Tsinghua University/School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Clinical Nutrition,Shenzhen Hospital,Southern Medical University,Shenzhen 518101,China)
出处
《中国食物与营养》
2022年第8期83-86,共4页
Food and Nutrition in China
基金
北京清华长庚医院研究基金(项目编号:12019C1003)。
关键词
知信行
孕期营养管理
妊娠期糖尿病
妊娠结局
Knowledge
Attitude and Practice(KAP)
nutrition management during pregnancy
Gestational Diabetes Mellitus(GDM)
pregnancy outcome
