膳食评估微信平台在肥胖孕妇营养干预中的应用-现代医学

膳食评估微信平台在肥胖孕妇营养干预中的应用

单位：南京医科大学附属南京医院(南京市第一医院)妇产科, 江苏南京 210006

分类号：R714.7

出版年·卷·期（页码）：2019·47·第五期（517-521）

摘要：

目的：探讨膳食评估微信平台在肥胖孕妇营养干预中的应用效果。方法：将2016年5月至2017年10月在本院进行围产期营养管理的136例孕前即肥胖的孕妇列入肥胖组，并随机分为两组，即单一组和联合组，每组68例。单一组采用24 h回顾法行膳食调查对孕妇的当前营养摄入状况进行评估，将结果与中国营养学会推荐的孕期营养素推荐摄入量进行对比，并应用围产营养管理系统软件制定个体化营养指导方案。联合组在给予单一组同法指导的基础上，可同时通过膳食评估微信平台获知每日主要营养素的实际摄入量，并与推荐量进行对比，及时进行膳食调整。以同期分娩的孕前体质量及孕期增重均正常的孕妇130例作为正常组。分析3组孕妇的妊娠结局。结果：肥胖组孕妇妊娠期高血压疾病、妊娠期糖尿病及巨大儿的发生率分别为27.94%、25.74%、22.79%，剖宫产率为69.12%。正常组孕妇相应妊娠结局发生率分别为3.85%、6.15%、4.62%及33.08%。肥胖组孕妇妊娠期高血压疾病、妊娠期糖尿病、巨大儿及剖宫产的发生风险明显增高，差异有统计学意义（P<0.01）。肥胖组内妊娠期高血压疾病、妊娠期糖尿病的发生率及剖宫产率无明显差异（P>0.05）。单一组孕妇巨大儿的发生率为30.89%，联合组为14.71%；联合组孕妇巨大儿的发生率明显降低，差异有统计学意义（P<0.01）。结论：肥胖孕妇与正常体质量孕妇相比，产科并发症的发生率明显增高。对于肥胖孕妇，在常规个体化营养指导的基础上联合应用膳食评估微信平台，可以有效降低巨大儿的发生率。

Objective:To explore the effect of dietary assessment WeChat platform on nutrition intervention in obese pregnant women. Methods:136 pregnant women who were obese before pregnancy during the perinatal nutrition management in our hospital from May 2016 to October 2017 were included in the obesity group, and then randomly divided into two groups, single group and combined group. A single group used the 24-hour review method to conduct a dietary survey to evaluate the current nutritional intake status of pregnant women, and the results were compared with the recommended prenatal nutrient intake recommended by the Chinese nutrition society. A personalized nutrition guidance program was developed by using perinatal nutrition management system software. On the basis of giving the same guidance to a single group, the combined group could simultaneously obtain the actual daily intake of major nutrients through the dietary assessment WeChat platform, and compare with the recommended amount to timely adjust the diet. 130 pregnant women who had normal weight before delivery and normal weight gain during pregnancy were taken as the normal group. The pregnancy outcomes of three groups of pregnant women were analyzed. Results:The incidence of hypertensive disorders of pregnancy, gestational diabetes mellitus and macrosomia in obese pregnant women was 27.94%, 25.74%, 22.79% and 69.12% respectively. The corresponding pregnancy outcomes were 3.85%, 6.15%, 4.62% and 33.08% in normal pregnant women. The risk of hypertensive disorders of pregnancy, gestational diabetes mellitus, macrosomia and cesarean section was significantly increased in obese group, and the difference was statistically significant(P<0.01). There was no significant difference in the incidence of hypertension, gestational diabetes mellitus and cesarean section rate in obese group. The incidence of macrosomia was 30.89% in the single group and 14.71% in the combined group. The incidence of macrosomia in combined group was significantly reduced, and the difference was statistically significant(P<0.01). Conclusion:Compared with normal weight pregnant women, the incidence of obstetric complications are significantly increased in obese pregnant women. For obese pregnant women, the combined application of dietary assessment WeChat platform on the basis of routine individualized nutrition guidance can effectively reduce the incidence rate of macrosomia.

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