Prevention of Adverse Pregnancy Outcomes in High-Risk Pregnant Women with Gestational Diabetes Mellitus by Combining Nutritional Interventions in Early Pregnancy with Traditional Chinese Medicine Physical Dialectics
- VernacularTitle:孕早期营养干预结合中医体质辩证预防高风险妊娠期糖尿病孕妇的不良妊娠结局
- Author:
Yufeng GUO
1
,
2
;
Yuxia ZHANG
;
Junwen LU
;
Chengyao LIU
;
Lijun ZHOU
;
Hong DING
Author Information
1. 新疆医科大学公共卫生学院,新疆乌鲁木齐 830017
2. 新疆特殊环境与健康研究重点实验室,新疆乌鲁木齐 830017
- Keywords:
Gestational diabetes mellitus;
Nutritional intervention;
Traditional Chinese medicine physical dia-lectics;
Diet;
Adverse pregnancy outcomes
- From:
Journal of Practical Obstetrics and Gynecology
2024;40(10):833-840
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the effects of nutritional interventions combined with Traditional Chinese Med-icine(TCM)physical dialectics on the development of gestational diabetes mellitus(GDM),dietary status during pregnancy,and maternal and infant outcomes in high-risk pregnant women in early pregnancy.Methods:298 high-risk pregnant women with GDM in early pregnancy(gestational week≤14 weeks)registered in the Obstet-rics Department of Urumqi Maternal and Child Health Hospital from 1st December 2022 to 30th March 2023 were selected as the study subjects and randomly divided into the intervention group(149 cases)and the control group(149 cases).During 14 to 23+6 weeks of pregnancy,TCM constitution nutritional intervention was carried out for pregnant women in the intervention group,and routine guidance and healthy dietary education was carried out in the control group.The incidence of GDM in the two groups was compared at 24-28 weeks of pregnancy,and the relationship between early pregnancy nutritional intervention combined with TCM constitution and the risk of GDM was analysed in subgroups using logistic regression and likelihood ratio test.The dietary situation,biochemical in-dexes and delivery outcomes after the intervention were compared at 32-36 weeks of pregnancy.Results:①The incidence of GDM in the intervention group was significantly lower than that in the control group(14.09％vs.23.49％,P＜0.05).The effect of the TCM constitution based nutritional intervention on the risk probability of GDM was statistically significant only among pregnant women with different ranges of gestational weight gain(GWG)(P=0.018).Among them,pregnant women with GWG lower than the recommended range had a reduced risk of GDM after intervention(OR 0.27,95％Cl 0.10-0.68,P=0.008).② After intervention,the evaluation index of di-etary balance index of pregnant women in the intervention group was better than that of the control group(P＜0.05),and the intake of cereals and potatoes,vegetables,and water of pregnant women in late pregnancy in the intervention group was higher than that of the control group(P＜0.05).③The levels of triglycerides,total choles-terol,low-density lipoprotein,glycated haemoglobin,uric acid and creatinine of pregnant women in the intervention group were lower than those of the control group in late pregnancy(P＜0.05).GWG,gestational age at delivery,the rate of low-birth-weight,and the neonatal 1-minute Apgar scores were all better than those of the control group(P＜0.05.Conclusions:Nutritional interventions in early pregnancy combined with TCM constitution can sig-nificantly reduce the incidence of GDM in high-risk pregnant women and the chances of low-birth-weight babies.Obstetrics outpatient clinics can actively develop extensive collaboration with TCM and clinical nutrition depart-ments to reduce adverse pregnancy outcomes for both mother and fetus.
