【摘要】 目的从孕期膳食营养成分及摄入量、餐次结构,以及体重指数(BMI)、孕期增重等方面评价孕妇营养状况,并进行相应营养指导。方法采用24h回顾法进行膳食调查,将1009例孕中期孕妇为研究对象,其中妊娠期糖尿病(GDM)孕妇68例,调查其诊断为GDM前后营养摄入情况;非GDM孕妇941例,调查其指导前一天营养摄入情况。根据中国居民孕中期膳食营养素推荐摄入量(RNI)为标准,利用营养分析软件,对各营养素摄入情况进行分析,并给予合理营养指导。结果1.非GDM孕妇组在营养指导前存在饮食失衡现象,蛋白质摄入量占RNI的109.4%(占RNI的80%～100%为合适范围),矿物质和维生素摄入低于RNI的80%;2.GDM孕妇组饮食更不合理,诊断前蛋白质摄入量占RNI的157.1%,尤其水果摄入量是非GDM孕妇6倍以上。而在诊断后各营养素摄入量仅占RNI的60%～70%之间;3.经过合理营养指导,GDM孕妇组和非GDM孕妇组在孕期增重和新生儿出生体重之间没有差异(P>0.05);4.1009例孕妇的巨大儿发生率为5.95%,其中GDM组的巨大儿发生率为10.29%,且无一例需要胰岛素治疗。结论本研究表明孕妇膳食营养摄入不均衡,尤其GDM孕妇更明显。根据RNI标准及多年临床实践,提出合理的"孕期膳食宝塔",作为预防妊娠期疾病(如:GDM、巨大儿、肥胖等),指导孕期合理饮食的依据,使巨大儿发生率明显低于国内外水平,尤其是针对GDM孕妇个性化营养指导,使孕妇不需使用胰岛素即可控制病情。更多还原

【Abstract】 Objective:To evaluate nutrition conditions of pregnant women from the amount of nutrients and food intake,meal times,body mass index and gestational weight gain to guide their diet.Methods:24h retrospective dietary survey was conducted to 1009 pregnant women(including 68 with GDM and 941 without GDM) during their second trimester.Women with GDM were surveyed twice,before and after diagnosis of GDM.The other group was surveyed once.The intake of nutrients(such as energy,protein,minerals and vitamins) were analyzed through nutrient analyze software according to Chinese residents recommended nutrient intake(RNI).Then adequate recommendations were given to them.Results:1.The normal group had unbalanced diet,the average intake amount of protein accounts for 109.4% of RNI(the normal range is between 80%-100%).The mineral and vitamins were lower than 80%.2.The GDM group was worse.Before diagnosis of GDM,their average protein intake was 157.1% of RNI.The amount of fruit they took was 5 times more than normal group.After diagnosis,their average energy,minerals and vitamins(A,B1,C) were between 60%-70%.3.After proper diet guidance,there were no differences between GDM and normal pregnant women in their gestational weight gain and newborn birth weight(P>0.05).4.The incidence of macrosomia among 1009 pregnancies was 5.95%.In normal group,the percentage was 5.63% and in GDM group it was 10.29%.None of the GDMs need insulin treatment.Conclusion:Pregnant women especially the GDM′s diet was unbalanced.According to RNI and many years′ clinical practice,Food Pyramid for Pregnant Women was worked out to give guidance to different kinds of people to prevent diseases such as GDM,macrosomia and obesity during pregnancy.So that it could make the incidence of macrosomia much lower than the average level both in the country and abroad.In particular,women with GDM didn′t need insulin treatment during pregnancy after personal diet guidance.更多还原