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目的:通过分析妊娠糖尿病患者与正常孕妇的饮食行为,探讨妊娠糖尿病发病饮食相关的危险因素,为孕期妇女提供科学合理膳食指导。方法:采用多阶段连续等比例抽样,选取确诊GDM的孕妇150例为病例组,同期就诊非GDM孕妇150例为对照组,利用24小时膳食回顾法进行饮食行为和一般情况的问卷调查。采用Logistic回归筛选GDM饮食相关危险因素。结果:多因素Logistic回归分析显示,怀孕年龄(OR=1.157)、孕前BMI(OR=1.780)、糖尿病家族史(OR=2.448)、产次(OR=1.157)、总能量、水果摄入量(OR=4.109)、豆类(OR=0.998)与妊娠糖尿病发生相关(OR=0.998)。采用多变量模型具体分析水果的摄入量,同时调整与妊娠糖尿病发生的相关因素结果显示:与水果摄入量小于200 g/d相比,水果的摄入量200~400 g/d,400~600 g/d和超过600 g/d其OR值分别为0.38、2.48、2.63(P<0.01)。结论:除高龄、肥胖、糖尿病家族史等妊娠糖尿病高危因素外,饮食行为与GDM存在一定的相关性。针对高危人群早期干预,同时对孕期妇女进行科学合理的饮食指导,调整饮食结构,控制食物摄入量,以减少GDM的发病。
Objective: To analyze the dietary behaviors of pregnant women with gestational diabetes mellitus and normal pregnant women, to explore the risk factors related to gestational diabetes mellitus and to provide scientific and reasonable diet guidance for pregnant women. Methods: 150 cases of pregnant women with confirmed GDM were selected as the case group by multi-stage continuous proportional sampling. 150 cases of non-GDM pregnant women in the same period were selected as the control group. The diet behavior and general situation questionnaire were investigated by 24-hour dietary review. Logistic regression was used to screen the risk factors associated with GDM diet. Results: The multivariate Logistic regression analysis showed that the average age of children (OR = 1.157), pre-pregnancy BMI (OR = 1.780), family history of diabetes (OR = 2.448), parity (OR = 1.157), total energy and fruit intake OR = 4.109). Legumes (OR = 0.998) were associated with gestational diabetes mellitus (OR = 0.998). Multivariable model was used to analyze the intake of fruits and adjust the related factors of gestational diabetes mellitus. The results showed that compared with fruit intake of less than 200 g / d, fruit intake was 200-400 g / d, 400 OR of ~ 600 g / d and over 600 g / d were 0.38, 2.48 and 2.63, respectively (P <0.01). Conclusion: Except for the high risk factors of gestational diabetes, such as age, obesity and family history of diabetes, there is a certain correlation between dietary behavior and GDM. In order to reduce the incidence of GDM, the early intervention for high-risk groups is carried out. At the same time, scientific and reasonable diet guidance for pregnant women is adjusted to adjust diet structure and control food intake.