| PrefaceGDM(gestational diabetes mellitus) is impaired glucose tolerance of varied degrees appeared or detected the first time during pregnancy.GDM is common perinatal complications often occurred in middle or late pregnancy.Domestic incidence rate of GDM is about 1%～5%,while foreign's is 0.15%～15%,and the trend has increased year by year.GDM will exert short-term or long-term impact on the mater and the fetus. Diseases such as gestational hypertension,placental abruption,spontaneous abortion, premature birth,infection and polyhydramnios will occure in pregnant women,while fetus macrosomia,congenital malformations,fetal distress,stillbirth easily occur in the fetus.The probability that GDM pregnant women and newborns suffered from type 2 diabetes mellitus increases significantly,while the reason has not been fully known. The relationship between GDM and obesity during pregnancy is reported increasingly in recent years.With the improvement of living standards and westernized diet,the domestic GDM incidence shows an upward trend year by year,and it will threat on the health of mother and fetus seriously.As it well known that dietary factors are closely related to obesity,scientific diet during pregnancy plays an important role in maternal and children's health.However,the effect of dietary factors on GDM is rarely reported. It is considered that dietary factors is only one of risk factors to GDM previously,and there is a lack of report on relativity between specific food and GDM,so it should not instruct scientific diet during pregnancy.In this study,dietary frequency surveys were carried out in 120 cases of GDM patients and 120 healthy pregnant women,the intakes of major nutrients from diets were found out,and the occurrence of GDM related to dietary factors was explored.The results will guide for reasonable pregnant nutrition and provide a theoretical basis of GDM prevention.Object and Method1.Research object120 cases of GDM pregnant women(28.2±4.8 years old) were choosed as a case group in obstetric department of China Medical University subsidiary Shengjing hospital from September 2007 to December 2008,and 120 healthy pregnant women in the same period of hospitalization(27.9±4.3 years old ) were choosed as the control group.2.Research methodThe questionnaire included basic information,dietary frequency survey,24h dietary review,the use of nutritional supplements.The survey questionnaire was conducted by trained investigators face to face,and the dietary intake of pregnant women was analyzed.ResultsThere was a significant increase in pre-pregnancy BMI of pregnant women compared with the control group(P＜0.05),while the age and the height has no significant differences(P＞0.05).The daily intake of sausage products,barbecue food, fried food and sweet food in GDM group increased significantly compared with the control group(P＜0.01 / P＜0.05),and the intake of coarse grains,seafood in case group decreased significantly(P＜0.05).Protein intake of GDM group was 65.2g,and the ratio of the proportion in total energy was 11.7%,relatively low,the high quality protein intake was 45.5%in total protein,the proportion between animal and plant sources was 1:2.5.The average daily intakes of Vitamin A,vitamin B1,vitamin B2, calcium,iron and dietary fiber were obviously insufficient,reached 26.9%,53.3%, 52.4%,57.6%,71.6%,60.0%of RDI(recommending dietary intake) separately.The energy distribution among breakfast,lunch,dinner in GDM group was 23.4%,33.6%, 43.0%,the energy distribution was lower in breakfast while higher in dinner.The ratio of calcium complementing in the case group was 53.3%,significantly lower than that in the control group(79.2%)(P＜0.05).while there was no statistical significance in the ratio of iron,multi-vitamin,folic acid,and other health food supplement(P＞0.05). After controlling correlated factors,six factors were put into the regression model through logistic regression analysis:the daily intakes of sweet food,sausage products, fried food,barbecue food were the risk factors(P=0.005,OR=1.431,95%C.I为1.202-1.780;P=0.004,OR=3.153,95%C.I为1.462-11.521;P=0.035,OR=2.655, 95%C.I为1.007-6.326;P =0.029,OR=2.857,95%C.I为1.032-7.672);the daily intakes of coarse grains,seafood were the protective factors(P=0.024,OR = 0.832,95%C.I为0.348-0.973;P=0.016,OR=0.753,95%C.I为0.545-0.810).ConclusionsIt was suggested that excessive intakes of sweet food,barbecue food,fried food and sausage products during pregnancy were possible risk factors for GDM.easonable increase in intakes of seafood and coarse grains was possibly protective factor.The intake of many nutrients in GDM group was an imbalance that protein,vitamin A, vitamin B1,vitamin B2,iron,calcium and dietary fiber were insufficient.The energy provided by breakfast,lunch and dinner in GDM group was not reasonable,the energy distribution was lower in breakfast while higher in dinner.There was some possible relativity between dietary factors and the occurrence of GDM.Nutritional health education during pregnancy should be strengthened,and the scientific dietary of the pregnant be instructed,especially prevented and controlled the related factors on GDM so as to decrease the incidence rate of GDM in pregnant women. |
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