Effect Of Online Individualized Nutrition Intervention On The Incidence Of GDM And Perinatal Outcomes During The COVID-19

Objective:To analyze maternal and perinatal outcomes under different kinds of intervention in pregnant women with gestational diabetes mellitus during the COVID-19,to investigate the effect of online individualized nutrition intervention on the onset and progression of GDM,and the feasibility of becoming a short-term alternative to the offline traditional nutrition intervention,to provide a new idea and model for online perinatal care of GDM during extraordinary times.Methods:From July 2021 to January 2023,a total of 3041 pregnant women who received obstetrical examination in Northern Jiangsu People’s Hospital and Yangzhou maternal and child care service center were selected,according to the high risk factors of GDM,1123 high-risk pregnant women and 1918 low-risk pregnant women were screened.After the screening of inclusion and exclusion criteria and approval of the Medical Ethics Committee of Northern Jiangsu People’s Hospital,they were divided into three groups voluntarily according to their choice of different intervention methods:online individualized nutrition intervention group(online intervention group),offline individualized nutrition intervention group(offline intervention group)and non-intervention group.To compare the morbidity of GDM in pregnant women,maternal and perinatal outcomes,pregnancy weight gain and satisfaction under different interventions.Results:1.Comparison of general data of pregnant women in the intervention group and the control group:high-risk pregnant women accounted for 36.93%of the total pregnant women who received antenatal examinations,low-risk pregnant women accounted for 63.07%of the total number.There were no significant differences in age,gravidity and parity history and body mass index among all groups(P>0.05).2.Comparison of the incidence of GDM in pregnant women under three different kinds of intervention methods:The incidence of GDM in pregnant women in the online intervention group,the offline intervention group and the non-intervention group was statistically significant(P<0.05).Online intervention and offline intervention could significantly reduce the incidence of GDM,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of GDM between online intervention and offline intervention(P>0.05).3.Comparison of pregnancy outcomes of GDM pregnant women under the three different kinds of intervention methods:there were significant differences in the rate of polyhydramnios and cesarean section rate under three intervention methods(P<0.05).Online and offline individualized nutrition intervention could reduce the probability of polyhydramnios and cesarean section rate,and the difference was statistically significant(P<0.05).Compared with offline intervention,there was no significant difference in the probability of polyhydramnios and cesarean section rate(P>0.05).There were no significant differences in the probability of premature rupture of membranes,postpartum hemorrhage and puerperal infection among pregnant women under three intervention methods(P>0.05).In the high-risk group of pregnant women,compared with no-intervention intervention,online and offline intervention can reduce the probability of hypertensive disorders of pregnancy,the difference was statistically significant(P<0.05).In the low-risk group,the probability of hypertensive disorders of pregnancy in online and offline intervention group was lower than without intervention group,but the difference was not statistically significant(P>0.05).4.Comparison of weight gain in pregnant women with GDM under three intervention methods:Weight gain of the three kinds of intervention were different,the difference was statistically significant(P<0.05).Both online and offline individualized nutrition intervention could effectively reduce the incidence of excessive weight gain during pregnancy,and the difference was statistically significant(P<0.05).Compared with offline intervention,there was no significant difference in excess weight gain during pregnancy(P>0.05).5.Comparison of maternal outcomes of GDM under three different kinds of interventions:There were significant differences among the groups in the probability of fetal macrosomia,FGR,preterm delivery and neonatal hypoglycemia(P<0.05).Online and offline individualized nutrition intervention can effectively reduce the occurrence of fetal macrosomia,FGR,preterm delivery and neonatal hypoglycemia,the difference was statistically significant(P<0.05),Compared with offline intervention,online intervention,there were no significant differences in the probability of fetal macrosomia,FGR,preterm delivery and neonatal hypoglycemia(P>0.05).There were no significant differences in the probability of abortion,fetal distress and neonatal hyperbilirubinemia among three kinds of interventions.(P>0.05).6.Comparison of patients’ satisfaction between online and offline individualized nutrition intervention groups:Patients receiving online intervention had higher satisfaction than offline intervention group,and the difference was statistically significant(P<0.05).Conclusions:The results of this study showed that individualized nutrition intervention based on the Internet model during the COVID-19 could effectively reduce the incidence of GDM and maternal and infant complications,and effectively prevent excessive weight gain during pregnancy.What’s more,this method can also improve maternal and infant outcomes.It can be used as a short-term alternative to traditional offline nutrition intervention in special periods,and became a supplement to physical medical treatment after the normal management of the epidemic.