The Effect Of Medical Nutrition Therapy For GDM On The Composition Of Maternal And Neonatal Serum Fatty Acid And Pregnancy Outcome

Objective: ①To study the effect of medical nutrition treatment(MNT) on gestational diabetes mellitus exerting on the maternal and neonatal termination. ②Comparing the difference in serum fatty acid profile between GDM patients and healthy pregnant women, in order to investigate the serum fatty acids in relation to the incidence of GDM. ③To investigate the differences in maternal and neonatal serum fatty acids at labor, comparing the effect of medical nutrition therapy in the composition of GDM maternal and neonatal serum fatty acids.Methods: ① There were 176 pregnant women participated in this study. 88 GDM pregnancies as nutrition treatment group had been given nutrition treatment and 88 pregnancies with normal blood glucose as control group had received general guidance. Blood glucose controlled level and the increase of pregnancy body weight were investigated in nutrition treatment group. Obstetric complications of the 88 GDM pregnancies were studied to compare with 88 normal pregnancies. ②30 GDM patients and 30 healthy pregnancy women were included in this study. Maternal serum fatty acid was detected by gas chromatography. Individual’s serum fatty acids were used to examine their relationship with GDM. ③This study included 60 pregnant women, including 30 GDM patients and 30 healthy pregnant women. Maternal and neonatal serum fatty acids were measured by gas chromatography. Mann-Whitney rank sum test was used to examine the difference between the GDM patients and the controls in maternal and neonatal serum fatty acids.Results: ① The efficiency of glucose control in GDM was 94.32%. There were no significant differences in the ratio of cesarean delivery, hypertension disorders of pregnancy, premature rupture of membrane, premature birth, macrosomia, newborn’s weight and length. However, GDM had a smaller pregnancy weeks(39.51±1.29 vs 39.95±0.95, P=0.010). ②The levels of SFA, MA, PA, SA, MUFA were higher, and the levels of PUFA, series n-6PUFA, LA were lower in women with GDM compared with control groups. After adjusting pre-pregnancy BMI, highest tertiles of SFA, MA, PA, and MUFA were found out an increasing prevalence of GDM, while highest tertitiles of PUFA and n-6PUFA showed an inverse association. High proportions of SFA, MA, PA, SA, andPOA, along with low proportions of PUFA, n-6PUFA and LA demonstrated the association with several baseline characteristics. ③The proportion of ALA and EPA was higher in GDM patients than in controls when they were at labor, there was no significant differences among other fatty acids. In neonatal cord serum, the proportion of SA increased in GDM neonates, however, the levels of AA and DHA were higher in GDM neonates than controls.Conclusion: ① Discovery in early days, diagnosing exactly in time, exertion on individual medical nutrition therapy can promote the GDM maternal and neonatal pregnancy outcome. ②Maternal serum fatty acids were in relation to the incidence of GDM. MA, PA and SA could increase the risk of pregnant women developing GDM, however, PUFA could down-regulate the risk. ③MNT may change the metabolism and transport of serum fatty acids in GDM patients, but the proportion of PUFA was influenced by gestational diabetes mellitus, finally resulted in a lower level of PUFA in GDM neonates than controls.