| Background: Gestational diabetes mellitus(GDM)refers to a group of diseases in which a pregnant woman has no obvious abnormal blood glucose metabolism before pregnancy.In the early or middle pregnancy,the blood glucose is found to be elevated through pregnancy tests.At present,the prevalence of GDM is increasing rapidly year by year.If GDM pregnant women do not take intervention measures in time during pregnancy,it can cause various degrees of adverse effects on the pregnant woman and the fetus.Therefore,once diagnosed with gestational diabetes,all pregnant women should receive regular diet and exercise counseling.Studies have shown that through the comprehensive management of diet,psychological education,and exercise,the blood glucose concentration of pregnant women can not be increased,and the weight during pregnancy and the growth of the fetus can be maintained within the normal range,and the occurrence of maternal and child complications can be reduced.At present,studies have found that in the process of comprehensive management,the level of patient compliance will have a certain impact on the effect of treatment.This study mainly analyzed the effects of personalized nutrition guidance and treatment compliance on blood glucose control,delivery methods,pregnancy outcomes and perinatal outcomes of pregnant women with GDM.Objective:1.To explore whether comprehensive management during pregnancy can better control the blood glucose level of patients with GDM,reduce the rate of cesarean section and improve maternal and fetal complications.2.To explore the influence of the compliance of patients with comprehensive management during pregnancy on the way of delivery,blood sugar control,and maternal and child complications of GDM pregnant women.Methods:1.Selected from January 2019 to August 2020 in the obstetrics clinic of Dongfeng Hospital affiliated to Hubei Medical College,140 cases of GDM singleton patients diagnosed at 24-28 weeks of gestation were selected for the study.They were divided into two groups,including 62 cases in the managed group and 78 cases in the unmanaged group.2.The unmanaged group received regular instruction: GDM pregnant women were given a knowledge education about gestational diabetes.3.The management group carries out comprehensive management during pregnancy,mainly including: We Chat knowledge push,one-day diabetes clinic,personalized plan formulation,follow-up and management compliance investigation.Pregnant women in the management group completed A compliance questionnaire during hospital delivery after intervention,and the management group was divided into two groups according to the compliance score: group A(good compliance)and group B(poor compliance).4.The methods of delivery,blood glucose concentration,pregnancy outcome and perinatal adverse outcomes of pregnant women with GDM in the two groups were obtained after the pregnant women were hospitalized for delivery.Results:1.Comparison of treatment effects of comprehensive management during pregnancy on pregnant women with GDM:The glycemic control rate of GDM patients under comprehensive management was significantly better than that of pregnant women in the unmanaged group(P=0.013).After comprehensive management,the rate of cesarean section,the total incidence of complications,the incidence of premature delivery,premature rupture of membranes and oligohydramnios in GDM patients were lower than those in pregnant women without comprehensive management(P < 0.05).However,there was no statistically significant difference between the incidence of HDCP and postpartum hemorrhage,possibly due to the small sample size(P > 0.05).2.Comparison of perinatal complications between the management group and unmanaged group: The incidence of adverse perinatal outcomes for pregnant women through comprehensive management was 29%,which was significantly lower than the55.1% of the unmanaged group(P = 0.000).Comprehensive management during pregnancy can also reduce the incidence of hypoglycemia in premature infants and neonates,with statistical significance(P < 0.05).However,there was no statistical significance in the incidence of macrosomia,neonatal malformation and neonatal jaundice between the two groups(P > 0.05).3.Comparison of treatment effect of pregnant women in management group A and B: The effective rate of blood glucose control in pregnant women in group A was significantly higher than that in group B(P=0.000).The overall incidence of pregnancy complications in group A(26%)was significantly lower than that in group B(41.7%)(P=0.025).Among them,the incidence of postpartum hemorrhage and oligohydramnios was significantly lower than that of group B(P <0.05);the comparison of the incidence of HDCP and cesarean section may be due to the small number of studies,it is meaningless(P>0.05).4.Comparison of adverse perinatal outcomes of pregnant women in the management group A and B: The total incidence of adverse perinatal pregnancy outcomes for pregnant women in group A was 20%,which was significantly lower than that of patients in group B(66.7%)(P=0.000);The incidence of jaundice in macrosomia and neonates was significantly lower than that in group B(P < 0.05).There was no statistical significance in the incidence of neonatal hypoglycemia and neonatal malformation among pregnant women in group A and B(P > 0.05).Conclusion:The comprehensive management therapy during pregnancy has a very significant effect on the treatment of GDM.This model significantly reduces the risk of maternal and child complications,and the treatment effect of GDM pregnant women with good treatment compliance is more significant. |
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