标题：DOHaD营养监测对孕期合理营养、体质量控制及围产儿结局的影响

      作者：刘佳，胡泯，张方芳    (攀枝花市妇幼保健院围产保健科，四川 攀枝花 617000)

      卷次： 2017年28卷19期

      【摘要】 目的 分析DOHaD营养监测对改善孕期营养、体质量控制的效果及对围产儿结局的影响，寻找保障母婴健康的新思路。方法 选择2015年1月至2016年1月在攀枝花市妇幼保健院建档行产期保健的孕早期孕妇208例作为研究对象，根据入组顺序编号，采用数字随机数表法分为对照组和观察组，每组 104例。对照组按照《孕前和孕期保健指南》推荐的保健和产检方案进行常规产检和保健，观察组在对照组保健和产检的基础上，采用DOHaD营养监测指导孕妇孕期饮食、能量方案，比较两组孕妇孕 12周、生产前一周的营养素供给量合格率，血清总蛋白、血脂、VitA、VitC、钙、铁、锌与《营养素供给量标准(RDA)》的符合率，以及体质量、体质量指数增加合格率，统计两组孕妇孕期、围产期并发症以及围产儿结局。结果 两组孕妇年龄、孕周、孕次、孕前体质量指数、入组时体质量指数、体质量、营养素供给量合格率、血清总蛋白、血脂、VitA、VitC、钙、铁、锌水平与 RDA的符合率比较差异均无统计学意义(P>0.05)；孕 12周、分娩前一周对照组孕妇较入组前增加体质量、增加体质量指数合格率均明显低于观察组，观察组孕妇血清总蛋白、血脂、VitA、VitC、钙、铁、锌水平与RDA比较的符合率均明显高于对照组，差异均有统计学意义(P>0.05)；观察组孕妇妊娠期、围产期内并发症发生率和围产儿不良结局率分别为 17.31%和 5.77%，均明显低于对照组的 27.88%和 10.58%，差异均有统计学意义(P>0.05)。结论 采用DOHaD营养监测指导孕期妇女饮食能量摄入的管理，可有效保证孕妇营养能量摄入的科学性，提升母婴健康水平，促进围产儿预后，对孕期女性具有较高的临床价值。
      【关键词】 孕期营养管理；营养监测；体质量控制；围产儿结局
      【中图分类号】 R714.12 【文献标识码】 A 【文章编号】 1003—6350（2017）19—3144—04

Effect of DOHaD nutrition monitoring on reasonable nutrition, weight control and perinatal outcome inpregnancy.
LIU Jia, HU Min, ZHANG Fang-fang. Department of Perinatal Health Care, Panzhihua Maternal and ChildHealth-Care Hospital, Panzhihua 617000, Sichuan, CHINA
【Abstract】 Objective To analyze the effect of the developmental origins of health and disease (DOHaD) nutri-tional monitoring on the improvement of nutrition and weight control during pregnancy and its influence on perinatal out-come, and to find a new way to protect the health of mother and baby. Methods A total of 208 cases of pregnant wom-en, who admitted to Panzhihua Maternal and Child Health-Care Hospital for perinatal care in early pregnancy from Janu-ary 2015 to January 2016, were selected as the research objects. The patients were divided into the observation groupand the control group by random number table method, with 104 cases in each group. The control group was given rou-tine antenatal examination and health care during pregnancy in accordance with the "guide" and recommended healthcheck scheme. The observation group was treated with DOHaD guidance during pregnancy nutrition monitoring of dietand energy program on the basis of the health care and check of the control group. The qualified rate of nutrient supply, se-rum total protein, blood lipid, VitA, VitC, calcium, iron, zinc and "nutrient supply standard" (RDA) with the rate of in-crease, and the body mass and body mass index qualified rate of the two groups of pregnant women for 12 weeks and oneweek before delivery were compared, and the gestation, perinatal complications and perinatal outcomes of the two groupswere are analyzed statistically. Results There was no significant difference in the maternal age, gestational weeks,pre-pregnancy body mass index, baseline body mass index, body weight, nutrient yield, total serum protein, blood lipid,VitA, VitC, calcium, iron, zinc levels and the coincidence rate of RDA between the two groups (P>0.05). At 12 weeks ofgestation and one week before delivery, the increase of body weight and the qualified rates of body mass index increaseof pregnant women in the control group were significantly lower than those in the observation group (P<0.05); the coin-cidence rates of total serum protein, serum lipid, VitA, VitC, calcium, iron and zinc levels compared with RDA and thequalified rate of body mass, body mass index increase were significantly higher than those in the control group (P<0.05). The complication rate and perinatal adverse outcomes rate during pregnancy and perinatal period in the observa-