| Objective:Gestational obesity refers to the status of pregnant women with excessive accumulation of adipose tissue, it increase the risk of complications during pregnancy, leading to adverse pregnancy outcomes. Our study is to investigate the administration of diet prescription for medical nutrition and behavioral therapy on obesity women during pregnancy, to correct poor eating habits and dietary pattern, to prevent and improve the complications, and to improve the clinical effects of pregnancy consequences.Methods:A case-control study was taken to investigate pregnancy obesity risk factors and pregnancy outcome, the cases were pregnant women from Tianjin Medical University General Hospital and the Armed Police Medical College Hospital,200cases of pregnancy in obese patients as the cases,200pregnant women of normal weight as the control. In addition,80cases of early pregnancy obesity women were selected,80cases were randomly divided into treatment and control groups respectively. Patients withinin treatment group were given proper diet according to the prescription designed via specific software of Nutritional Diet System, in accordance with the maternal body weight and energy requirements, and took necessary behavior modification treatment. The patients within control group were given conventional dietary guidance and nutrition education. This project is to investigate the clinical advantages of nutritional and behavioral treatment on obese pregnant women, and to correct the disadvantageous eating habits and dietary pattern, and finally to reduce the obstetric complications. Data processing applications SPSS17.0package was used for statistical analysis.Results:Case-control study by non-conditional logistic regression analysis showed that there are seven independent influencing factors for pregnancy obesity, listed by sequence of OR values as follows:daily intake of total energy, intake of fats, restaurant or takeaway meal frequency or, maternal age, educated level, meal times and exercise frequency. Among these items, the total daily intake of energy, intake of fats, frequently having restaurant meal or takeaway and elder maternal age are risk factors of gestational obesity, and the daily intake of total energy is the most associated factor. High level of education, more meal times, and more frequent exercise are protective factors for pregnancy obesity. Adverse pregnancy consequences related to pregnancy obesity include gestational hypertension, gestational diabetes, higer rate of cesarean section, shoulder dystocia, uterine atony, postpartum hemorrhage, retardation of descent of fetal head, birth process delay, macrosomia and neonatal hypoglycemia. Compared to the obese pregnant women with nutrition education, the therapeutic group got less intake of valley potatoes and various beans, more intake of green leafy vegetables, and less intake of meat and eggs, lower fat intake, lower fat for energy, and lower daily energy, the difference between the two groups were of statistical significance. After the application of medical nutrition therapy and behavior therapy, the levels of serum leptin, fasting glucose, fasting insulin, cholesterol, triglycerides and LDL in maternal blood were lower than that in control group. Furthermore higher adiponectin levels, higher risk of gestational diabetes, more vaginal trial productions, relatively fewer cesarean sections, fewer uterine atony and postpartum hemorrhage, lower birth weight, fewer macrosomia and hypoglycemia, less positive expression of placental leptin and more positive expression of adiponectin were observed in the therapeutic group.Conclusion:Application of dietary regimens including medical nutrition therapy and behavioral therapy to obese pregnant women, could effectively correct their poor dietary habits and behaviors, control unreasonable weight growth, control the pathological progress of insulin resistance, prevent pregnancy complications arising from obesity and improve birth outcomes. |
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