Effects Of Diet And Exercise Intervention In The Second Trimester Of Pregnancy On High-risk Pregnant Women To Prevent Gestational Diabetes Mellitus

Background:Gestational diabetes mellitus(GDM)poses serious threats and challenges to maternal and infant health,and it is one of the most common complications of pregnancy.age≥35 years old,Overweight,obese,family history of first-degree relatives with diabetes,etc.are risk factors for GDM.In recent years,systematic reviews and meta-analyses on diet and exercise intervention for preventing GDM in high-risk pregnant women failed to produce consistent results on whether diet and exercise intervention can reduce the incidence of GDM.Moreover,due to the low quality of the included studies,the large heterogeneity of the population and intervention programmes,the systematic reviews’ representativeness and ability to guide practice were poor.Therefore,a further meta-analysis is unlikely to improve the quality of evidence,nor can it address the heterogeneity of research populations,outcome measures,and interventions.It is necessary to explore whether diet and exercise intervention can prevent GDM and adverse pregnancy outcomes in high-risk pregnant women,and to provide a basis for the prevention of hospital outpatient work.Objectives:This study aimed to assess the effects of dietary and exercise intervention on incidence of GDM,body composition(extracellular water,edema index,etc.)gain,maternal weight gain,mode of delivery,incidence of gestational hypertension,macrosomia and premature among high-risk pregnant women.Methods:This study is a quasi-experimental study.Ninety-four high-risk pregnant women(8～13 weeks gestation)participated from October 2018 to September 2019 and were randomly divided into intervention group(n=47)and control group(n=47).The control group was given routine care.The intervention group,in addition to routine care,was provided with body composition determination,weight gain counseling,individualized diet and exercise intervention provided by nutritionists and exercise experts at weeks 13 and twice a week,until the oral glucose tolerance test(OGTT)was measured.The subjects measured pregnant women weight at 13 weeks of gestation,measured their weight,body composition,screened for gestational diabetes at 24 to 28 weeks of gestation,measured their weight before childbirth,recorded the delivery method,incidence of gestational hypertension,macrosomia and premature within one week after delivery.Results:1.At 24 to 28 weeks of gestation,46 women in the intervention group and 47 women in the control group were measured OGTT and body weight.76 pregnant women were measured body composition.The incidence of GDM(23.9%),extracellular water gain(0.75±0.42L)and edema index gain(0.003±0.004%)in the intervention group were lower than the incidence of GDM(51.1%),extracellular water gain(1.02±0.42L)and edema index gain(0.005±0.003%)in the control group,P<0.05.No statistically significant difference in weight gain between the two groups(P>0.05).2.From 29 weeks of gestation to delivery,41 women in the intervention group and 43 women in the control group were measured body weight and record pregnancy outcome.There was no significant difference in weight gain,and the incidence of gestational hypertension,premature infants and macroinfants in the two groups(P>0.05).Conclusions:Diet and exercise intervention in high-risk pregnancy can reduce the incidence of GDM,extracellular water and edema index gain.The effect of diet and exercise intervention on reducing weight gain and the incidence of gestational hypertension,premature infants,macroinfants in pregnant women should be further verified.