孕婦體操項(xiàng)目對(duì)妊娠期糖尿病婦女血糖控制和分娩結(jié)果的影響:隨機(jī)對(duì)照試驗(yàn)
分享智慧
共同成長(zhǎng)
Abstract
Background
Gestational diabetes mellitus affects millions of pregnant women. Lifestyle intervention is recommended as the first-line treatment, in which exercise plays an important role. Effective and safe exercise is required to facilitate glycaemic control and improve delivery outcomes.
Objective
To investigate the efficacy and safety of the original Gymnastics for Pregnant Women program for glycaemic control and delivery outcomes improvement in gestational diabetes mellitus women.
Design
The study was a two-arm parallel randomized controlled clinical trial.
Setting
The study was conducted in a tertiary specialized maternity hospital in Hangzhou, China.
Participants
Totally 131 eligible pregnant women were enrolled from June to December 2020.
Methods
Participants were randomly allocated to the control group (conventional intervention) or experimental group that engaged in the original Gymnastics for Pregnant Women program. The primary outcomes included glycaemic control during pregnancy and postpartum. Secondary outcomes included adverse events, maternal and neonatal outcomes.
Results
Participants showed a significant improvement in glycaemic control after engaging in the intervention for 2?weeks; the improvement was most significant in terms of the 2-h postprandial plasma glucose (P?<?0.05). The fasting blood glucose and 2-h postprandial plasma glucose data indicated a higher glycaemic control rate in the experimental than control group (86.16% vs. 66.67%, P?=?0.008; and 84.62% vs. 36.36% [6.09?±?0.79 vs. 6.96?±?1.06?mmol/L], P?<?0.001, respectively). After delivery, the 2-h oral glucose tolerance test results indicated better glycaemic control in the experimental than control group (75.44% vs. 57.41% [6.93?±?1.44 vs. 7.79?±?2.03?mmol/L], P?=?0.047). Additionally, the 2-h oral glucose tolerance test in the experimental group with reasonable exercise frequency (≥ 10 times per week) had the best glucose level (6.81?±?1.30?mmol/L), followed by the experimental group with a lower exercise frequency (< 10 times per week) (7.35?±?1.83?mmol/L) and the control group (7.79?±?2.03?mmol/L). No statistical differences in maternal or neonatal outcomes were observed between the control and experimental groups (P?>?0.05). In addition, there were no adverse events in the experimental group; however, in the control group, two cases experienced at least one hypoglycaemic episode and two cases received insulin during the study period.
Conclusions
The original Gymnastics for Pregnant Women was associated with greater improvements in blood glucose levels during pregnancy and postpartum compared with a conventional intervention for women with gestational diabetes mellitus.
摘要翻譯(僅供參考)
背景
妊娠期糖尿病影響著數(shù)百萬(wàn)孕婦。建議將生活方式干預(yù)作為一線治療,其中運(yùn)動(dòng)起著重要作用。需要有效和安全的運(yùn)動(dòng)來(lái)促進(jìn)血糖控制和改善分娩結(jié)果。
目標(biāo)
目的探討妊娠期糖尿病患者應(yīng)用原體體操項(xiàng)目控制血糖、改善分娩結(jié)局的有效性和安全性。
設(shè)計(jì)
本研究是一項(xiàng)雙臂平行隨機(jī)對(duì)照臨床試驗(yàn)。
場(chǎng)所
該研究在中國(guó)杭州的一家三級(jí)??茓D產(chǎn)醫(yī)院進(jìn)行。
參與者
2020年6月至12月共納入131名符合條件的孕婦。
方法
參與者被隨機(jī)分配到對(duì)照組(常規(guī)干預(yù))或試驗(yàn)組從事孕婦體操項(xiàng)目。主要結(jié)果包括妊娠期和產(chǎn)后血糖控制。次要結(jié)局包括不良事件、孕產(chǎn)婦和新生兒結(jié)局。
結(jié)果
干預(yù)2?周后患者血糖控制有明顯改善;以餐后2 h血糖改善最為顯著(P?<?0.05)??崭寡呛筒秃?小時(shí)血糖數(shù)據(jù)顯示,試驗(yàn)組血糖控制率高于對(duì)照組(86.16% vs. 66.67%, P?=?0.008;和84.62%和36.36%[6.09?±?0.79 vs 6.96?±1.06??更易/ L), P?<?0.001,分別)。分娩后2小時(shí)口服糖耐量試驗(yàn)結(jié)果顯示,試驗(yàn)組血糖控制優(yōu)于對(duì)照組(75.44%∶57.41%[6.93?±?1.44∶7.79?±?2.03?mmol/L], P?=?0.047)。此外,實(shí)驗(yàn)組2 h口服葡萄糖耐量試驗(yàn)的合理的運(yùn)動(dòng)頻率(每周≥10次)最好的血糖水平(6.81?±1.30??更易/ L),緊隨其后的是實(shí)驗(yàn)組運(yùn)動(dòng)頻率較低(< 10次/周)(7.35?±1.83??更易/ L)和對(duì)照組(7.79?±2.03??更易/ L)。對(duì)照組與實(shí)驗(yàn)組產(chǎn)婦及新生兒結(jié)局無(wú)統(tǒng)計(jì)學(xué)差異(P?>?0.05)。試驗(yàn)組無(wú)不良事件發(fā)生;然而,在對(duì)照組中,2例至少經(jīng)歷了一次低血糖發(fā)作,2例在研究期間接受了胰島素治療。
結(jié)論
與妊娠期糖尿病患者的常規(guī)干預(yù)相比,孕婦體操與妊娠期和產(chǎn)后血糖水平有更大的改善。
THE
END
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