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目的调查2015-2016年惠州地区客家618例孕产妇营养状况及妊娠结局并提出针对性预防对策。方法以2015年2月-2016年6月惠州市第一妇幼保健院所收治的惠州地区客家孕产妇618例作为观察组,另以366例非客家人群孕产妇作为对照组。采用问卷调查、实验室检查结合病例回顾的方式收集入选对象的相关资料,对比两组的孕期饮食情况、血糖、血脂、血压指标及妊娠结局。结果两组豆类、蛋类与蔬菜、肉禽水产类的摄入量差异无统计学意义(t值分别为1.353、0.674和1.656,均P>0.05);观察组谷类摄入量明显高于对照组,水果与奶制品的摄入量则低于对照组,差异有统计学意义(t值分别为16.014、23.126和22.356,均P<0.05)。两组均每天摄入谷类及豆类,两组大部分孕妇均每天摄入蔬菜、水果、肉禽鱼类,其中观察组分别占91.91%、69.90%、77.02%,低于对照组95.63%、78.96%、86.06%,差异有统计学意义(χ~2值分别为5.080、9.632和11.922,均P<0.05)。观察组有2.91%的孕妇从不摄入牛奶,高于对照组的0.27%,差异有统计学意义(χ~2=8.456,P<0.05)。两组蛋白质、脂肪及碳水化合物的每日摄入量差异均无统计学意义(t值分别为0.942、1.598和1.463,均P>0.05);观察组热量摄入量高于对照组,差异有统计学意义(t=8.248,P<0.05),维生素、膳食纤维的每日摄入量低于对照组,差异有统计学意义(t值分别为47.162、7.658,均P<0.05)。观察组阴道分娩率为68.93%,高于对照组38.25%,差异有统计学意义(χ~2=88.553,P<0.05);两组正常体重儿所占比例差异无统计学意义(χ~2=0.129,P>0.05)。观察组妊娠期并发症发生率为43.53%,高于对照组36.88%,差异有统计学意义(χ~2=4.191,P<0.05)。结论惠州地区客家孕产妇受到传统文化及饮食习惯的影响,多存在膳食不均衡的情况,妊娠期并发症发生率达43.53%,高于非客家孕产妇,值得引起重视。可通过加强孕妇健康教育、争取孕妇家庭支持、加强孕期增重管理、采取个性化饮食指导等措施预防相关并发症,改善妊娠结局。
Objective To investigate the nutritional status and pregnancy outcomes of 618 pregnant women in Hakka region of Huizhou during 2015-2016 and to put forward targeted preventive measures. Methods A total of 618 Hakka pregnant women were enrolled in Huizhou area from February 2015 to June 2016 as the observation group and another 366 non-Hakka pregnant women as the control group. Using questionnaires, laboratory tests combined with case retrospectively collected data on selected subjects, compared the two groups during pregnancy diet, blood glucose, blood lipids, blood pressure and pregnancy outcomes. Results The intake of legumes, eggs, vegetables and meat and poultry aquaculture had no significant difference (t = 1.353,0.674 and 1.656, respectively, P> 0.05). The cereal intake of the observation group was significantly higher than that of the control Group, fruit and dairy products intake was lower than the control group, the difference was statistically significant (t values were 16.014,23.126 and 22.356, P <0.05). The two groups were daily intake of cereals and beans, most of the two groups of pregnant women daily intake of vegetables, fruits, meat poultry fish, the observation group accounted for 91.91%, 69.90%, 77.02%, 95.63% lower than the control group, 78.96 %, 86.06% respectively. The difference was statistically significant (χ ~ 2 values were 5.080,9.632 and 11.922, respectively, P <0.05). In the observation group, 2.91% pregnant women never took milk, which was higher than 0.27% in the control group (χ ~ 2 = 8.456, P <0.05). There was no significant difference in daily intake of protein, fat and carbohydrate between the two groups (t = 0.942, 1.598 and 1.463, respectively, all P> 0.05). The calorie intake of the observation group was higher than that of the control group (T = 8.248, P <0.05). The daily intake of vitamins and dietary fiber was lower than that of the control group (t = 47.162 and 7.658, all P <0.05). The vaginal delivery rate in the observation group was 68.93%, which was higher than that in the control group (38.25%), the difference was statistically significant (χ ~ 2 = 88.553, P <0.05). There was no significant difference in the proportion of normal weight between the two groups = 0.129, P> 0.05). The incidence of complications in observation group was 43.53%, higher than 36.88% in control group, the difference was statistically significant (χ ~ 2 = 4.191, P <0.05). Conclusions Hakka pregnant women in Huizhou area are affected by traditional culture and eating habits, and there are many cases of unbalanced diet. The incidence of complications during pregnancy reaches 43.53%, which is higher than that of non-Hakka pregnant women and deserves attention. By strengthening the health education of pregnant women, striving for family support for pregnant women, strengthening the management of weight gain during pregnancy, taking individualized dietary guidance and other measures to prevent related complications and improve pregnancy outcomes.