孕妇体操项目对妊娠期糖尿病妇女血糖控制和分娩结果的影响:随机对照试验

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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.

摘要翻译（仅供参考）

背景

妊娠期糖尿病影响着数百万孕妇。建议将生活方式干预作为一线治疗，其中运动起着重要作用。需要有效和安全的运动来促进血糖控制和改善分娩结果。

目标

目的探讨妊娠期糖尿病患者应用原体体操项目控制血糖、改善分娩结局的有效性和安全性。

设计

本研究是一项双臂平行随机对照临床试验。

场所

该研究在中国杭州的一家三级专科妇产医院进行。

参与者

2020年6月至12月共纳入131名符合条件的孕妇。

方法

参与者被随机分配到对照组(常规干预)或试验组从事孕妇体操项目。主要结果包括妊娠期和产后血糖控制。次要结局包括不良事件、孕产妇和新生儿结局。

结果

干预2 周后患者血糖控制有明显改善;以餐后2 h血糖改善最为显著(P < 0.05)。空腹血糖和餐后2小时血糖数据显示，试验组血糖控制率高于对照组(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,分别)。分娩后2小时口服糖耐量试验结果显示，试验组血糖控制优于对照组(75.44%∶57.41%[6.93 ± 1.44∶7.79 ± 2.03 mmol/L]， P = 0.047)。此外,实验组2 h口服葡萄糖耐量试验的合理的运动频率(每周≥10次)最好的血糖水平(6.81 ±1.30  更易/ L),紧随其后的是实验组运动频率较低(< 10次/周)(7.35 ±1.83  更易/ L)和对照组(7.79 ±2.03  更易/ L)。对照组与实验组产妇及新生儿结局无统计学差异(P > 0.05)。试验组无不良事件发生;然而，在对照组中，2例至少经历了一次低血糖发作，2例在研究期间接受了胰岛素治疗。

结论

与妊娠期糖尿病患者的常规干预相比，孕妇体操与妊娠期和产后血糖水平有更大的改善。

THE

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