目的 观察采用都哈(developmental origins of health and disease, DOHaD)营养监测模式对孕期营养按照孕周进行分级分阶管理的效果。方法 将2014-08至2014-12来我院建档并符合纳入标准的孕妇600例,随机分为观察组与对照组,观察组根据不同孕周的孕妇对营养需求情况及体重增长目标要求进行分阶管理,实施个性化营养指导,并根据孕妇膳食记录及体重测量结果,给予评价和再指导;对照组给予常规孕期营养膳食指导。结果 观察组巨大儿出生率4.2%,妊娠期高血压疾病发病率3.0%,妊娠期糖尿病发病率3.8%及孕前基础体重正常的孕妇体重增长幅度(14.85±2.03 )kg,均低于对照组,差异均有统计学意义(P＜0.05),观察组孕前超重孕妇孕期体重增长幅度(14.00±1.30)kg,明显低于对照组,差异有统计学意义(P＜0.01),观察组胎儿宫内生长受限发生率1.0%、低出生体重儿出生率1.0%,与对照组相比差异无统计学意义。结论 对孕妇进行孕期营养监测及指导,能减少和降低妊娠并发症和不良妊娠结局的发生。

Objective To observe the effects using DOHaD nutritional surveillance onclassified stage management of nutrition in pregnant women. Methods A total of 600 pregnant women were recruited between August 2014 and December 2014.They were divided into study group and negtive control group randomly.The study group were managed in stages by nutrition demand and body weight growth target of different gestational age. The results were evaluated by diet conditions of pregnant women and their weights. The control group were treated with traditional diet guidance. Results The results instudy group were as follows. Macrosomia birthrate was 4.2%, the incidence of gestational hypertension was 3.0%, the incidence of GDM was 3.8%, the weight increase of basis weight pregnant women was(14.85±2.03) kg, all of which were significantly lower than those in control group;the difference was statistically significant(P＜0.05). The weight increase of overweighted pregnant women was(14.00±1.30) kg, which was significantly lower than that in control group, the difference was statistically significant(P＜0.01). The incidence of fetal growth restriction was 1.0% in the study group, the birthrate of SGA was 1.0%. The results had no statistically significant compared difference with the control group (P＞0.05). Conclusions Prenatal nutrition monitoring and guidance to pregnant women reduces the incidence of pregnancy complications and adverse pregnancy outcomes.