Chinese General Practice ›› 2023, Vol. 26 ›› Issue (24): 2968-2972.DOI: 10.12114/j.issn.1007-9572.2023.0045

• Focused Research·Pregnancy Health • Previous Articles     Next Articles

Influence of Group Cognitive Behavioral Therapy on Pregnancy Outcomes among Pregnant Women with Gestational Diabetes Mellitus: a Propensity Score Matching Study

  

  1. 1. School of Public Health, Shanxi Medical University, Taiyuan 030001, China
    2. Maternity Care Comprehensive Outpatient, Shanxi Maternal and Child Health Hospital, Taiyuan 030013, China
  • Received:2022-11-16 Revised:2023-03-05 Published:2023-08-20 Online:2023-04-04
  • Contact: WANG Ling

团体认知行为治疗对妊娠期糖尿病孕妇妊娠结局的影响:一项倾向性评分匹配研究

  

  1. 1.030001 山西省太原市,山西医科大学公共卫生学院
    2.030013 山西省太原市,山西省妇幼保健院妇产保健综合门诊
  • 通讯作者: 王苓
  • 作者简介:
    作者贡献:车国瑜负责研究设计、数据统计分析、表格绘制、结果讨论及论文撰写;马啊琴、杨澜负责数据整理、录入及参考文献收集,并对文章进行审阅校对;李静负责数据的收集及数据的审核;王荃对文章整体负责,监督管理。
  • 基金资助:
    山西省卫生计生委科研课题(2015060;2018GW07)

Abstract:

Background

Gestational diabetes mellitus (GDM) is a common complication during pregnancy. However, the adherence to individualized medical nutrition therapy (IMNT) alone among GDM women is poor and the impact of group cognitive behavioral therapy (GCBT) on their pregnancy outcomes remains unclear.

Objective

To examine the impact of GCBT on the pregnancy outcomes of women with GDM, and to provide reference for improving pregnancy outcomes and developing effective gestational diabetes management programme.

Methods

A total of 878 pregnant women with GDM who delivered and received IMNT in our hospital from 2020 to 2021 were retrospectively selected as the study subjects and divided into the observation group including 141 pregnant women with GDM who received GCBT and the control group including 737 pregnant women with GDM who did not receive GCBT. The differences in pregnancy outcomes of pregnant women with GDM between the two groups before and after propensity score matching were analyzed.

Results

There were 134 pregnant women with GDM in the observation group and 256 pregnant women with GDM in the control group after 1∶2 propensity score matching. The proportion of pregnant women with GDM who gained normal weight in the observation group (50.7%, 68/134) was higher than that in the control group (37.5%, 96/256) (P<0.05) . The gestational weeks of delivery of pregnant women with GDM in the observation group (39.0±1.1) were longer than those in the control group (38.5±1.7) (P<0.05) . Additionally, the proportions of preterm infants (3.7%) , macrosomia (1.5%) , and low birth weight infants (2.2%) were lower than those in the control group (10.5%, 5.9%, and 9.0%, respectively) (P<0.05) .

Conclusions

GCBT can help reduce the risk of the delivery of preterm infants, low birth weight infants, and macrosomia in pregnant women with GDM, providing a reference for the establishment of a multidisciplinary management model for GDM.

Key words: Diabetes, gestational, Cognitive behavioral therapy, Fetal macrosomia, Infant, premature, Infant, low birth weight, Pregnancy outcome, Propensity score

摘要:

背景

妊娠期糖尿病(GDM)是妊娠期常见的并发症,在GDM孕妇中实施单纯的个体化医学营养治疗依从性较差,团体认知行为治疗(GCBT)对GDM孕妇妊娠结局的影响尚不明确。

目的

探讨团体认知行为治疗在GDM妊娠结局中的作用,为改善妊娠结局并制定有效的GDM管理方案提供参考依据。

方法

回顾性选取2020—2021年接受个体化医学营养治疗并在本院分娩的878例GDM孕妇为研究对象,接受GCBT的GDM孕妇为观察组(n=141),未接受GCBT干预的GDM孕妇为对照组(n=737),分析倾向性评分匹配前后两组GDM孕妇妊娠结局差异。

结果

通过1∶2倾向性评分匹配后观察组GDM孕妇134例,对照组GDM孕妇256例。匹配后,观察组GDM孕妇增重正常比例(50.7%,68/134)高于对照组(37.5%,96/256)(χ2=6.334,P<0.05);观察组GDM孕妇分娩孕周〔(39.0±1.1)周〕长于对照组〔(38.5±1.7)周〕(t=3.080,P<0.05),早产儿(3.7%)、巨大儿(1.5%)、低出生体质量儿(2.2%)比例低于对照组(10.5%,5.9%,9.0%)(P<0.05)。

结论

GCBT可降低GDM孕妇分娩早产儿、低出生体质量儿及巨大儿的发生可能,为建立GDM多学科管理模式提供参考依据。

关键词: 糖尿病, 妊娠, 认知行为治疗, 巨大胎儿, 婴儿, 早产, 婴儿, 出生时低体重, 妊娠结局, 倾向性评分