Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), E 28040 Madrid, Spain.
Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), E 28040 Madrid, Spain.
Nutrients. 2020 Nov 14;12(11):3505. doi: 10.3390/nu12113505.
Gestational diabetes mellitus (GDM) is the most frequent morbidity found in pregnancy, and it increases the risk for several maternal-fetal complications. Hispanic women are considered at high risk. The St. Carlos GDM prevention study is a randomized controlled trial (RCT) conducted from 2016-2017. Normoglycemic women were randomized at 12-14 Gestation week (WG) to an intervention group (IG) receiving recommendations based on the MedDiet (supplemented with ExtraVirgin Olive Oil/pistachios), or to a control group (CG), recommended to limit fat intake. After RCT conclusion, IG recommendations were applied to a real-world group (RW) in routine clinical practice. The primary endpoint of the current study is an assessment of the GDM rate in Hispanic participants of the aforementioned studies: 132 RCT, 128 CT, 284 RW participants. The GDM rate was lower in IG: 19/128(14.8%), = 0.021, and RW: 38/284(13.4%), = 0.029) than in CG: 34/132(25.8%). Adjusted RR (95%CI) for GDM: 0.72 (0.50-0.97), = 0.037 in IG and 0.77 (0.61-0.97), = 0.008 in RW. Rates of urinary tract infections, emergency caesarean-sections and perineal trauma were also lower in IG and RW. Other adverse outcomes were lower in IG vs. CG. In conclusion, a MedDiet-based intervention reduces the rate of GDM and several adverse maternal-fetal outcomes in Hispanic women residing in Spain.
妊娠期糖尿病(GDM)是妊娠期最常见的疾病之一,它会增加多种母婴并发症的风险。西班牙裔女性被认为是高危人群。圣卡洛斯 GDM 预防研究是一项 2016-2017 年进行的随机对照试验(RCT)。在妊娠 12-14 周时,正常血糖的女性被随机分为干预组(IG)和对照组(CG)。IG 组接受基于 MedDiet(补充特级初榨橄榄油/开心果)的建议,CG 组则建议限制脂肪摄入。RCT 结束后,IG 的建议在常规临床实践中应用于真实世界组(RW)。本研究的主要终点是评估上述研究中西班牙裔参与者的 GDM 发生率:132 名 RCT 参与者、128 名 CT 参与者、284 名 RW 参与者。IG 组的 GDM 发生率较低,分别为 19/128(14.8%), = 0.021,RW 组为 38/284(13.4%), = 0.029),CG 组为 34/132(25.8%)。GDM 的调整 RR(95%CI)为:IG 组 0.72(0.50-0.97), = 0.037;RW 组 0.77(0.61-0.97), = 0.008。IG 和 RW 组的尿路感染、紧急剖宫产和会阴创伤发生率也较低。IG 组的其他不良结局也低于 CG 组。总之,基于 MedDiet 的干预措施可降低西班牙裔女性的 GDM 发生率和多种母婴不良结局。