Effects and Significance of Individualized Nutrition Guidance of Patients with Polycystic Ovary Syndrome During Pregnancy

Abstract

Objective To explore the effects and significance of individualized nutrition guidance of patients with polycystic ovary syndrome (PCOS) during pregnancy. Methods Between January 2010 and March 2013, sixty eight pregnant women who were diagnosed as PCOS in Wuxi Maternal and Child Health Hospital Affiliated to Nanjing Medical University were recruited into the study. They were divided into intervention group (n =36) and control group (n =32) . Intervention group accepted individualized nutritional guidance, and control group follow the traditional nutritional guidance. The complications and pregnancy outcomes were compared between two groups. Two groups both underwent 75 g oral glucose tolerance test (OGTT) and insulin - releasing test during 32-36 pregnancy weeks . Fasting plasma glucose (FPG) , fasting plasma insulin (FINS) , homeostasis model assessment-insulin resistance (HOMA-IR) , HOMA-β, area under curve of glucose (AUCglu) and area under curve of insulin (AUCINS) were calculated. Lipid level including total cholesterol(TC) , triglyceride (TG) , high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were examined between two group. The significant differences were not found between two groups on age, delivery weeks, body mass index (BMI) before pregnancy, FPG. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Wuxi Matemal and Child Health Hospital Affiliated to Nanjing Medical University. Informed consent was obtained from all participates. Results The incidence rates of GDM and macrosomia of two groups were 22.2%, 46.9% and 8.3%, 31.3%, with significant differences (P 0.05) ．There had no significant differences between two groups on TC [(6.36 ± 1.97) mmol/ L vs． (6.43 ± 2.01) mmol/ L, P>0.05], but had significant differences on TG [(1.17 ± 0.05) mmol/ L vs． (2.31 ± 0.14) mmol/ L], LDL[(3.45 ± 0.16) mmol/ L vs．(4.38 ± 0.23) mmol/ L], and HDL[(1.93 ± 0.18) mmol/ L vs．(1.18 ± 0.21) mmol/ L, P 0.05) between two groups on FPG [(4.39 ± 0.56) mmol/ L vs．(4.53 ± 0.67) mmol/ L], FINS [(6.35 ± 4.92) mU/ L vs．(7.82 ± 4.39) mU/ L], HOMA-IR(1.34 ± 0.87 vs． 1.67 ± 0.98) , HOMA-β(132.8 ± 87.8 vs． 171.5 ± 99.8) , and there had significant differences between two groups on AUCglu [(20.14 ± 3.79) mmol/ Lh vs．(23.36 ± 5.18) mmol/ Lh, P<0.01] and AUCINS [(163.7 ± 71.80) mU/ Lh vs． (230.5 ± 130.32) mU/ Lh, P<0.01]. Conclusions The individualized nutritional guidance of patients with PCOS during pregnancy may improve glucose and lipid metabolism, decrease the pregnancy complications such as GDM and macrosomia. Key words: Polycystic ovary syndrome; Nutritional support; Pregnancy outcome; Glucose and lipid metabolism