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| Effect of Roy′s adaptation model on glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus |
| ZHANG Yi PAN Huirong▲ LI Yan |
| Department of Outpatient and Emergency, the First Maternity and Infant Hospital Affiliated to Tongji University, Shanghai 201204, China |
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Abstract Objective To investigate the effect of Roy′s adaptation model on glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus (GDM). Methods From January to September 2018, 301 cases who diagnosed GDM for the first time in the First Maternity and Infant Hospital Affiliated to Tongji University were seletced. They were divided into control group (154 cases) and intervention group (147 cases) according to the result of lottery. Control group was treated with routine medical intervention, and intervention group was treated with Roy′s adaptation model (RAM) on the basis of control group. Body mass index (BMI) in early pregnancy, weight gain during pregnancy and fasting blood glucose, 2 h postprandial blood glucose, and HbA1c level after 8 weeks of intervention were compared between two groups. Treatment, pregnancy complications and pregnancy outcomes were compared between two groups. Results There was no significant difference in BMI between two groups in early pregnancy (P > 0.05). After 8 weeks of intervention, pregnancy weight gain and HbA1c levels in intervention group were lower than those in control group, with statistically significant differences (P < 0.05). There was no significant difference in fasting blood glucose and 2 h postprandial blood glucose between two groups (P > 0.05). There was no significant difference in the number of blood ketone positive cases between the two groups (P > 0.05). The number of cases treated with insulin and HbA1c higher than 6% in pregnancy in intervention group were less than those in control group, with statistically significant differences (P < 0.05). There was no statistically significant difference in the incidence of prenatal fever, excess amniotic fluid, postpartum hemorrhage, premature delivery, fetal distress and neonatal asphyxia between the two groups (P > 0.05). The incidence of hypertension during pregnancy, macromacroia and hyperbilirubinemia in neonates in intervention group was lower than that in control group, with statistically significant differences (P < 0.05). Conclusion RAM intervention can reduce blood glucose level, reduce the use of insulin, reduce the occurrence of pregnancy complications, and improve pregnancy outcome in GDM patients, which is worthy of promotion.
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