International Journal of Clinical Research

Objective To explore the effect of the continuous lifestyle intervention model based on the Internet + flipped classroom starting from the early pregnancy on reducing the incidence of gestational diabetes mellitus (GDM) and adverse pregnancy outcomes in high-risk pregnant women. Methods A total of 200 high-risk pregnant women who established cards in the obstetric outpatient department from May 2023 to December 2023 and were at 6-12 weeks of gestation were randomly divided into a conventional group (100 cases, with a single general nutrition outpatient group education in the early pregnancy) and an intervention group (100 cases, participating in the flipped classroom and further continuous lifestyle management through the Internet WeChat platform). Both groups underwent a 75g oral glucose tolerance test (OGTT) for GDM screening at 24-28 weeks of gestation. The incidence of GDM, weight gain during pregnancy, adverse pregnancy outcomes, and neonatal birth weight were statistically analyzed. Results Compared with the control group, the incidence of GDM in the intervention group was significantly lower [13%（13/100）vs 38%（38/100）, χ2=44.22, P<0.001], with a statistically significant difference; the weight gain during pregnancy in the intervention group was significantly less [12.57±1.25 vs 14.23±1.32, t=9.13, P<0.001], reached statistical significance; the incidence of adverse pregnancy outcomes: (1) The incidence of adverse outcomes in the intervention group was significantly lower: gestational hypertension, postpartum hemorrhage, and cesarean section combined [17%（17/100）vs 36%（36/100）, χ2=9.27, P<0.001], showed statistically significant divergence; (2) The incidence of adverse neonatal outcomes decreased: including preterm birth, macrosomia, FGR, clavicle fracture, and asphyxia combined [2%（2/100）vs 8%（8/100）, χ2=2.63, P>0.05], but the difference was not statistically significant. The birth weight of neonates in the intervention group yielded statistically significant lower [3.39±0.05 vs 3.55±0.07, t=18.59, P<0.001]. Conclusion Continuous lifestyle management for high-risk pregnant women with GDM through the Internet + flipped classroom starting from the early pregnancy can reduce the incidence of GDM, decrease weight gain during pregnancy, and adverse pregnancy outcomes, and the neonatal birth weight is also significantly lower.

Gestational diabetes mellitus; Internet; Flipped classroom; High-risk population; Pregnancy outcome