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Xu J, Chen Y, Zhao J, Wang J, Chen J, Pan X, Zhang W, Zheng J, Zou Z, Chen X, Zhang Y. Current status of electronic health literacy among pregnant women with gestational diabetes mellitus and their perceptions of online health information: a mixed-methods study. BMC Pregnancy Childbirth 2024; 24:392. [PMID: 38807050 PMCID: PMC11134622 DOI: 10.1186/s12884-024-06594-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Women diagnosed with gestational diabetes mellitus often rely on internet-based health information for managing their condition. This study aims to investigate the present state of electronic health literacy among women with gestational diabetes mellitus, analyze the influencing factors, and explore their experiences regarding accessing, comprehending, evaluating, and applying online health information pertinent to gestational diabetes mellitus. METHODS A sequential explanatory mixed methods research design was adopted in this study. Initially, 235 women with gestational diabetes mellitus participated in a cross-sectional survey. The research tools included general information and the Chinese version of the electronic Health Literacy Scale (eHEALS). Descriptive analyses were conducted to describe the characteristics of the sample, and multiple linear regression analyses were used to explore the factors influencing electronic health literacy among women with gestational diabetes mellitus. Secondly, 11 women with gestational diabetes mellitus joined semi-structured in-depth interviews to obtain their perceptions about online health information. The data were analyzed using inductive content analysis to develop themes. RESULTS The median score of eHEALS in the Chinese version among 235 women diagnosed with gestational diabetes mellitus was 29 (interquartile range [IQR], 26 to 32). Factors influencing electronic health literacy among these women included accessing health information from medical professionals (β = 0.137, p = 0.029) and utilizing health information from applications (β = 0.159, p = 0.013). From the qualitative phase of the study, four thematic categories emerged: reasons and basis for accessing health information from the Internet; address barriers to accessing and applying online health information; desires for a higher level of online health information services; outcomes of accessing and applying online health information. CONCLUSION The electronic health literacy of women diagnosed with gestational diabetes mellitus remains suboptimal and warrants improvement. The sources of access to health information affect electronic health literacy in women with gestational diabetes mellitus. Moreover, women facing gestational diabetes encounter numerous impediments when attempting to access health-related information online, underscoring the necessity for enhanced online health information services to meet their needs.
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Affiliation(s)
- Jingqi Xu
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Yujia Chen
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Jing Zhao
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Jiarun Wang
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Jianfei Chen
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Xinlong Pan
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Wei Zhang
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Jin Zheng
- Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, Hubei, 430079, China.
| | - Zhijie Zou
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China.
| | - Xiaoli Chen
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China.
| | - Yingzi Zhang
- Magnet Program & Nursing Research Department, UT Southwestern Medical Center, 8200 Brookriver Dr, Dallas, TX, 75247, USA
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Simjak P, Anderlova K, Smetanová D, Kršek M, Mráz M, Haluzík M. Glucose control during pregnancy in patients with type 1 diabetes correlates with fetal hemodynamics: a prospective longitudinal study. BMC Pregnancy Childbirth 2024; 24:264. [PMID: 38605306 PMCID: PMC11007889 DOI: 10.1186/s12884-024-06462-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Maternal diabetes adversely affects fetal cardiovascular system development. Previous studies have reported that the fetuses of mothers with diabetes exhibit both structural and functional changes; nevertheless, prior studies have not examined the association between glucose control and fetal cardiac morphology and performance. Thus, the objective was to determine the association between fetal cardiac morphology and function and maternal glucose control in type 1 diabetes and to compare the differences in measured cardiac parameters between the fetuses of mothers with diabetes and healthy controls. METHODS In this prospective, longitudinal case-control study - including 62 pregnant women with type 1 diabetes mellitus and 30 healthy pregnant women - fetal cardiac assessment using B-mode, M-mode, and spectral pulsed-wave Doppler was performed in the second and third trimesters. In women with T1DM, glycated hemoglobin and data obtained from glucose sensors - including the percentage of time in, below, and above the range (TIR, TBR, and TAR, respectively), and coefficient of variation (CV) - were analyzed across three time periods: the last menstrual period to 13 (V1), 14-22 (V2), and 23-32 weeks (V3) of gestation. Fetal cardiac indices were compared between groups, and the correlation between glucose control and fetal cardiac indices was assessed. RESULTS At 28-32 weeks, the fetuses of women with T1DM exhibited increased left ventricular end-diastolic length, relative interventricular septum thickness, right ventricular cardiac output, and pulmonary valve peak systolic velocity compared with healthy controls. At 18-22 weeks, pulmonary and aortic valve diameters, left and right ventricular stroke volumes, and left cardiac output inversely correlated with the CV and glycated hemoglobin levels at V1 and V2. Furthermore, at 28-32 weeks, pulmonary and aortic valve diameters, left ventricular stroke volume, cardiac output, and right/left atrioventricular valve ratio inversely correlated with the TBR at V1, V2, and V3. Moreover, diastolic functional parameters correlated with the TAR and glycated hemoglobin levels, particularly after the first trimester. CONCLUSION In women with T1DM, maternal hyperglycemia during pregnancy correlates with fetal diastolic function, whereas glucose variability and hypoglycemia inversely correlate with fetal left ventricular systolic function in the second and third trimesters.
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Affiliation(s)
- Patrik Simjak
- Clinic of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Gennet s.r.o, Fetal Medicine Center, Prague, Czech Republic
| | - Katerina Anderlova
- Clinic of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
- 3rd Internal Clinic, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
| | | | - Michal Kršek
- 3rd Internal Clinic, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Miloš Mráz
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Martin Haluzík
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Sakcak B, Farisoğulları N, Denizli R, Menekse Beser D, Tanacan A, Goncu Ayhan S, Öcal FD, Sahin D. Evaluation of the fetal myocardial performance ındex and Epicardial fat thickness in pregnant women with preterm prelabor rupture of membranes. J Matern Fetal Neonatal Med 2023; 36:2192322. [PMID: 36944418 DOI: 10.1080/14767058.2023.2192322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To assess the epicardial fat thickness (EFT) and modified myocardial performance index (Mod-MPI) measurements in fetuses at pregnant women with preterm prelabor rupture of membranes (pPROM) and compare them to healthy pregnant women's fetuses. METHODS Forty patients who presented to our clinic at 24-36 + 6 gestational weeks and were diagnosed with pPROM were included in the patient group. During the same period, 40 healthy pregnant women at similar gestational weeks were randomly selected as the control group. RESULTS The pPROM and control groups were similar in terms of demographics. In the pPROM group, EFT, Mod-MPI, and isovolumetric contraction(ICT) and relaxation times(IRT) were significantly higher and ejection time (ET) was significantly lower compared to the control group. In addition, Mod-MPI z-scores, IRT z-scores, ICT z-scores were significantly higher and ET z-scores was significantly lower in the pPROM. According to the ROC analysis, the optimal cutoff value of EFT was calculated as 1.55 mm, with 68% sensitivity and 71% specificity (AUC: 0.718, 95% CI: 0.550-0.786, p = .018) for predicting NICU requirement and the optimal cutoff value of EFT was calculated as 1.55 mm with 72% sensitivity and 73% specificity (AUC: 0.726, 95% CI: 0.556-0.896, p = .015) for predicting medication use in the pPROM group. CONCLUSION This study revealed differences in the EFT and Mod-MPI measurements of the fetuses of pregnant women with pPROM. Considering that EFT is an important energy source for the myocardium, as well as an endocrine structure in which inflammatory and anti-inflammatory markers are secreted, it is recommended to be evaluated in inflammatory conditions such as pPROM.
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Affiliation(s)
- Bedri Sakcak
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Nihat Farisoğulları
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ramazan Denizli
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Menekse Beser
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Fatma Doğa Öcal
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Division of Perinatology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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Yao S, Yang T, Kong X, Dang Y, Chen P, Lyu M. The Influence of Maternal Condition on Fetal Cardiac Function during the Second Trimester. Diagnostics (Basel) 2023; 13:2755. [PMID: 37685293 PMCID: PMC10486346 DOI: 10.3390/diagnostics13172755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE Maternal health has a direct, profound and lasting effect on the formation and development of the fetal cardiovascular system. The aim of this research was to find whether maternal age, BMI hypertension (GH) or gestational diabetic mellitus (GDM) would affect fetal cardiac function in the second trimester. METHOD 329 mothers who had a fetal echocardiogram examination at the International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai, China, from 1 January 2020 to 30 April 2020 were enrolled at the gestational age of 21 to 26 weeks (mean 22.78 ± 1.13 weeks). Single-factor analysis and multi-factor line regression analysis were used to find the contribution values of each factor to fetal cardiac function. RESULTS at the second trimester, maternal age had a minor influence on the fetal left ventricle diastolic function. Higher maternal BMI could cause a decrease in the fetal diastolic function of both the left and right ventricle and the systolic function of the left ventricle. Maternal hypertension and gestational diabetic mellitus had a profound influence on both the left and right fetal heart ventricles of both systolic and diastolic function. CONCLUSION maternal condition will have a profound influence on fetal cardiac function as early as the second trimester.
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Affiliation(s)
- Shifa Yao
- Ultrasound Department, The International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (S.Y.); (T.Y.); (X.K.); (Y.D.); (P.C.)
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
| | - Tian Yang
- Ultrasound Department, The International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (S.Y.); (T.Y.); (X.K.); (Y.D.); (P.C.)
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
| | - Xiaoxiao Kong
- Ultrasound Department, The International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (S.Y.); (T.Y.); (X.K.); (Y.D.); (P.C.)
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
| | - Yuanyuan Dang
- Ultrasound Department, The International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (S.Y.); (T.Y.); (X.K.); (Y.D.); (P.C.)
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
| | - Ping Chen
- Ultrasound Department, The International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (S.Y.); (T.Y.); (X.K.); (Y.D.); (P.C.)
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
| | - Mingli Lyu
- Ultrasound Department, The International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (S.Y.); (T.Y.); (X.K.); (Y.D.); (P.C.)
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
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Pu Y, Liu Q, Hu K, Liu X, Bai H, Wu Y, Zhou M, Fan P. CYP2E1 C-1054T and 96-bp I/D genetic variations and risk of gestational diabetes mellitus in chinese women: a case-control study. BMC Pregnancy Childbirth 2023; 23:403. [PMID: 37264354 DOI: 10.1186/s12884-023-05742-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/27/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Cytochrome P450 2E1 (CYP2E1) plays a key role in the metabolism of xenobiotic and endogenous low-molecular-weight compounds. This study aimed to determine if the genetic variations of 96-bp insertion/deletion (I/D) and C-1054T (rs2031920) in CYP2E1 were associated with the risk of gestational diabetes mellitus (GDM). METHODS CYP2E1 polymorphisms were genotyped in a case-control study of 1,134 women with uncomplicated pregnancies and 723 women with GDM. The effects of genotype on the clinical, metabolic, and oxidative stress indices were assessed. RESULTS The CYP2E1 C-1054T variant was associated with an increased risk of GDM based on the genotype, recessive, dominant, and allele genetic models (P < 0.05). The TT + CT genotype remained a significant predictive factor for GDM risk after correcting for maternal age and pre-pregnancy body mass index (OR = 1.277, 95% CI: 1.042-1.563, P = 0.018). Moreover, fasting insulin concentrations and homeostatic model assessment of insulin resistance were significantly higher in GDM patients carrying the T allele than in those with the CC genotype (P < 0.05). Furthermore, the combined genotype II + ID/TT + CT of the 96-bp I/D and C-1054T polymorphisms further increased the risk of GDM when the combined genotype DD/CC was set as the reference category (OR = 1.676, 95% CI: 1.182-2.376, P = 0.004). CONCLUSIONS The T allele of the C-1054T polymorphism and its combination with the I allele of the 96-bp I/D variation in CYP2E1 are associated with an increased risk of GDM in the Chinese population. The - 1054T allele may be associated with more serious insulin resistance in patients.
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Affiliation(s)
- Yifu Pu
- Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Qingqing Liu
- Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Kaifeng Hu
- Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Xinghui Liu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Huai Bai
- Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Yujie Wu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Mi Zhou
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Ping Fan
- Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
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