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Ma X, Yang Y, Qian S, Ding Y, Lin Q, Wang N. Perceptions of Chinese women with a history of gestational diabetes regarding health behaviors and related factors: a directed qualitative content analysis. BMC Public Health 2024; 24:1237. [PMID: 38711101 PMCID: PMC11071205 DOI: 10.1186/s12889-024-18731-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/29/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders during pregnancy and is associated with adverse outcomes in both mothers and their children. After delivery, women who experience GDM are also at higher risk of both subsequent GDM and type 2 diabetes mellitus (T2DM) than those who do not. Therefore, healthcare providers and public health practitioners need to develop targeted and effective interventions for GDM. In this study, we aimed to explore the perceptions regarding health behaviors and related factors during the inter-pregnancy period among Chinese women with a history of GDM through the lens of the theory of planned behavior (TPB). METHODS Between December 2021 and September 2022, 16 pregnant Chinese women with a history of GDM were purposively recruited from a tertiary maternity hospital in Shanghai for face-to-face semi-structured interviews. They were asked questions regarding their health behaviors and related factors. The transcribed data were analyzed using a directed qualitative content analysis method based on the theory of TPB. RESULTS The health-related behaviors of the women varied substantially. We identified five domains that influenced women's behaviors according to TPB constructs and based on the data collected: behavioral attitude (perceived benefits of healthy behaviors and the relationship between experience and attitude towards the oral glucose tolerance testing); subjective norms (influences of significant others and traditional cultural beliefs); perceived behavior control (knowledge of the disease, multiple-role conflict, the impact of COVID-19, an unfriendly external environment and difficulty adhering to healthy diets), incentive mechanisms (self-reward and external incentives); preferences of professional and institutional support (making full use of social media platform and providing continuous health management). CONCLUSIONS The health-related behaviors of women with a history of GDM were found to be affected by multiple factors. Healthcare professionals are recommended to provide women with sufficient information regarding the disease and to take advantage of the power of the family and other social support networks to improve women's subjective norms and to promote the adoption of a healthy lifestyle.
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Affiliation(s)
- Xiaoxia Ma
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090, China
- School of Nursing, Fudan University, Shanghai, China
| | - Yun Yang
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090, China
| | - Shuhua Qian
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090, China
| | - Yan Ding
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090, China
| | - Qiping Lin
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090, China.
| | - Na Wang
- Nursing Department, Obstetrics and Gynaecology Hospital of Fudan University, No. 128 Shenyang Road, Shanghai, 200090, China.
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Yi J, Chen L, Meng X, Chen Y. The impact of gestational weeks of Coronavirus disease 2019 (COVID-19) infection on perinatal outcomes. Reprod Health 2024; 21:31. [PMID: 38433197 PMCID: PMC10910700 DOI: 10.1186/s12978-024-01762-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 02/24/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND To evaluate the relationship between coronavirus disease 2019 (COVID-19) infection at different time points during pregnancy and perinatal outcomes. METHODS This retrospective study included 611 women who hospitalized for delivery between December 7 and April 30, 2023. Based on the different pregnancy weeks infected with COVID-19, the participants were divided into four groups: Group 1 (14-27+6 weeks gestation), Group 2 (28-36+6 weeks gestation), Group 3 (37-39+6 weeks gestation), and Group 4 (≥ 40 weeks gestation). Data including maternal demographic characteristics, clinical profiles, and perinatal outcomes were analyzed. RESULTS There were no significant differences in maternal demographic characteristics among the four groups (P > 0.05). Compared to Groups 3 and 4, a higher rate of fever was noted in Groups 1 and 2 (P < 0.05). The frequency of preeclampsia and gestational diabetes mellitus showed a decreasing trend as pregnancy progressing (P < 0.05). Preterm delivery and neonatal intensive care unit admission were more frequently observed in Groups 1 and 2 than in Groups 3 and 4 (P < 0.05). Multivariate logistic regression analysis demonstrated that the timing of gestation in which COVID-19 was infected was not associated with preterm delivery and neonatal intensive care unit admission (P > 0.05), whereas gestational age at COVID-19 infection was negatively associated with the occurrence of preeclampsia and gestational diabetes mellitus (P < 0.05). CONCLUSIONS Gestational age at COVID-19 infection is a simple parameter that predicts adverse perinatal outcomes to aid clinicians in determining to provide early enhanced prenatal care and increased monitoring to reduce maternal complications.
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Affiliation(s)
- Jiao Yi
- Department of Obstetrics and Gynecology, Maternal and Child Health Care Hospital Affiliated With Anhui Medical University, Anhui Maternal and Child Health Care Hospital, No 15 Yimin Street, Hefei, 230000, China.
| | - Lei Chen
- Department of Obstetrics and Gynecology, Maternal and Child Health Care Hospital Affiliated With Anhui Medical University, Anhui Maternal and Child Health Care Hospital, No 15 Yimin Street, Hefei, 230000, China
| | - Xianglian Meng
- Department of Obstetrics and Gynecology, Maternal and Child Health Care Hospital Affiliated With Anhui Medical University, Anhui Maternal and Child Health Care Hospital, No 15 Yimin Street, Hefei, 230000, China
| | - Yi Chen
- Department of Obstetrics and Gynecology, Maternal and Child Health Care Hospital Affiliated With Anhui Medical University, Anhui Maternal and Child Health Care Hospital, No 15 Yimin Street, Hefei, 230000, China
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Farewell C, Tong S, Sehrt M, Siegart J, Nicklas J. Factors associated with postpartum depression among high-risk women during the COVID-19 pandemic. Women Health 2024; 64:224-234. [PMID: 38287691 DOI: 10.1080/03630242.2024.2310047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 01/18/2024] [Indexed: 01/31/2024]
Abstract
The purpose of this study was to investigate the impacts of the COVID-19 pandemic on multi-level factors associated with depression among a high-risk sample of postpartum women using longitudinal data collected at two timepoints. High-risk postpartum participants in the United States were recruited to participate in a parent study focused on mitigating risk of cardiometabolic disease in postpartum women. Individuals completed a baseline survey which included the Edinburgh Postpartum Depression Scale (EPDS) at 6-weeks postpartum between 2017 through 2019. A modified survey with the inclusion of selected questions from the Coronavirus Health Impact Survey (CRISIS) questionnaire was administered again during the first 6-months of the COVID-19 pandemic and individuals who completed both the baseline assessment and the COVID-19 assessment were included for analyses (n = 46). Multivariate models were run to investigate the impacts of individual-, interpersonal-, and structural-level factors on change in EPDS scores across the postpartum period. Findings suggest that losing contact with social supports (β = 4.5, SE = 1.9, p = .02) and individuals who reported a total household income of less than $75,000 (β = 3.4, SE = 1.7, p = .05) were more likely to report significantly worsening postpartum depression scores compared to others. Recommendations to mitigate the stressors that have been amplified by the COVID-19 pandemic and resulting mental health disparities include screening all high-risk postpartum women for depression and anxiety during both postpartum and pediatric healthcare visits, providing informational flyers with tips related to healthy coping behaviors and free/affordable community resources, and linking individuals to peer-led support groups.
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Affiliation(s)
- Charlotte Farewell
- Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, Colorado, USA
| | - Suhong Tong
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Madeleine Sehrt
- Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, Colorado, USA
| | - Jamie Siegart
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jacinda Nicklas
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
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Xing Y, Wang H, Chao C, Ding X, Li G. Gestational diabetes mellitus in the era of COVID-19: Challenges and opportunities. Diabetes Metab Syndr 2024; 18:102991. [PMID: 38569447 DOI: 10.1016/j.dsx.2024.102991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND AND AIMS The impact of the coronavirus disease 2019 (COVID-19) pandemic on pregnant women, especially those with gestational diabetes mellitus (GDM), has yet to be fully understood. This review aims to examine the interaction between GDM and COVID-19 and to elucidate the pathophysiological mechanisms underlying the comorbidity of these two conditions. METHODS We performed a systematic literature search using the databases of PubMed, Embase, and Web of Science with appropriate keywords and MeSH terms. Our analysis included studies published up to January 26, 2023. RESULTS Despite distinct clinical manifestations, GDM and COVID-19 share common pathophysiological characteristics, which involve complex interactions across multiple organs and systems. On the one hand, infection with severe acute respiratory syndrome coronavirus 2 may target the pancreas and placenta, resulting in β-cell dysfunction and insulin resistance in pregnant women. On the other hand, the hormonal and inflammatory changes that occur during pregnancy could also increase the risk of severe COVID-19 in mothers with GDM. Personalized management and close monitoring are crucial for treating pregnant women with both GDM and COVID-19. CONCLUSIONS A comprehensive understanding of the interactive mechanisms of GDM and COVID-19 would facilitate the initiation of more targeted preventive and therapeutic strategies. There is an urgent need to develop novel biomarkers and functional indicators for early identification and intervention of these conditions.
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Affiliation(s)
- Yuhan Xing
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, 518107, China; Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China; Qingdao Women and Children's Hospital, Qingdao University, Qingdao, Shandong Province, China
| | - Hong Wang
- Public Health School, Medical College of Qingdao University, Qingdao, Shandong Province, China
| | - Cong Chao
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, Shandong Province, China
| | - Xueteng Ding
- Public Health School, Medical College of Qingdao University, Qingdao, Shandong Province, China
| | - Guoju Li
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, Shandong Province, China.
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Țieranu ML, Iovoaica-Rămescu C, Preda A, Zorilă GL, Drocaș I, Istrate-Ofițeru AM, Drăgușin RC, Iliescu DG. Hospitalizations for Obstetrical Conditions During and After the Covid-19 Pandemic. CURRENT HEALTH SCIENCES JOURNAL 2024; 50:36-44. [PMID: 38846479 PMCID: PMC11151953 DOI: 10.12865/chsj.50.01.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/28/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND During the Covid-19 pandemic there have been a drastic decrease in hospitalizations for non-Covid conditions. The aim of this study was to evaluate the trend in hospitalizations for obstetrical conditions during and after the Covid-19 pandemic. METHODS For this study there we used electronical data base in order to search for all the obstetrical patients that were hospitalized in a tertiary maternity, Clinical Emergency County Hospital Craiova, during the pre-pandemic period (between March - December 2019), during pandemics (2020 March - December, 2021 March - December) and post pandemics (2022 March - December). RESULTS The total number of hospitalizations during 2020 dropped by 28% compared to the pre-pandemic year - 2019, and further by 30% in 2021, and by 26% in 2022. In terms of day admissions, a decreasing trend can be observed, with a total of 3230 admissions, from which, 208 in 2020 showing a decrease of 93%, 695 in 2021 with a decrease of 78% and 941 in 2022 with a decrease of 70% compared to 2019.We experienced a significant increase of vaginal birth rate during the pandemic (2020-2021) of 24% that can be attributed to the unavailability of many surrounding low-risk birth units during the pandemic. CONCLUSION The obstetrical conditions hospitalizations dramatically dropped during the COVID-19 pandemic and have not yet recovered to the pre-pandemic level.
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Affiliation(s)
- Maria-Loredana Țieranu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 20039 Craiova, Romania
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
| | - Cătălina Iovoaica-Rămescu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 20039 Craiova, Romania
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
| | - Agnesa Preda
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
| | - George-Lucian Zorilă
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ileana Drocaș
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
| | - Anca-Maria Istrate-Ofițeru
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Histology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Research Centre for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Roxana Cristina Drăgușin
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dominic-Gabriel Iliescu
- Department of Obstetrics and Gynecology, Emergency County Hospital of Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Lake AJ, Williams A, Neven ACH, Boyle JA, Dunbar JA, Hendrieckx C, Morrison M, O’Reilly SL, Teede H, Speight J. Barriers to and enablers of type 2 diabetes screening among women with prior gestational diabetes: A qualitative study applying the Theoretical Domains Framework. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1086186. [PMID: 36993822 PMCID: PMC10012118 DOI: 10.3389/fcdhc.2023.1086186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/12/2023] [Indexed: 03/02/2023]
Abstract
IntroductionWomen with previous gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes (T2D). Guidelines recommend postnatal diabetes screening (oral glucose tolerance test or HbA1c) typically 6-12 weeks after birth, with screening maintained at regular intervals thereafter. Despite this, around half of women are not screened, representing a critical missed opportunity for early identification of prediabetes or type 2 diabetes. While policy and practice-level recommendations are comprehensive, those at the personal-level primarily focus on increasing screening knowledge and risk perception, potentially missing other influential behavioral determinants. We aimed to identify modifiable, personal-level factors impacting postpartum type 2 diabetes screening among Australian women with prior gestational diabetes and recommend intervention functions and behavior change techniques to underpin intervention content.Research design and methodsSemi-structured interviews with participants recruited via Australia’s National Gestational Diabetes Register, using a guide based on the Theoretical Domains Framework (TDF). Using an inductive-deductive approach, we coded data to TDF domains. We used established criteria to identify ‘important’ domains which we then mapped to the Capability, Opportunity, Motivation–Behavior (COM-B) model.ResultsNineteen women participated: 34 ± 4 years, 19 ± 4 months postpartum, 63% Australian-born, 90% metropolitan, 58% screened for T2D according to guidelines. Eight TDF domains were identified: ‘knowledge’, ‘memory, attention, and decision-making processes’, ‘environmental context and resources’, ‘social influences’, ‘emotion’, ‘beliefs about consequences’, ‘social role and identity’, and ‘beliefs about capabilities’. Study strengths include a methodologically rigorous design; limitations include low recruitment and homogenous sample.ConclusionsThis study identified numerous modifiable barriers and enablers to postpartum T2D screening for women with prior GDM. By mapping to the COM-B, we identified intervention functions and behavior change techniques to underpin intervention content. These findings provide a valuable evidence base for developing messaging and interventions that target the behavioral determinants most likely to optimize T2D screening uptake among women with prior GDM.
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Affiliation(s)
- Amelia J. Lake
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioral Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- *Correspondence: Amelia J. Lake,
| | - Amelia Williams
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioral Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Adriana C. H. Neven
- Monash Centre for Health Research and Implementation, Monash Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Jacqueline A. Boyle
- Monash Centre for Health Research and Implementation, Monash Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
- Monash Department of Obstetrics and Gynecology, Monash Health, Clayton, VIC, Australia
| | - James A. Dunbar
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, VIC, Australia
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioral Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | | | - Sharleen L. O’Reilly
- School of Exercise & Nutrition Science, Deakin University, Burwood, VIC, Australia
- UCD Institute of Food and Health, College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioral Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
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Auger N, Wei SQ, Dayan N, Ukah UV, Quach C, Lewin A, Healy-Profitós J, Ayoub A, Chang J, Luu TM. Impact of Covid-19 on rates of gestational diabetes in a North American pandemic epicenter. Acta Diabetol 2023; 60:257-264. [PMID: 36346488 PMCID: PMC9640820 DOI: 10.1007/s00592-022-02000-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022]
Abstract
AIMS We assessed the impact of Covid-19 on gestational diabetes rates in Quebec, the pandemic epicenter of Canada. METHODS We conducted a population-based study of 569,686 deliveries in Quebec between 2014 and 2021. We measured gestational diabetes rates in wave 1 (March 1, 2020-August 22, 2020) and wave 2 (August 23, 2020-March 31, 2021), compared with the prepandemic period. We used interrupted time series regression to assess changes in gestational diabetes rates during each wave, and log-binomial regression models to estimate adjusted risk ratios (RR) and 95% confidence intervals (CI) for the association of the pandemic with gestational diabetes. We identified the types of patients that contributed to the change in gestational diabetes rates using Kitagawa's decomposition. RESULTS Gestational diabetes rates were higher during the first (13.2 per 100 deliveries) and second waves (14.3 per 100 deliveries) than during the prepandemic period (12.4 per 100 deliveries). Risk of gestational diabetes increased both in wave 1 (RR 1.05, 95% CI 1.02-1.09) and wave 2 (RR 1.14, 95% CI 1.10-1.18), compared with the prepandemic period. However, most of the increase in gestational diabetes rates was driven by low-risk women without Covid-19 infections who were socioeconomically advantaged, had no comorbidity, and were 25-34 years of age. CONCLUSIONS Gestational diabetes rates increased during the pandemic, mainly among women traditionally at low risk of hyperglycemia who did not have Covid-19 infections. Sudden widespread changes in screening or lifestyle can have a large impact on gestational diabetes rates in a population.
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Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, QC, Canada.
- Institut national de santé publique du Québec, Montreal, QC, Canada.
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada.
| | - Shu Qin Wei
- Institut national de santé publique du Québec, Montreal, QC, Canada
- Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, QC, Canada
| | - Natalie Dayan
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Ugochinyere V Ukah
- Institut national de santé publique du Québec, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Caroline Quach
- Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, QC, Canada
- Department of Microbiology, Infectious Diseases, and Immunology, University of Montreal, Montreal, QC, Canada
| | - Antoine Lewin
- Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, QC, Canada
- Medical Affairs and Innovation, Héma-Québec, Montreal, QC, Canada
| | - Jessica Healy-Profitós
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Aimina Ayoub
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Jungmin Chang
- University of Montreal Hospital Research Centre, Montreal, QC, Canada
- Institut national de santé publique du Québec, Montreal, QC, Canada
| | - Thuy Mai Luu
- Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, QC, Canada
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Tollini V, Lemaître M, Garabedian C, Martin C, Bengler C, Vambergue A, Ghesquière L. The impact of lockdown on maternal and neonatal morbidity in gestational diabetes mellitus. Am J Obstet Gynecol 2022; 227:775-777. [PMID: 35764141 PMCID: PMC9617643 DOI: 10.1016/j.ajog.2022.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Valentine Tollini
- CHU Lille, Department of Gynecology and Obstetrics, Lille University Hospital, Lille, France
| | - Madleen Lemaître
- CHU Lille, Department of Diabetology, Endocrinology, Metabolism and Nutrition, Lille University Hospital, Lille, France
| | - Charles Garabedian
- CHU Lille, Department of Gynecology and Obstetrics, Lille University Hospital, Lille, France; Univ. Lille, CHU Lille, ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Claire Martin
- CHU Lille, Department of Biostatistics, Lille University Hospital, Lille, France; Univ. Lille, CHU Lille, ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Cyril Bengler
- CHU Lille, Department of Gynecology and Obstetrics, Lille University Hospital, Lille, France
| | - Anne Vambergue
- CHU Lille, Department of Diabetology, Endocrinology, Metabolism and Nutrition, Lille University Hospital, Lille, France; European Genomic Institute for Diabetes, University School of Medicine, Lille, France
| | - Louise Ghesquière
- CHU Lille, Department of Gynecology and Obstetrics, Lille University Hospital, Lille, France; Univ. Lille, CHU Lille, ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France.
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9
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Quansah DY, Gilbert L, Kosinski C, Le Dizès O, Horsch A, Benhalima K, Cosson E, Puder JJ. Cardio-Metabolic and Mental Health Outcomes Before and During the COVID-19 Pandemic in a Cohort of Women With Gestational Diabetes Mellitus in Switzerland. Front Endocrinol (Lausanne) 2022; 13:948716. [PMID: 35957818 PMCID: PMC9361046 DOI: 10.3389/fendo.2022.948716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has been associated with worsened metabolic and mental health in the general and perinatal population. The postpartum is a critical moment regarding these outcomes particularly in women with gestational diabetes mellitus (GDM). We investigated the cardio-metabolic and mental health outcomes before and during the pandemic in this population. METHODS This cohort study included 418 women with GDM, recruited during two distinct periods. This included 180 women exposed to the pandemic (E+) and recruited between May 2020-April 2021 and 238 women who were not exposed to the pandemic during their postpartum period (attended a year before=non-exposed (E-)) and recruited between January-December 2019. Among the E+, a nested-subcohort of 120 women were exposed both during pregnancy and postpartum. During the pandemic, we adopted a hybrid follow-up of women that consisted of in-person consultations, regular contact via phone calls (35%), sent recorded exercise guide to patients to follow at home and linked to our website. We specifically focused on maintaining motivation and keeping a strong focus on healthy lifestyle behaviors. Obstetric, neonatal, cardio-metabolic and mental health outcomes were assessed during pregnancy and postpartum. RESULTS The pandemic was not associated with worsened weight, weight retention, glucose tolerance, metabolic syndrome, well-being or depression in the postpartum with the exception of a minimally increased HbA1c, diastolic blood pressure and lower emotional eating scores in E+ women (all p ≤ 0.046). In the nested subcohort, E+ women had a slightly increased HbA1c at the first GDM visit and a higher need for glucose-lowering medication (both p ≤ 0.014), but HbA1c at the end of pregnancy and other cardio-metabolic, mental health, obstetric and neonatal outcomes during pregnancy were similar. CONCLUSIONS The pandemic was not associated with any clinically relevant worsening of cardio-metabolic, mental health, obstetrical and neonatal outcomes in our GDM cohort. This was possibly due to a continued hybrid follow-up, and the partial lockdown in Switzerland.
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Affiliation(s)
- Dan Yedu Quansah
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
- *Correspondence: Dan Yedu Quansah,
| | - Leah Gilbert
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Christophe Kosinski
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Le Dizès
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Katrien Benhalima
- Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Jardena J. Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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