Prevalence of gestational diabetes and its association with stillbirth, preterm birth, macrosomia, abortion and cesarean delivery: a national prevalence study of 11 provinces in Iran

The relationship between quality of life and some mental problems in women with gestational diabetes mellitus (GDM): a cross-sectional study

BACKGROUND

Women with medical problems during pregnancy, including women with Gestational Diabetes Mellitus (GDM), experience an increased prevalence of mental health disorders which can affect their quality of life. This study aimed to assess the relationship between GDM-related quality of life and depression, anxiety, and stress.

METHODS

This analytical cross-sectional study was performed on 150 women with GDM. The participants were selected using a multi-stage sampling including quota and then randomized method from maternal care centers affiliated with Shahid Beheshti University of Medical Sciences, Tehran-Iran. The data were collected using a personal information questionnaire, the GDM-related quality of life questionnaire (GDMQoL-36), and the depression, anxiety, and stress scale (DASS). The data were analyzed using SPSS-23 software and statistical tests of coefficient Spearman's correlation, t-test, analysis of variance, and multiple linear regression.

RESULTS

The mean ± SD score for the GDM-related quality of life and the DASS scale were 55.51 ± 8.87 and 27.12 ± 19.43%, respectively. Different degrees of depression, anxiety, and stress were present in 40, 61.3, and 42% of women, respectively. The total score of GDM-related quality of life had a significant negative correlation with the total score of DASS and the scores of the subscales including depression, anxiety, and stress (P < 0.001). There were significant correlations between the total score of GDM-related quality of life with age, BMI, length of marriage, educational level of the woman and her spouse, the occupation of the woman and her spouse, income, and economic class of the family. Multiple linear regression revealed that depression, education, and job are predictive factors for GDM-related quality of life.

CONCLUSION

GDM-related quality of life is related to some mental disorders. Therefore, it is important to consider the mental health promotion of pregnant women with GDM in future prenatal health programs to improve their quality of life. This also shows the importance of integrating mental health promotion strategies to enhance the quality of life of pregnant women with GDM.

Associations of elevated glucose levels at each time point during OGTT with fetal congenital heart diseases: a cohort study of 72,236 births

BACKGROUND

It remains unclear how the condition of glucose metabolism during pregnancy affects fetal outcomes. This study aimed to investigate the associations of gestational diabetes mellitus (GDM) and elevated glucose levels at each time point during oral glucose tolerance test (OGTT) with congenital heart disease (CHD) risk in offspring.

METHODS

We conducted a retrospective cohort study of mothers with singleton pregnancies of 20 weeks or more registered at Maternal and Child Health Centers in Fujian Province, China. The OGTT results and offspring CHD occurrence were collected. We used logistic regression to analyse the association between elevated blood glucose at each time point during OGTT and CHD.

RESULTS

A total of 71,703 normal and 533 CHD fetuses were included. Compared to the corresponding normal group, women with GDM, elevated blood glucose at different time points in OGTT (0 h ≥ 5.1 mmol/L, 1 h ≥ 10 mmol/L, and 2 h ≥ 8.5 mmol/L) showed an increased risk of CHD in offspring (adjusted OR = 1.41, 1.36, 1.37, and 1.41, all P < 0.05, respectively). Compared to group 1 (normal OGTT 0 h, 1 h and 2 h), the risk of CHD was higher in group 3 (normal OGTT 0 h and abnormal OGTT 1 h or 2 h) and group 4 (abnormal OGTT 0 h, 1 h and 2 h), OR = 1.53 and 2.21, all P < 0.05, respectively. Moreover, we divided participants by advanced maternal age, multipara, assisted reproduction, fetal sex, and others, similar associations were observed in the subgroup analyses.

CONCLUSION

Elevated blood glucose at different time points during OGTT was associated with CHD in offspring. Fetuses of pregnant women with GDM should be screened for a high risk of CHD.

Temporal Patterns of Diabetes in Pregnancy: Analyzing Pregestational and Gestational Diabetes Mellitus Among Women Aged 15-44 Years Using the United States Diabetes Surveillance System (USDDS) Database

BACKGROUND

Diabetes in pregnancy, including pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM), is a significant global health concern. Understanding its temporal patterns is crucial for effective healthcare planning and intervention strategies.

METHODS

This retrospective observational study utilized data from the United States Diabetes Surveillance System (USDDS) spanning 2000 to 2019. We conducted a comprehensive analysis of temporal trends in PGDM and GDM prevalence among people aged 15-44 years. Additionally, age and race-based subgroup analyses were performed to identify variations in diabetes patterns.

RESULTS

Over the two-decade study period, PGDM and GDM exhibited distinct temporal patterns. PGDM prevalence remained stable initially (1.1% per 100 deliveries) but gradually increased to 1.6% by 2019. In contrast, GDM prevalence showed a consistent rise, reaching 9.6% per 100 deliveries by 2019. Age-specific analysis revealed higher prevalence rates in older age groups, peaking at 40-44 years. Race-based analyses unveiled significant disparities, with Asians having the highest GDM rates and Black individuals having the highest PGDM rates.

CONCLUSION

The prevalence of diabetes in pregnancy in the United States has increased significantly from 2000 to 2019, emphasizing the need for continued surveillance and tailored interventions. Age and race-specific disparities highlight the importance of the growing impact of diabetes in pregnancy on maternal and fetal health.

Prioritizing the Psychosocial Support Needs of Mothers with Gestational Diabetes: A Delphi Study

Background

Gestational diabetes is the most common medical complication in pregnancy, and the psychosocial health of women suffering from this condition affects their adherence to treatment and self-efficacy. However, since it is not possible to design interventions dealing with all of these needs, the aim of this study was to prioritize the psychosocial supportive needs of women with gestational diabetes.

Materials and Methods

This was a modified Delphi design study involving 22 experts who were selected using purposive and snowball sampling methods. The study was conducted between April 2021 and June 2021. First, the psychosocial needs of diabetic pregnant women were extracted through a qualitative study involving interviews with multidisciplinary specialists and diabetic pregnant mothers (22 participants) and a systematic review of reputable scientific databases. Throughout the two Delphi stages, the questionnaire was classified, quantified, and analyzed.

Results

Based on the results of this study, the following are the top priorities when addressing the psychosocial needs of mothers with gestational diabetes: paying attention to and identifying the mother's worries and anxiety, husband and family support for diabetic pregnant women, the inclusion of specialized nutrition counseling services in mothers' treatment plan, timely education of mothers about diabetes and its complications, and proper nutrition for diabetic mothers.

Conclusions

The priorities of the supportive needs obtained in this study can be used to design interventions aimed at promoting psychosocial health, reducing stress and anxiety, and improving medication adherence in women with gestational diabetes.