The gestational weight gain (GWG) range of Chinese women with gestational diabetes mellitus (GDM) remains unclear. Our objective was to identify the ranges of GWG in Chinese women with GDM and to investigate the associations between prepregnancy body mass index (BMI), GWG and maternal-infant adverse outcomes. Cases of GDM women who delivered singletons from 2013 to 2018 in a public hospital were collected. Logistic regression analysis was used to assess the joint effects of prepregnancy BMI and GWG on maternal-infant adverse outcomes. Ultimately, 14,578 women were collected. The ranges of GWG in Chinese women with GDM were different from the National Academy of Medicine’s (NAM) recommendation. The ranges of GWG of Chinese women with GDM in the underweight, normal weight, overweight and obese groups were 5.95–21.95 kg, 4.23–21.83 kg, 0.88–21.12 kg and − 1.76 to 19.95 kg, respectively. The risks of large for gestational age (LGA), macrosomia and caesarean delivery were significantly increased with the increasing prepregnancy BMI. Furthermore, the risks of LGA, macrosomia and caesarean delivery were significantly higher in the normal weight group with a GWG higher than the NAM recommendation. Similarly, in the overweight group with a GWG higher than the NAM recommendation, the risks of LGA were significantly higher, while the risks of macrosomia were significantly lower. Overall, we determined the range of GWG in different prepregnancy BMI groups. And GDM women with high prepregnancy BMI and excessive GWG were associated with the higher risks of maternal-infants adverse outcomes in China.
Background. Probiotic supplements may be seen as a promising way to improve glucose metabolism. This study aimed to evaluate the effects of probiotic supplements on blood glucose, insulin resistance/sensitivity, and prevention of gestational diabetes mellitus (GDM) among pregnant women. Methods. Eleven electronic databases were searched from inception to May 2020. Two authors independently identified randomized controlled trials (RCTs), assessed the eligibility and quality of the included studies, and then extracted data. The primary outcomes were fasting plasma glucose (FPG), 1 h and 2 h plasma glucose after 75 g oral glucose tolerance test (OGTT), HbA1c, fasting plasma insulin, insulin resistance, and insulin sensitivity. Fixed and random effect models were used to pool the results. Results. A total of 20 RCTs involving 2972 participants were included according to the inclusion and exclusion criteria. The pooled results of this research showed that probiotic supplements could reduce the level of FPG (mean difference (MD) = −0.11; 95% CI = −0.15 to −0.04; P = 0.0007 ), serum insulin (MD = −1.68; 95% CI = −2.44 to −0.92; P < 0.00001 ), insulin resistance (MD = −0.36; 95% CI = −0.53 to −0.20; P < 0.00001 ), and insulin sensitivity (MD = −21.80; 95% CI = −31.92 to −11.67; P < 0.00001 ). Regarding the subgroup analysis of different pregnant women, the effects of probiotics on FPG, insulin, and insulin resistance were more obvious among GDM and healthy women than among overweight/obese women. Furthermore, the differences were not significant in HbA1c (MD = −0.05; 95% CI = −0.12 to 0.03; P = 0.23 ), 1 h OGTT (MD = −0.07; 95% CI = −0.25 to 0.10; P = 0.42 ), and 2 h OGTT (MD = −0.03; 95% CI = −0.17 to 0.12; P = 0.72 ). Conclusion. This review found that probiotic supplements had certain functions to reduce the level of FPG and improve insulin, insulin resistance, and insulin sensitivity, especially for GDM and healthy pregnant women.
Background The evaluation of mothers’ breastfeeding behaviour within 6 weeks postpartum could help health workers comprehensively identify maternal breastfeeding shortcomings, clarify nursing problems, and provide targeted interventions. However, no prior study was found, therefore this study aimed to develop and validate the reliability and validity of the mothers’ breastfeeding behaviour scale within 6 weeks postpartum. Methods A main two-step approach was used: (1) a qualitative pilot study using the purposive sampling method was adopted to test the fitness, simplicity, and clarity of items with 30 mothers; (2) a cross-sectional survey using the convenient sampling method was conducted for item analysis and psychometric validation with 600 mothers. Results The final version of the scale consisted of 36 items with seven dimensions, explaining 68.852% of the total variance. The Cronbach’s α, split-half, and retest coefficients were 0.958, 0.843, and 0.753, respectively. The validity of the scale: (1) Content validity: content validity index (CVI) range of items was between 0.882 and 1.000. The scale-level-CVI was 0.990. (2) Structure validity: The fitting indices were as follows: χ2/ⅆf =2.239, RMR = 0.049, RMSEA = 0.069, TLI = 0.893, CFI = 0.903, IFI = 0.904, PGFI = 0.674, and PNFI = 0.763. (3) Convergent validity: The composite reliability and average variance extracted (AVE) of the seven dimensions were between 0.876 and 0.920 and between 0.594 and 0.696. (4) Distinguish validity: The correlation coefficients were less than the square root of the AVE, except for self-decision behaviour, self-coping behaviour, and self-control behaviour. However, the fit index of the original three-factor model was better than that of the other new models, with significant differences (P < 0.001). (5) Calibration validity: The area under the curve was 0.860 or 0.898 when the scale was used to predict exclusive or any breastfeeding at 42 days. The correlation coefficients of the maternal breasting feeding evaluation scale, breastfeeding self-efficacy short-form scale, and the scale were 0.569 and 0.674, respectively. Conclusion The newly developed mothers’ breastfeeding behaviour scale within 6 weeks postpartum consists of 36 items belonging to seven dimensions with good reliability and validity and is a reliable and valid instrument to be used in future maternal breastfeeding behaviour assessments and interventions.
Background: The evaluation of mothers' breastfeeding behavior within six weeks postpartum could help health workers to identify maternal breastfeeding shortcomings comprehensively, clarify nursing problems, and provide targeted interventions. However, no prior study was found and the study aimed to develop and validate the reliability and validity of mothers' breastfeeding behavior scale within six weeks postpartum.Methods: The main two-step approach was used: (1) A qualitative pilot study using the purposive sampling method was adopted to test fitness, simplicity, and clarity of items with 30 mothers; (2) A cross-sectional survey using the convenient sampling method was conducted for item analysis and psychometric validation with 600 mothers.Results: The final version of the scale consisted of 36 items with seven dimensions, explaining 68.852% of the total variance. The Cronbach's α, split-half, and re-test coefficients were 0.958, 0.843, and 0.753, respectively. The validity of the scale: (1) Content validity: The content validity indexes (CVI) range of items were between 0.882 and 1.000. The scale-level-CVI was 0.990. (2) Structure validity: The fitting index were as follows: =2.239, RMR=0.049, RMSEA=0.069, TLI=0.893, CFI=0.903, IFI=0.904, PGFI=0.674, PNFI=0.763. (3) Convergent validity: The composite reliability and Average Variance Extraction (AVE) of 7 dimensions were between 0.876 and 0.920, 0.594 and 0.696. (4) Distinguish validity: The correlation coefficients were less than the square root of the AVE, excepting self-decision behavior, self-coping behavior, and self-control behavior. However, the fitting index of the original three-factor model was better than other new models with significant differences (P<0.001). (5) Calibration validity: The area under the curve was 0.860 or 0.898 when the scale was used to predict exclusive or any breastfeeding at 42 days. The correlation coefficient of maternal breasting feeding evaluation scale, breastfeeding self-efficacy short-form scale, and the scale were 0.569 and 0.674.Conclusion: The newly developed mothers' breastfeeding behavior scale within six weeks postpartum consists of thirty-six items belonging to seven dimensions with good reliabilities and validities, a reliable and valid instrument to be used in future maternal breastfeeding behavior assessments and interventions.
Background The evaluation of mothers' breastfeeding behavior within six weeks postpartum could help health workers to identify maternal breastfeeding shortcomings comprehensively, clarify nursing problems, and provide targeted interventions. However, no prior study was found and the study aimed to develop and validate the reliability and validity of mothers' breastfeeding behavior scale within six weeks postpartum. Methods The main two-step approach was used: (1) A qualitative pilot study using the purposive sampling method was adopted to test fitness, simplicity, and clarity of items with 30 mothers; (2) A cross-sectional survey using the convenient sampling method was conducted for item analysis and psychometric validation with 600 mothers. Results The final version of the scale consisted of 36 items with seven dimensions, explaining 68.852% of the total variance. The Cronbach's α, split-half, and re-test coefficients were 0.958, 0.843, and 0.753, respectively. The validity of the scale: (1) Content validity: The content validity indexes (CVI) range of items were between 0.882 and 1.000. The scale-level-CVI was 0.990. (2) Structure validity: The fitting index were as follows: \({\chi }^{2}/df\)=2.239, RMR=0.049, RMSEA=0.069, TLI=0.893, CFI=0.903, IFI=0.904, PGFI=0.674, PNFI=0.763. (3) Convergent validity: The composite reliability and Average Variance Extraction (AVE) of 7 dimensions were between 0.876 and 0.920, 0.594 and 0.696. (4) Distinguish validity: The correlation coefficients were less than the square root of the AVE, excepting self-decision behavior, self-coping behavior, and self-control behavior. However, the fitting index of the original three-factor model was better than other new models with significant differences (P<0.001). (5) Calibration validity: The area under the curve was 0.860 or 0.898 when the scale was used to predict exclusive or any breastfeeding at 42 days. The correlation coefficient of maternal breasting feeding evaluation scale, breastfeeding self-efficacy short-form scale, and the scale were 0.569 and 0.674. Conclusion The newly developed mothers' breastfeeding behavior scale within six weeks postpartum consists of thirty-six items belonging to seven dimensions with good reliabilities and validities, a reliable and valid instrument to be used in future maternal breastfeeding behavior assessments and interventions.
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