Factors affecting the quality of life in women with gestational diabetes mellitus: a path analysis model

Abstract

Background: Quality of life (QoL) is the most important indicator for assessing the status of health care in chronic diseases. The present study aimed to determine the pathway determinants model of QoL in patients with gestational diabetes mellitus (GDM). Methods: This cross-sectional study was conducted on 329 women with GM referred to health care centers in Qom, Iran during 2018. Convenience sampling methods was used. Inclusion criteria were: afflicted by GM and received pregnancy care services from health center. Several questionnaires (Knowledge, attitude, self-efficacy (SE), social support (SS), pregnancy distress, self-management(SM) and QoL) were used for data collection. Data were analyzed with SPSS-21 and Lisrel-8.8 software using statistical path analysis. Results: The mean age of participants was 30.93 ± 5.42 years. The final path model fitted well (CFI =1, RMSEA = 0.0003) and showed that, only age variable from both direct and indirect path had an impact on QoL (B = 0.51). Among variables that directly affected the QoL, SS had the highest effect (B = 1.02) and SE (B = 0.01) had the lowest effect. In the indirect path, only the knowledge variable by affecting the SE had an impact on the QoL (B = 0.0045). Conclusion: SS had the greatest impact on the QoL. Obviously, providing all the requirements to support patients can help them overcome problems and improve their QoL. Distress negatively affects the QoL through SM and it should be noticed in interventional studies.

The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

“…Despite the wide range of endorsements and guidelines for the diagnosis of GDM in pregnant women recommended by international societies [1,13,[69][70][71][72][73][74], there is a strong controversy over the definition of GDM including advice on selective approaches such as universal or risk-based screening, the optimal time for screening in the first and second trimesters, appropriate screening method or criteria for diagnosis, and proper threshold values. Furthermore, there are ongoing debates concerning the risk of adverse pregnancy outcomes and the cost-effectiveness of different screening or diagnostic strategies.…”

Perspectives on the psychological and emotional burden of having gestational diabetes amongst low-income women in Cape Town, South Africa

“…Interestingly, women with GDM in an Italian study reportedly experienced a better quality of life, compared to pregnant women without GDM [ 7 ] as a result of the improved health behaviours. Considering that among low-income women in South Africa, the experience of at least one stressful event can impact on maternal mental health [ 25 ], risk surveillance for mental health disorders, close monitoring and tailored programmes to reduce perceived emotional distress may have benefits for the overall well-being of women with GDM [ 10 , 11 , 16 , 19 ].…”

“…There is an expectation of women diagnosed with GDM to make considerable adjustments to their health behaviour with little recognition of or sensitivity from the medical and social environment to the multiple barriers they face in changing these behaviours. For low-income women like those represented in our sample, the nature of the physical and social environment, availability and access to healthy affordable food and the extent of social support from partners and family all profoundly influence women's capacity for lifestyle change and adherence to clinical recommendations [10,22,32,33,43]. Yet, women in our study and others report feeling that they are held primarily accountable for the health of their unborn child and that any pregnancy complications or adverse outcomes are perceived both by themselves and others as reproductive or maternal failure [22,33,44].…”

“…Women with GDM face increased risk of maternal, foetal and perinatal complications and have a significantly increased risk of developing type 2 diabetes [4,5]. GDM may also have a negative impact on women's mental wellbeing, functioning and quality of life [6][7][8][9][10]. The sparse literature on GDM and mental health suggests that the diagnosis of GDM is a risk factor for anxiety and stress during pregnancy [11][12][13][14], antenatal [15] and postpartum depression [16,17], with potentially negative effects on treatment adherence [8,9,18].…”

Gestational Diabetes Mellitus: A Harbinger of the Vicious Cycle of Diabetes

“…Based on observational studies, many women diagnosed with GDM are unaware of the risk factors and complications of their diagnosis [ 107 , 108 , 109 ]. A study in Finland reported that there was an inverse relationship between socioeconomic status and GDM [ 110 ].…”