Puerperium experience and lifestyle in women with gestational diabetes mellitus and overweight/obesity in China: A qualitative study

Abstract

IntroductionWomen with overweight or obesity and gestational diabetes mellitus (GDM) are at a high risk of developing type 2 diabetes mellitus (T2DM) and other metabolic diseases. Healthy postpartum lifestyles in women with GDM are important for effectively preventing early T2DM occurrence; however, few studies and guidelines focus in China on this issue.AimsThis qualitative study aimed to understand the puerperium experience and lifestyle of women with overweight/obesity and GDM.MethodsA face-to-face, in-depth, and semi-structured interview was conducted using a hermeneutical phenomenology method to collect data that were analyzed through thematic analysis.ResultsOut of 61 recruited women with overweight/obesity and history of GDM, 14 women underwent an interview and provided detailed descriptions of their lifestyle experiences during puerperium. The interview data were used to generate four themes—puerperium dietary behavior, weight perception and “confinement” behavior, family support, disease knowledge, and perceived risk—and nine sub-themes.ConclusionUnhealthy lifestyles, misconceptions about food, the conflict between physical activity and confinement behavior, a lack of social and family support, and low awareness of disease risk are all common among overweight/obese women with a history of GDM. Thus, we emphasized that healthcare providers should provide continuous preventive care from pregnancy to postpartum and promote long-term health in high-risk populations with a history of GDM associated with overweight/obesity.

Effect of dietary and physical activity behavioral interventions on reducing postpartum weight retention among women with recent gestational diabetes: A systematic review and meta‐analysis of randomized controlled trials

“…In contrast to women with GDM who are treated and managed intensely for GDM during pregnancy, the postpartum period presents a sense of abandonment. 47,48 In many countries, women with a history of GDM do not receive ongoing care to support T2DM prevention after delivery. Maintaining healthy behaviors, weight management experience, and reducing the incidence of obesity in women with GDM require the cooperation of women and various sectors of society.…”

“…In contrast to women with GDM who are treated and managed intensely for GDM during pregnancy, the postpartum period presents a sense of abandonment 47,48 . In many countries, women with a history of GDM do not receive ongoing care to support T2DM prevention after delivery.…”

Effects of women with gestational diabetes mellitus related weight gain on pregnancy outcomes and its experiences in weight management programs: a mixed-methods systematic review

“…Moreover, women with GDM have both positive and negative experiences and perceptions of weight management, which are important influencing factors of weight management. The main motivators for women with GDM to achieve self-weight management are infant health and well-being (13,42). Recommendations for weight management/lifestyle changes that are unrealistic or difficult to implement can increase the adversely affected relationships of women with GDM and healthcare providers and exacerbate their weight stigma, especially for women with obesity (43,44).…”

Dose-Response Relationship between Gestational Weight Gain and Neonatal Birthweight in Chinese Women with Excess Weight/Obesity and Gestational Diabetes Mellitus

“…Studies discovered, however, that women with GDM and pre-pregnancy obesity were more likely to exceed the IOM’s suggested criteria [ 16 , 17 ]. Furthermore, studies have revealed that the total GWG of women with GDM is below the IOM recommendations value can reduce adverse pregnancy outcomes, and are favorable to postpartum metabolism [ 18 , 19 ].…”

“…GWG has been identified as a strong and potentially controllable predictor of short-and long-term health outcomes in women and infants with GDM, increasing the risk of LGA and macrosomia [ 18 , 19 ]. Mustaniemi et al reported that GDM, obesity, and excess GWG are associated with a higher risk of LGA in infants, and interventions targeting normal GWG are also likely to reduce LGA rates and birthweight standard deviation scores [ 20 ].…”