The stigma associated with gestational diabetes mellitus: A scoping review

Davidsen, Emma; Maindal, Helle Terkildsen; Rod, Morten Hulvej; Olesen, Kasper; Byrne, Molly; Damm, Peter; Nielsen, Karoline Kragelund

doi:10.1016/j.eclinm.2022.101614

Cited by 22 publications

(13 citation statements)

References 66 publications

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“…Several qualitative studies have documented that women with GDM may experience internalised stigma. 12 Our study suggests that the media may be a source in facilitating this. In addition, the articles included in our study frequently used the term ‘sugar disease’ synonymously with diabetes.…”

Section: Discussionmentioning

confidence: 74%

Maternal responsibility and omission of complexity: an exploration of the portrayal of gestational diabetes mellitus in Danish written media

Eskildsen,

Davidsen,

Sørensen

et al. 2024

BMJ Open

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ObjectivesGestational diabetes mellitus (GDM) has implications for the future health of both mother and offspring, and there is a risk that mothers are held responsible and blamed for their own and their offspring’s long-term health. The media plays a significant role in shaping public perceptions of health. Therefore, our study aimed to investigate how GDM and women with GDM are portrayed in Danish written media.DesignWe identified written newspaper articles reporting on GDM from 2018 to 2019 and analysed them using thematic network analysis and elements from critical discourse analysis.ResultsIn total, 130 articles were included in the analysis. Four themes emerged: (1) ways of introducing GDM, (2) descriptions of causes and prevention of GDM, (3) descriptions of consequences of GDM and (4) value-laden descriptions of GDM. GDM was often mentioned in relation to other conditions or factors and with lack of differentiation. Maternal responsibility was emphasised via oversimplified descriptions of causal relations, descriptions of individual agency and no emphasis on structural causes and preventive measures. GDM was positioned as resulting in ‘bad pregnancies’ using value-laden wordings.ConclusionWe identified various aspects of how GDM is portrayed in written media. The findings signal the importance of clear, nuanced and respectful communication on GDM, including conveying the complexity of the condition and the role of structural factors.

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Section: Discussionmentioning

confidence: 74%

Maternal responsibility and omission of complexity: an exploration of the portrayal of gestational diabetes mellitus in Danish written media

Eskildsen,

Davidsen,

Sørensen

et al. 2024

BMJ Open

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“…Another explanation for the finding of lower prepregnancy BMI could be related to stigma. Women with GDM may experience stigma associated with the GDM diagnosis and/or weight 47. Additionally, the finding that women with multiparity, preterm delivery, and multiple delivery were less represented may be explained by higher level of strain, thus less surplus of energy to prioritize participation.…”

Section: Discussionmentioning

confidence: 99%

Health promotion intervention among women with recent gestational diabetes mellitus: penetration, participation, and baseline findings from the Face-it randomized controlled trial

Jensen,

Kragelund Nielsen,

Dahl-Petersen

et al. 2023

BMJ Open Diab Res Care

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IntroductionFace-it is a randomized controlled trial for women with recent gestational diabetes mellitus (GDM) and their families designed to evaluate the effect of a health promotion intervention on type 2 diabetes mellitus (T2DM) risk and quality of life. This study examined (1) the penetration and participation rates for the Face-it trial, (2) the characteristics of the participating women and the potential differences in characteristics according to partner participation status, and (3) representativity of the women at baseline.Research design and methodsWe identified women with GDM during pregnancy and invited them and their partners to a baseline examination 10–14 weeks after delivery. Representativity was assessed by comparing the baseline participants with non-participating women, the general population of women with GDM delivering in Denmark, and populations from other intervention trials.ResultsThe penetration rate was 38.0% (867/2279) and the participation rate was 32.9% (285/867). The 285 women who attended baseline had a mean age of 32.7 (±4.8) years and body mass index (BMI) of 28.1 (±5.4) kg/m2, and 69.8% had a partner who participated. The women participating with a partner were more often primiparous, born in Denmark (82.8% vs 68.2%), were younger, and more often had a BMI ≤24.9 kg/m2(35.7% vs 21.2%) compared with women without a partner. Compared with the general population of women with GDM in Denmark, these women broadly had similar degree of heterogeneity, but had higher rates of primiparity and singleton deliveries, and lower rates of preterm delivery and prepregnancy obesity.ConclusionsThe penetration and participation rates were acceptable. We found a high rate of partner participation. Overall, women participating with a partner were comparable with those participating without a partner. Participating women were broadly similar to the general national GDM population, however with prepregnancy obesity, multiparity, preterm delivery, and multiple pregnancy being less represented.Trial registration numberNCT03997773.

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“…Notably, they highlighted evidence of increased allostatic load markers and longer lengths of exposure to discrimination based on exposure increased one's likelihood of adverse birth outcomes. Those who have gestational diabetes mellitus have reported stigma when seeking healthcare but also with their friends and families (Davidsen et al, 2022). Davidsen et al found that the experience of stigma for those with gestational diabetes mellitus was similar to that of those who experience weight stigma.…”

Section: Discussionmentioning

confidence: 99%

“…Experiencing stigma and discrimination affected these patients by leading to increased levels of chronic stress, poor cardiometabolic outcomes, and increased risk of other adverse health outcomes. Additionally, those who experienced weight stigma felt discouraged to attend healthcare appointments (Davidsen et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

The association of racism and discrimination in disparities of hypertensive disorders of pregnancy: an analysis of PRAMS data

Lee

Pellowski

Brayboy

et al. 2022

Preprint

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Background: Hypertensive disorders of pregnancy are a leading cause of maternal mortality. Racial disparities in maternal mortality in the United States are well-documented, but the role of racism and/or discrimination in affecting one’s risk of developing a hypertensive disorder of pregnancy is not well-studied. Methods: Data from 17 sites that asked questions regarding experiences with racism and/or discrimination during pregnancy via the Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 (2016-2020) from was used. Regression models were used to estimate odds of hypertensive disorder diagnosis in pregnancy using adjusted models controlling for cofounders: biological risk factors, socioeconomic factors, and experiences of racism and/or discrimination. Results: Among participants with live births (N = 69,751), 14.9% of participants stated they were diagnosed with hypertension during pregnancy with non-Hispanic and Hispanic Black individuals having the highest rates (19.8%). 13.1% of participants experienced racism and 15.6% of participants experienced discrimination. Experiencing racism or discrimination increased one’s odds of having hypertension during pregnancy by 1.14 times (CI: 1.00 - 1.31) and 1.30 times (CI: 1.02 - 1.65), respectively. When experiences with discrimination were included, non-Hispanic and Hispanic Black individuals did not have statistically significantly higher odds of having hypertension during pregnancy compared to non-Hispanic White individuals. Conclusions: Experiences of racism and/or discrimination drive racial disparities in hypertensive disorders in pregnancy. Public Health Implications: It is vital to eliminate racist and discriminatory practices in healthcare to reduce maternal morbidity and mortality.

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The stigma associated with gestational diabetes mellitus: A scoping review

Cited by 22 publications

References 66 publications

Maternal responsibility and omission of complexity: an exploration of the portrayal of gestational diabetes mellitus in Danish written media

Maternal responsibility and omission of complexity: an exploration of the portrayal of gestational diabetes mellitus in Danish written media

Health promotion intervention among women with recent gestational diabetes mellitus: penetration, participation, and baseline findings from the Face-it randomized controlled trial

The association of racism and discrimination in disparities of hypertensive disorders of pregnancy: an analysis of PRAMS data

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