Changes in health status experienced by women with gestational diabetes and pregnancy-induced hypertensive disorders.
ABSTRACT To examine changes in health status among women with gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH).
We examined perceived health status changes from the prepregnancy, as recalled at 12-20 weeks gestation, to the postpartum period in women with GDM (n = 64) vs. unaffected gravidas (n = 1233) and women diagnosed with PIH (n = 148) vs. unaffected gravidas. We used patient survey and medical record data from a prospective cohort study. Health status measures included the Short Form-36 scales for physical function, vitality, and self-rated health and the Center for Epidemiologic Studies-Depression Scale (CES-D). Multivariate logistic regression models controlled for age, parity, race, education, prepregnancy body mass index (BMI) and exercise levels, food insufficiency, and GDM or PIH during a prior pregnancy.
Women with PIH more often reported a significant decline in vitality (odds ratio [OR] 1.51, 95% confidence interval [CI] 1.02-2.23) and self-rated health (OR 2.12, 95% CI 1.19- 3.77) and an increase in depressive symptoms from prepregnancy to postpartum compared with unaffected women (OR 1.84, 95% CI 1.11-3.05). Decline in self-rated health was partially mediated by cesarean birth and preterm delivery. Similar proportions of women with GDM and unaffected women reported declines in health status measures.
Women with PIH, but not GDM, more often experience significant declines in health status from prepregnancy to postpartum than unaffected women.
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ABSTRACT: The concept of primary maternal preoccupation defined by Winnicott constituted the theoretical framework. We assessed the establishment of the mother–child relationship in primiparous women who developed pre‐eclampsia in the final trimester of pregnancy. This qualitative study was based on semi‐structured interviews conducted with 15 women treated at a tertiary referral hospital for high‐risk pregnancy in Brazil, whose babies were 1–4 months old at the time of the interview. For analysis, themes were organised around the principal signs of primary maternal preoccupation and the relationship of the women with their mothers in accordance with the proposed theoretical framework, emerging themes relevant for the comprehension of the data collected concerning the significance of the diagnosis of pre‐eclampsia in women's lives and the importance of the women's social support network. The results showed that all participants referred to signs of primary maternal preoccupation, the importance of the relationship with their own mother as constituting a model of childcare, the relevance of social support, and the difficulties encountered in fully understanding the medical implications of the diagnosis in their lives and in dealing with hospitalisation. In conclusion, despite feeling the effect of the disease on their lives, these women developed a good mother–child relationship.Journal of Reproductive and Infant Psychology 08/2010; 28(3):297-306. DOI:10.1080/02646831003729104 · 0.67 Impact Factor
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ABSTRACT: Many women develop postpartum mental health symptoms, ranging from the maternity blues to clinically diagnosed postpartum depression (PPD). Substantial literature supports an association between depression and type 2 diabetes, but there is limited literature regarding to what extent this relationship pertains to gestational diabetes (GDM) and postpartum depression. Review of the literature regarding GDM and PPD with a particular focus on describing the prevalence of PPD among women who may be at increased risk for GDM, including low-income and ethnic minority groups, was performed. Literature searches were conducted across four databases for studies reporting postpartum mental health outcomes (including postpartum depression, behavioral symptoms, mental disorders, mood, anxiety, quality of life) following a diagnosis of GDM. Studies including subgroups of women with GDM were included if postpartum mental health outcomes were reported. Of the 245 abstracts identified, ten studies were included in the final review. Findings suggest that PPD was high among low-income, ethnic minority women. Additional research is required to understand the complex relationship between GDM and PPD among low-income women, with the ultimate goal of implementing tailored interventions to address their medical and psychiatric needs.Archives of Women s Mental Health 10/2014; DOI:10.1007/s00737-014-0460-5 · 1.96 Impact Factor
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ABSTRACT: Preeclampsia (PE) is a serious life event that can change women's psychological profile. The aim of this study was to evaluate the physical and mental health-related quality of life (HR-QoL) in women after PE and the impact of contributing factors. Ninety-five women who had suffered from PE answered the Short-Form-12 Health Survey on general state of health. Comparison was made with the reference values and among the study cohorts, namely mild (14.7 %), severe (74.7 %) and superimposed PE (10.5 %). Medical parameters were evaluated as additional factors, and age served as covariate. Quality of mental life was significantly worse in all patients (p < 0.01), especially in those after severe PE (p < 0.01) compared to the reference range. These women demonstrated significantly worse results than those affected by the mild form (p = 0.03). Women who had had superimposed PE were neither physically nor mentally impaired compared to the standard population values (p = 0.94 and p = 0.90, respectively). After controlling for medical parameters and age, differences remained statistically significant. Multiparous women scored significantly worse on the mental scale than primiparous (p = 0.02), and pregnant women scored significantly worse than non-pregnant women on the physical level (p = 0.04). This study shows that women who have suffered from severe PE are substantially reduced in their mental quality of life. An extensive medical care including HR-QoL parameters might improve pregnancy outcome.Quality of Life Research 10/2013; DOI:10.1007/s11136-013-0525-3 · 2.86 Impact Factor