Factors Influencing Postpartum Follow-Up for Diabetes Screening in Mothers with a History of Gestational Diabetes Mellitus
Main Article Content
Abstract
Purpose: To examine the influence of parity, attitude towards gestational diabetes, classification of gestational diabetes, social support, service satisfaction, and health insurance on returning for postpartum diabetes screening among mothers with a history of gestational diabetes mellitus.
Design: Predictive research design.
Methods: The study subjects included postpartum mothers diagnosed with gestational diabetes who was admitted after delivery at the postpartum ward in a university hospital, Bangkok. Data were collected using the demographic information questionnaire, the attitude toward gestational diabetes questionnaire, the social support questionnaire, and the satisfaction toward services questionnaire. Descriptive statistics, chi-square test, and binary logistic regression were used to analyze data.
Main findings: The study found that the parity, attitude toward gestational diabetes, classification of gestational diabetes, social support, service satisfaction, and health insurance could together account for 37.3 % (R2 = .37) of the variance explained in the postpartum follow-up screening for diabetes in mothers with gestational diabetes mellitus. The attitude toward gestational diabetes mellitus (OR = 15.67, 95%CI [3.42, 71.86]) and Civil Servant Medical Benefit Scheme (OR = 8.69, 95%CI [1.38, 54.66]) could significantly predict postpartum follow-up screening for diabetes in the mothers (p < .05).
Conclusion and recommendations: The attitude towards gestational diabetes mellitus and Civil Servant Medical Benefit Scheme could predict postpartum follow-up for diabetes screening in mothers with gestational diabetes mellitus. Therefore, positive attitude toward gestational diabetes mellitus should be established among the mothers and promote policies regarding accessibility to health insurance that covers postpartum diabetes screening.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright Notice: Nursing Science Journal of Thailand has exclusive rights to publish and distribute the manuscript and all contents therein. Without the journal’s permission, the dissemination of the manuscript in another journal or online, and the reproduction of the manuscript for non-educational purpose are prohibited.
Disclaimer: The opinion expressed and figures provided in this journal, NSJT, are the sole responsibility of the authors. The editorial board bears no responsibility in this regard.
References
Buchanan TA, Xiang, AH. Gestational diabetes mellitus. J Clin Invest. 2005;115(3):485-91. doi: 10.1172/JCI24531.
Mack LR, Tomich PG. Gestational diabetes: diagnosis, classification, and clinical care. Obstet Gynecol Clin North Am. 2017;44(2):207-17. doi: 10.1016/j.ogc.2017.02.002.
Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. BMJ. 2020;369:m1361. doi: 10.1136/bmj.m1361.
Wong VW, Chong S, Chenn R, Jalaludin B. Factors predicting recurrence of gestational diabetes in a high-risk multi-ethnic population. Aust N Z J Obstet Gynaecol. 2019;59(6):831-6. doi: 10.1111/ajo.12973.
Association Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care. 2021;44 Suppl 1:15-33. doi: 10.2337/dc21-S002.
Castling ZA, Farrell T. An analysis of demographic and pregnancy outcome data to explain non-attendance for postpartum glucose testing in women with gestational diabetes mellitus: Why are patients missing follow-up? Obstet Med. 2019;12(2):85-9. doi: 10.1177/1753495x18797201.
Youngwanichsetha S, Phumdoung S. Factors related to prediabetes among postpartum Thai women with a history of gestational diabetes mellitus. Nurs Health Sci. 2013;15(4):449-53. doi: 10.1111/nhs.12055.
McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15(4):351-77. doi: 10.1177/109019818801500401.
Liu Z-Y, Zhao J-J, Gao L-L, Wang AY. Glucose screening within six months postpartum among Chinese mothers with a history of gestational diabetes mellitus: a prospective cohort study. BMC Pregnancy Childbirth. 2019;19(1):134. doi: 10.1186/s12884-019-2276-9.
Abu Bakar FA, Ismail TAT. Factors associated with postpartum glucose testing following gestational diabetes mellitus. Oman Med J. 2021;36(4):e282. doi: 10.5001/omj.2021.125.
Quaresima P, Visconti F, Chiefari E, Puccio L, Foti DP, Venturella R, et al. Barriers to postpartum glucose intolerance screening in an Italian population. Int J Environ Res Public Health. 2018;15(12):2853. doi: 10.3390/ijerph15122853.
Lake AJ, Neven ACH, Williams A, O'Reilly SL, Hendrieckx C, Morrison M, et al. Barriers to and enablers of type 2 diabetes screening among women with prior gestational diabetes: a systematic review update and qualitative synthesis applying the Theoretical Domains Framework. Diabet Med. 2022;39(4):e14772. doi: 10.1111/dme.14772.
Herrick CJ, Keller MR, Trolard AM, Cooper BP, Olsen MA, Colditz GA. Factors associated with postpartum diabetes screening in women with gestational diabetes and medicaid during pregnancy. Am J Prev Med. 2021;60(2):222-31. doi: 10.1016/j.amepre.2020.08.028.
Paul JC, Fitzpatrick JJ. Postpartum glucose screening among women with gestational diabetes. Appl Nurs Res. 2020;56:151341. doi: 10.1016/j.apnr.2020.151341.
Sunny SH, Malhotra R, Ang SB, Lim CSD, Tan YSA, Soh YMB, et al. Facilitators and barriers to post-partum diabetes screening among mothers with a history of gestational diabetes mellitus–a qualitative study from Singapore. Front Endocrinol (Lausanne). 2020;11:602. doi: 10.3389/fendo.2020.00602.
Rafii F, Rahimparvar SFV, Mehrdad N, Keramat A. Barriers to postpartum screening for type 2 diabetes: a qualitative study of women with previous gestational diabetes. Pan Afr Med J. 2017;26:54. doi: 10.11604/pamj.2017.26.54.11433.
Battarbee AN, Yee LM. Barriers to postpartum follow-up and glucose tolerance testing in women with gestational diabetes mellitus. Am J Perinatol. 2018;35(4):354-60. doi: 10.1055/s-0037-1607284.
Apriani A, Wijayanti, Andhikatias YR, Widyastuti DE. Systematic literature review: Adaptation and psychological changes of pregnant women with diagnosis gestational diabetes mellitus. Gaster Jurnal Kesehatan. 2021;19(2):168-82. doi: 10.30787/gaster.v19i2.714.
Islam B, Islam F, Nyeem MAB, Mannan A, Neaz AA. Knowledge and attitude regarding gestational diabetes mellitus (GDM) among obese pregnant women coming for antenatal checkup at a tertiary care hospital. Int J Chem Stud. 2017;5(5):179-89.
Phalasri A, Phahuwatanakorn W, Ratinthorn A, Predictive factors of anxiety in women with first diagnosed gestational diabetes mellitus. Journal of Nursing and Health Care. 2015;33(2):15-22. (in Thai).
Trakulboonnate N. The satisfaction of out-patient department service in the Princess Mother Navuti Hospital. Journal of The Police Nurses. 2017;9(2):64-74. (in Thai).
Ingol TT, Kue J, Conrey, EJ, Oza-Frank R, Weber MB, Bower JK. Perceived barriers to type 2 diabetes prevention for low-income women with a history of gestational diabetes: a qualitative secondary data analysis. Diabetes Educ. 2020;46(3):271-8. doi: 10.1177/0145721720920255.
Werner EF, Has P, Kanno L, Sullivan A, Clark MA. Barriers to postpartum glucose testing in women with gestational diabetes mellitus. Am J Perinatol. 2019;36(2):212-8. doi: 10.1055/s-0038-1667290.
Roberts SP, Brown SJS, Roberts SH. Women's engagement, views and experiences of postnatal follow-up after gestational diabetes mellitus in pregnancy. Midwifery. 2021;101:103043. doi: 10.1016/j.midw.2021.103043.