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妊娠期和产后生活质量:糖尿病患者的研究。

Quality of life in pregnancy and post-partum: a study in diabetic patients.

机构信息

DPT Scienze Mediche e Chirurgiche, Università di Padova, Via Giustiniani 2, 35128, Padova, Italy.

出版信息

Qual Life Res. 2012 Mar;21(2):291-8. doi: 10.1007/s11136-011-9940-5. Epub 2011 Jun 2.

DOI:10.1007/s11136-011-9940-5
PMID:21633879
Abstract

PURPOSE

We evaluated quality of life in pregnant women with diabetes followed up at Italian diabetes clinics.

METHODS

A total of 245 pregnant women (30 type 1 diabetes mellitus (T1DM), 176 gestational diabetes (GDM) and 39 controls) were asked to fill in a questionnaire including the SF-36 Health Survey and the Center for Epidemiological Studies-Depression (CES-D) Scale in third trimester of pregnancy and after delivery. GDM and T1DM also completed two diabetes-specific questionnaires (Diabetes-related stress and Diabetes health distress). Quality of life scores were compared between the groups with the Mann-Whitney U-test, mean changes in scores (after delivery to 3rd trimester) were compared between groups by ANCOVA.

RESULTS

Regarding the SF-36 scores in the third trimester of pregnancy, T1DM and GDM women had a better Standardised Physical Component score than controls (P < 0.0001, P = 0.009, respectively). GDM and T1DM pregnant women scored significantly lower for general health perception than controls (P = 0.009 and P = 0.001, respectively). T1DM patients had lower Standardised Mental Component scores than controls (P = 0.03). Compared with the third trimester of pregnancy, the severity of depressive symptoms increased significantly after delivery in both diabetic groups, but not in controls (P < 0.0001). Scores improved in all SF-36 areas in healthy and GDM women, while they all became worse in the T1DM group.

CONCLUSIONS

Pregnancy is associated with a perception of poor general health in women with both T1DM and GDM. After delivery, significantly worse depressive symptoms were documented in both groups, while a generally worse physical and psychological well-being was only identified in women with T1DM. These findings have important implications for pregnancy follow-up.

摘要

目的

我们评估了在意大利糖尿病诊所接受随访的妊娠糖尿病患者的生活质量。

方法

共有 245 名孕妇(30 名 1 型糖尿病患者(T1DM)、176 名妊娠糖尿病患者(GDM)和 39 名对照组)在妊娠晚期和产后填写了一份问卷,其中包括 SF-36 健康调查和中心流行病学研究-抑郁量表(CES-D)。GDM 和 T1DM 还完成了两份糖尿病特异性问卷(糖尿病相关压力和糖尿病健康困扰)。使用 Mann-Whitney U 检验比较各组的生活质量评分,使用协方差分析比较组间产后至妊娠晚期的评分变化。

结果

在妊娠晚期,T1DM 和 GDM 女性的 SF-36 评分标准生理成分评分均优于对照组(P<0.0001,P=0.009)。GDM 和 T1DM 孕妇的总体健康感知评分明显低于对照组(P=0.009 和 P=0.001)。T1DM 患者的标准心理成分评分低于对照组(P=0.03)。与妊娠晚期相比,产后两组糖尿病患者的抑郁症状严重程度均显著增加,但对照组无此变化(P<0.0001)。健康孕妇和 GDM 孕妇的所有 SF-36 领域评分均有所改善,而 T1DM 组的所有评分均恶化。

结论

妊娠会导致 T1DM 和 GDM 女性对一般健康状况的感知较差。产后,两组的抑郁症状均明显恶化,而 T1DM 女性的身体和心理健康状况普遍恶化。这些发现对妊娠随访具有重要意义。

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