Biology and health laboratory, Faculty of Sciences, Ibn Tofail University - Kenitra, Morocco.
National School of Public Health, Rabat, Morocco.
Afr J Reprod Health. 2023 May;27(5s):96-109. doi: 10.29063/ajrh2023/v27i5s.12.
Gestational Diabetes Mellitus (GDM) is strongly associated with the future risk of type 2 diabetes mellitus (T2DM). Women with GDM have a 10 times higher risk than women without GDM over a 10-year follow-up period. The objective of this review is to synthesise the existing evidence regarding women's views and experiences of the emotional and practical impact of GDM and its implications for diabetes prevention. Findings will be used to inform the design of interventions to prevent or delay T2DM. A systematic review of qualitative studies was conducted searching PubMed, MEDLINE, Science Direct, Scopus, and PsycINFO, from 2010 to 2021. Studies were eligible if they addressed how women's experiences and perceptions of GDM influenced women's adherence to postpartum follow-up and lifestyle interventions. The Social-Ecological Model guided the data analysis including five levels of influence specific to health behaviour: intrapersonal factors, interpersonal factors, health system organisational factors, public policy and environmental factors, and community factors. We included 31 articles after screening 22 943 citations and 51 full texts. We found that women's role as mother and caregiver is competing with one's own health priority resulting in poor postpartum screening and poor management of eating and physical activity behaviours. A supportive environment including partners, family, peers and health professionals is essential for lifestyle changes. Other environmental factors such as limited financial means or lack of health education were also barriers to adopting a healthy lifestyle. Many factors hinder T2DM postpartum screening and healthy lifestyle behaviours after GDM, yet the postpartum period is an opportunity to improve access to diabetes prevention, care and education. Women's experiences and needs should be considered when designing strategies and interventions to promote healthier lifestyles in this population.
妊娠期糖尿病（GDM）与 2 型糖尿病（T2DM）的未来风险密切相关。在 10 年的随访期间，患有 GDM 的女性发生 T2DM 的风险比没有 GDM 的女性高 10 倍。本综述的目的是综合现有证据，了解女性对 GDM 的情绪和实际影响的看法和经验，以及这些影响对糖尿病预防的意义。研究结果将用于为预防或延迟 T2DM 的干预措施的设计提供信息。从 2010 年到 2021 年，我们对 PubMed、MEDLINE、Science Direct、Scopus 和 PsycINFO 进行了系统的定性研究综述。如果研究探讨了女性对 GDM 的经历和看法如何影响女性对产后随访和生活方式干预的依从性，则这些研究符合入选标准。社会生态模型指导了数据分析，包括与健康行为相关的五个特定影响水平：个体因素、人际因素、卫生系统组织因素、公共政策和环境因素以及社区因素。在筛选了 22943 条引文和 51 篇全文后，我们纳入了 31 篇文章。我们发现，女性作为母亲和照顾者的角色与自己的健康优先事项相冲突，导致产后筛查不佳，饮食和身体活动行为管理不善。一个支持性的环境，包括伴侣、家人、同龄人以及卫生专业人员，对于生活方式的改变是至关重要的。其他环境因素，如有限的经济手段或缺乏健康教育，也是采用健康生活方式的障碍。许多因素阻碍了 GDM 后产后筛查和健康的生活方式行为，但产后时期是改善糖尿病预防、护理和教育机会的机会。在设计策略和干预措施以促进这一人群更健康的生活方式时，应该考虑到女性的经验和需求。
