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妊娠期糖尿病对母婴产后结合的影响:东北大学医学巨量数据库母婴三代队列研究的结果。

The effect of gestational diabetes mellitus on postnatal mother-infant bonding: Findings from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

机构信息

Department of Psychological Medicine, King's College London, London, UK.

Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University Sendai, Miyagi, Japan; Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

出版信息

Prev Med. 2024 Oct;187:108101. doi: 10.1016/j.ypmed.2024.108101. Epub 2024 Aug 14.

DOI:10.1016/j.ypmed.2024.108101
PMID:39151806
Abstract

PURPOSE

Gestational diabetes mellitus (GDM) is a common complication of pregnancy and is associated with considerable psychological burden for women. In qualitative research, women with GDM describe increased awareness about their bonding with their infant, potentially resulting from the highly medicalised nature of the condition. The primary aim was to examine quantitatively whether GDM was associated with lower mother-infant bonding in the postnatal period.

METHODS

Data were analysed from 10,419 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017 in Japan. GDM status was collected from hospital records and measured using the oral glucose tolerance test. Mother-infant bonding was assessed using the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) at one-month postpartum, higher scores representing lower bonding. Data were analysed in SAS using multiple regression adjusting for relevant confounders.

RESULTS

GDM did not appear to be associated with worse mother-infant bonding scores at one-month postpartum. There was a non-significant unadjusted trend in the mean mother-infant bonding scores (1.43(SD=1.11) versus (1.75(SD1.71)), and the proportion with bonding disorder (n = 4 (4.12%) versus n = 969 (9.39%)) in the GDM versus non GDM group respectively, indicating higher self-reported bonding in the GDM group. This remained not statistically significant in the adjusted analyses.

CONCLUSIONS

We observed the reverse of our hypothesis, that there was a trend for women with GDM to self-report higher bonding compared to non-GDM women. There is need to replicate this finding in cohorts specifically designed to measure GDM-specific psychological distress.

摘要

目的

妊娠糖尿病(GDM)是一种常见的妊娠并发症,会给女性带来相当大的心理负担。在定性研究中,患有 GDM 的女性表示对她们与婴儿的联系有了更高的认识,这可能是由于该疾病的高度医学化性质所致。主要目的是定量研究 GDM 是否与产后母婴结合力降低有关。

方法

本研究分析了 2013 年至 2017 年期间在日本东北医疗巨型银行项目生育和三代队列研究中参与的 10419 名女性的数据。GDM 状况是从医院记录中收集的,并使用口服葡萄糖耐量试验进行测量。产后一个月使用日本版母婴结合量表(MIBS-J)评估母婴结合情况,得分越高表示结合力越低。数据使用 SAS 进行分析,采用多元回归调整相关混杂因素。

结果

GDM 似乎与产后一个月母婴结合评分较差无关。在未调整的平均母婴结合评分中存在非显著趋势(1.43(SD=1.11)与(1.75(SD1.71)),以及 GDM 组中出现结合障碍的比例(n=4(4.12%)与非 GDM 组 n=969(9.39%)),表明 GDM 组自我报告的结合力更高。在调整分析中,这仍然没有统计学意义。

结论

我们观察到与我们假设相反的结果,即患有 GDM 的女性自我报告的结合力高于非 GDM 女性。有必要在专门设计用于测量 GDM 特异性心理困扰的队列中重复这一发现。

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