2型糖尿病女性在孕前、孕期及产后的经历:定性研究的系统综述

Experiences of women with type 2 diabetes during the pre-pregnancy, pregnancy and postpartum periods: A systematic review of qualitative studies.

作者信息

Hopkins Lily, O'Leary Noreen, Burton Aileen, Dyer Eleanor, Flynn Angela C, Gunabalasingam Sowmiya, Heslehurst Nicola, Kyrka Artemis, Lebrett Rivka, Meek Claire L, Schoenaker Danielle A J M, White Sara L, Forde Rita

机构信息

Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

Diabet Med. 2025 Sep;42(9):e70094. doi: 10.1111/dme.70094. Epub 2025 Jul 3.

Abstract

AIM

To explore the experiences of women with type 2 diabetes prior to, during and after pregnancy.

METHODS

Six databases were systematically searched in September 2023. Qualitative studies involving women of childbearing age living with type 2 diabetes in the pre-pregnancy, pregnancy and postpartum periods were included. A thematic synthesis was conducted to inductively generate themes related to the experiences of women with type 2 diabetes. Descriptive themes were mapped to the Socio-Ecological Model to generate analytical themes relating to the personal, interpersonal and organisational level impacts that underlie women's experiences. Study quality was assessed using the CASP checklist for qualitative studies.

RESULTS

Eleven papers from seven countries met the inclusion criteria. Four themes containing six subthemes were generated. At a personal level, women prioritised their desire to plan a family over 'family planning'; however, once pregnant they were fearful for the future health of their children. At the interpersonal level, women reported that their self-efficacy was influenced by family and socio-cultural factors which often lacked diabetes-specific information. At the organisational level, women described a fragmented healthcare system and felt that healthcare professionals' unfamiliarity with the reproductive health needs of women with type 2 diabetes resulted in ineffective integration into their diabetes care.

CONCLUSION

The provision of appropriate care to women with type 2 diabetes prior to and during pregnancy is inadequate, leaving them vulnerable to increased health risks and emotional distress. Innovative ways are needed to embed reproductive healthcare into mainstream diabetes management for women with type 2 diabetes prior to and post-pregnancy.

摘要

目的

探讨2型糖尿病女性在孕前、孕期及产后的经历。

方法

于2023年9月系统检索了六个数据库。纳入了涉及育龄期2型糖尿病女性孕前、孕期及产后阶段的定性研究。进行了主题综合分析,以归纳出与2型糖尿病女性经历相关的主题。将描述性主题映射到社会生态模型,以生成与女性经历背后的个人、人际和组织层面影响相关的分析性主题。使用定性研究的CASP清单评估研究质量。

结果

来自七个国家的11篇论文符合纳入标准。生成了包含六个子主题的四个主题。在个人层面,女性将生育意愿置于“计划生育”之上;然而,一旦怀孕,她们便会担心孩子未来的健康。在人际层面,女性报告称,她们的自我效能感受到家庭和社会文化因素的影响,而这些因素往往缺乏糖尿病相关信息。在组织层面,女性描述了一个碎片化的医疗保健系统,并认为医疗保健专业人员对2型糖尿病女性的生殖健康需求缺乏了解,导致无法有效地将其纳入糖尿病护理。

结论

在孕前和孕期为2型糖尿病女性提供适当护理的工作存在不足,使她们容易面临更高的健康风险和情绪困扰。需要创新方法,将生殖保健纳入孕前和产后2型糖尿病女性的主流糖尿病管理中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb8f/12352727/97ac002e7c6f/DME-42-e70094-g002.jpg

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