Quality of life in pregnancy and post-partum: a study in diabetic patients
Quality of life in pregnancy and post-partum: a study in diabetic patients
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DOI：
10.1007/s11136-011-9940-5
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发表时间：
2012-03-01
影响因子：
3.5
通讯作者：
Lapolla, A.
中科院分区：
文献类型：
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作者：
Dalfra, M. G.;Nicolucci, A.;Lapolla, A.
目的：我们评估在意大利糖尿病诊所随访的糖尿病孕妇的生活质量。方法对245例妊娠期1型糖尿病（T1DM）患者（30例）、妊娠期糖尿病（GDM）患者（176例）和对照组（39例）在妊娠晚期及分娩后填写SF-36健康调查问卷和流行病学研究中心抑郁量表（CES-D）。GDM和T1DM还完成了两份糖尿病特定问卷（糖尿病相关压力和糖尿病健康困扰）。采用Mann-Whitney u检验比较各组间的生活质量评分，采用ANCOVA比较各组间（分娩至妊娠晚期）评分的平均变化。结果妊娠晚期SF-36评分中，T1DM和GDM妇女的标准化身体成分评分高于对照组（P < 0.0001, P = 0.009）。GDM和T1DM孕妇的总体健康感知得分显著低于对照组（分别为P = 0.009和P = 0.001）。T1DM患者的标准化精神成分评分低于对照组（P = 0.03）。与妊娠晚期相比，两组糖尿病患者分娩后抑郁症状的严重程度均显著增加，但对照组无明显差异（P < 0.0001）。健康和GDM女性的SF-36评分均有所提高，而T1DM组的SF-36评分均变差。结论妊娠与T1DM和GDM患者总体健康状况不佳有关。分娩后，两组患者的抑郁症状都明显加重，而只有患有T1DM的女性才会出现普遍加重的生理和心理健康状况。这些发现对妊娠随访具有重要意义。
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.