GDM孕妇产后自我管理状况及影响因素分析

Analysis of the postpartum self-management and its related influencing factors of pregnant women with gestational diabetes mellitus

目的:调查分析妊娠期糖尿病(GDM)患者产后自我管理情况及有关影响因素。方法:选取2021年1月-2022年12月本院产科就诊的GDM患者202例临床资料行回顾性分析,应用一般资料问卷、爱丁堡产后抑郁量表(EPDS)、匹兹堡睡眠质量指数问卷(PSQI)、一般自我效能感量表(GSES)、家庭关怀度指数问卷(APGAR)、糖尿病前期自我管理量表对GDM患者进行调查。采用Pearson相关性分析探讨GDM患者产后自我管理情况与EPDS、PSQI、GSES、APGAR评分的关系;多元线性回归分析GDM患者产后自我管理影响因素。结果:共发放202份问卷,回收有效问卷191份,总有效回收率94.6%。191例患者EPDS评分7.92±2.74分,PSQI评分6.28±1.92分,GSES评分24.06±4.75分,APGAR评分7.74±0.86分;糖尿病前期自我管理量表评分93.86±16.37分,得分率为58.7%,产后自我管理情况低水平。单因素分析,不同学历、家庭人均月收入、孕期应用胰岛素、产后血糖状况、对T2DM的风险认知水平GDM患者产后自我管理评分有差异(P<0.05);Pearson相关性分析显示,GDM患者产后自我管理评分与EPDS评分、PSQI评分呈负相关关系,与GSES评分、APGAR评分呈正相关(均P<0.001);多元线性回归分析显示,孕期应用胰岛素、对T2DM的风险认知水平低、GSES评分、APGAR评分可对患者产后自我管理情况产生正向影响,EPDS评分、PSQI评分可对患者产后自我管理情况产生影响。结论:GDM患者产后自我管理情况处于较低水平,影响因素多样,临床应据此采取针对性指导及干预。

Objective:To investigate and analyze the postpartum self-management and its related influencing factors of pregnant women with gestational diabetes mellitus(GDM).Methods:The clinical data of 202 pregnant women with GDM from January 2021 to December 2022 were analyzed retrospectively.The general information questionnaire,Edinburgh Postpartum Depression Scale(EPDS),Pittsburgh Sleep Quality Index Questionnaire(PSQI),General Self-Efficacy Scale(GSES),Family APGAR Index Questionnaire(APGAR),and Prediabetes Self-Management Scale(PSMS)were used to investigate these women.Pearson correlation analysis was used to explore the correlation between the postpartum self-management situation of the women with GDM and their scores of EPDS,PSQI,GSES,and APGAR.Multivariate linear regression analysis was used to observe the influencing factors of the postpartum self-management of the women.Results:A total of 202 questionnaires were delivered,and 191 valid questionnaires were collected,with a total effective returned rate of 94.6%.The scores of EPDS,PSQI,GSES,and APGAR of 191 women were 7.92±2.74 points,6.28±1.92 points,24.06±4.75 points,7.74±0.86 points,respectively.The score of PSMS of the women was 93.86±16.37 points,with the scoring rate of 58.7%.The postpartum self-management of the women was low.Univariate analysis showed that there was significant difference in the postpartum self-management score among the women with different education background,among the women with different family per capita monthly income,among the women with different insulin used situation during pregnancy,among the women with different postpartum blood glucose status,and among the women with different risk cognition level for T2DM(P<0.05).Pearson correlation analysis showed that the postpartum self-management score of the women with GDM was negatively correlated with their EPDS score and PSQI score,and was positively correlated with their GSES score and APGAR score(all P<0.001).Multiple linear regression analysis showed that the insulin used during pregnancy,the low perception level for T2DM risk,the GSES score,and the APGAR score of the women with GDM had positive impacts on their postpartum self-management,while the EPDS score and the PSQI score of the women with GDM had negative impacts on their postpartum self-management.Conclusion:The postpartum self-management level of the pregnant women with GDM is low,and which is impacted by diverse factors.So targeted guidance and intervention should be taken accordingly in clinic.