Quality of life in pregnancy and post-partum: a study in diabetic patients
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- Dalfrà, M.G., Nicolucci, A., Bisson, T. et al. Qual Life Res (2012) 21: 291. doi:10.1007/s11136-011-9940-5
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We evaluated quality of life in pregnant women with diabetes followed up at Italian diabetes clinics.
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.
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.
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.