Women's experiences of a diagnosis of gestational diabetes mellitus: a systematic review

Louise Eisten Craig, Rebecca Sims, Paul P Glasziou, Rae Louise Thomas

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Abstract

Background: Gestational diabetes mellitus (GDM) - a transitory form of diabetes induced by pregnancy - has
potentially important short and long-term health consequences for both the mother and her baby. There is no
globally agreed definition of GDM, but definition changes have increased the incidence in some countries in recent
years, with some research suggesting minimal clinical improvement in outcomes. The aim of this qualitative systematic
review was to identify the psychosocial experiences a diagnosis of GDM has on women during pregnancy and the
postpartum period.
Methods: We searched CINAHL, EMBASE, MEDLINE and PsycINFO databases for studies that provided qualitative data
on the psychosocial experiences of a diagnosis of GDM on women across any stage of pregnancy and/or the
postpartum period. We appraised the methodological quality of the included studies using the Critical Appraisal Skills
Programme Checklist for Qualitative Studies and used thematic analysis to synthesis the data.
Results: Of 840 studies identified, 41 studies of diverse populations met the selection criteria. The synthesis revealed
eight key themes: initial psychological impact; communicating the diagnosis; knowledge of GDM; risk perception;
management of GDM; burden of GDM; social support; and gaining control. The identified benefits of a GDM diagnosis
were largely behavioural and included an opportunity to make healthy eating changes. The identified harms were
emotional, financial and cultural. Women commented about the added responsibility (eating regimens, appointments),
financial constraints (expensive food, medical bills) and conflicts with their cultural practices (alternative eating, lack of
information about traditional food). Some women reported living in fear of risking the health of their baby and
conducted extreme behaviours such as purging and starving themselves.
Conclusion: A diagnosis of GDM has wide reaching consequences that are common to a diverse group of women.
Threshold cut-offs for blood glucose levels have been determined using the risk of physiological harms to mother and
baby. It may also be advantageous to consider the harms and benefits from a psychosocial and a physiological
perspective. This may avoid unnecessary burden to an already vulnerable population.
Original languageEnglish
Article number76
Number of pages15
JournalBMC Pregnancy and Childbirth
Volume20
Issue number1
DOIs
Publication statusPublished - 7 Feb 2020

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