IntroductionRisk of developing type 2 diabetes is increased in women with previous gestational diabetes mellitus (GDM). Postpartum glycemic screening is recommended in women with recent GDM. But this screening rate is low and the reasons are unclear. The aim of this study was to explore the experiences of Iranian women with recent GDM on barriers of postpartum screening for diabetes.MethodsThis qualitative study was conducted in Tehran, Iran in 2016. Semi-structured interview was used for data collection. 22 women with recent GDM were interviewed. These women gave birth in Tehran hospitals at a minimum of 6 months before interview. The missed screening defined as not attending to laboratory for Fasting Blood Sugar and/or Oral Glucose Tolerance Test, 6 week to 6 month after their child birthing. The data was analyzed by content analysis method.ResultsThemes and sub-themes that illustrated the barriers to postpartum diabetes screening were: inadequate education (about developing diabetes in the future, implementation of the screening, and glucometer validity in diagnosis of diabetes), perceiving the screening as difficult (feeling comfortable with the glucometer, poor laboratory conditions, issues related to the baby/babies, and financial problems), improper attitudes toward the screening (unwilling to get diagnosed, not giving priority to oneself, having false beliefs) and procrastination (gap to intention and action, self-deception and self-regulation failure).ConclusionWomen with recent GDM reported several barriers for postpartum diabetes screening. This study help to develop the evidence-based interventions for improving this screening rate.

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Background: Women with previous gestational diabetes mellitus (GDM) are at elevated risk for developing Type 2 diabetes. Despite the recommendation for postpartum diabetes screening for these women, the rate of screening is low. Objectives: The present study aimed at conducting an in-depth exploration of the experiences of Iranian women with recent GDM in the process of diabetes screening. Methods: This grounded theory qualitative study was conducted in Tehran, Iran, from 2013 to 2016. In this study, 22 women with recent GDM, who gave birth at least 6 months before the interview, were selected by purposeful sampling method; then, to achieve saturation, the participants were followed using theoretical sampling method. The participants were asked about their postpartum experiences, specially about the process of attendance/not attendance in diabetes screening at 6 weeks to 6 months after child birth, using semi-structured interviews. Data were analyzed using Corbin and Strauss method (2008). Results: Three main categories were extracted as postpartum diabetes screening process in women with a recent GDM: to be aware, to be sensitive, and to perceive severity of the threat. Also, the outcomes have been classified into 4 levels: selective screening, accidental screening, primary lack of screening, and secondary lack of screening. In our study, the participants had a range of procrastination in screening, from no procrastination in selective screening to high procrastination in secondary lack of screening. Sometimes, the participants had the intention to be screened but they took no action, did not do the screening due to self-deception, or perceived screening as lacking immediate reward (3 main features of procrastination). Thus, due to procrastination, they did not do the screening. Screening in the range of procrastination, as the core category, was the most obvious concept that implicitly existed in all the data. Conclusions: Even when sensitivity and perceiving a threat about diabetes were activated in women with recent GDM, they did not undertake screening due to procrastination. Procrastination is an important and missed factor in screening. Conducting further studies is recommended to develop evidence-based strategies to decrease women's procrastination in screening.

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Background: Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI). Methods: This was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R).Results: Analysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P<0.001) and in the mean score of GSI between the groups with varying degrees of depression (P=0.01) and anxiety (P<0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score.Conclusion: Various factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses.