Study protocol on risk factors for the diagnosis of gestational diabetes mellitus in different trimesters and their relation to maternal and neonatal outcomes (GDM-RIDMAN)

Abstract

IntroductionGestational diabetes mellitus (GDM) is often associated with adverse pregnancy outcomes. However, the association of risk factors with GDM diagnosis, maternal and neonatal health outcomes is less established when compared with women without GDM. We aim to examine the diagnostic accuracy of the conventional and novel risk factors for a GDM diagnosis and their impact on maternal and neonatal health outcomes.Methods and analysisThis retrospective cohort and nested case–control study at six public health clinics is based on medical records and questionnaire survey of women between 2 and 12 months postpartum. The estimated required sample size is 876 complete records (292 cases, 584 control, at a ratio of 1:2). Oral glucose tolerance test results will be used to identify glucose dysregulation, and maternal and neonatal outcomes include maternal weight gain, pre-eclampsia, polyhydramnios, mode of delivery, preterm or postdate birth, complications in labour, birth weight, gestational age at birth, Apgar score, congenital anomaly, congenital hypothyroidism, neonatal death or stillbirth, hypoglycaemia and hyperbilirubinaemia. Psychosocial measures include the WHO Quality of Life: brief, mother–infant bonding (14-item Postpartum Bonding Questionnaire and 19-item Maternal Postnatal Attachment Scale), anxiety (7-item Generalised Anxiety Disorder), depression (9-item Patient Health Questionnaire) and stress (Perceived Stress Scale symptoms) questionnaires. The comparative incidences of maternal and neonatal health outcomes, the comparative prevalence of the psychosocial outcomes between women with GDM and without GDM, specificity, sensitivity, positive and negative predictive values of the risk factors, separately and combined, will be reported. All GDM risk factors and outcomes will be modelled using multivariable regression analysis and the receiver operating characteristics curve will be reported.Ethics and disseminationThis study was approved by the Malaysia Research and Ethics Committee, Ministry of Health Malaysia. Informed consent will be obtained from all participants. Findings will be submitted for publications in scientific journals.

Applying King's Theory of Goal Attainment combined with FMEA-PDCA quality management tool in Gestational Diabetes Mellitus health education: A randomized controlled trial

“…The Impact of Integrating King's Theory of Goal Attainment with FMEA-PDCA Quality Management Tool on Anxiety Levels of GDM Patients in Health EducationThe application of King's Theory of Goal Attainment combined with the FMEA-PDCA quality management tool in health education for patients with GDM has shown superior effects in reducing anxiety compared to traditional health education methods. The study indicate that this approach can signi cantly lower anxiety levels among GDM patients, consistent with literature(25). The success of this method may be attributed to several factors: rstly, through continuous and consistent health education, researchers immediately assess patient needs, elucidate relevant disease knowledge, and prevent potential issues, thereby formulating personalized educational content and providing compassionate care to alleviate anxiety associated with glycemic control during pregnancy and facilitate disease management.…”