Abstract
BackgroundA woman with a history of GDM has at least seven-fold increased lifetime risk of developing type 2 diabetes mellitus (T2DM), compared to women who have normoglycemic pregnancies. Postpartum lifestyle modification has been shown to reduce postpartum weight retention and prevent the progression to T2DM. The aim of this study was to explore the postpartum dietary and physical activity-related beliefs and behaviors among women in Singapore who had GDM in their most recent pregnancies.MethodsSemi-structured in-depth interviews were conducted with 14 women, who were up to four months postpartum and had GDM in their most recent pregnancies. Interview data were analyzed using thematic analysis.ResultsThree themes were identified in the analysis: (1) risk perception and knowledge regarding future diabetes, (2) suboptimal diet and physical activity after delivery and (3) factors influencing the postpartum lifestyle.ConclusionsThe study findings provided useful information on the postpartum lifestyle beliefs and behaviors among women with a history of GDM. Most participants had low risk perception of future diabetes and their diet and physical activity after delivery were suboptimal due to various influences. These insights can be used to design tailored materials and programs to support women who have had GDM reduce their risk of developing future T2DM.
Highlights
Gestational diabetes mellitus (GDM) is associated with a higher risk of maternal type 2 diabetes mellitus (T2DM), metabolic syndrome and cardiovascular disease later in life [1, 2]
Studies have shown that many women with a history of GDM have increased caloric intake, suboptimal levels of physical activity, increased post-pregnancy weight and body mass index (BMI) after delivery [9,10,11,12], which increases the risks of postpartum T2DM and prediabetes [13]
Design We chose a qualitative descriptive research design with the use of semi-structured in-depth individual interviews to explore the postpartum dietary and physical activityrelated beliefs and behaviors among women with a history of GDM in Singapore. Though this methodology has been regarded by some researchers as less theoretical compared to other qualitative designs, it proved to be a valuable approach in our study as it allowed the investigators to study the topic in its natural state, remain close to the data, gain an accurate and straight understanding of the participants’ experiences and perceptions on their diet and physical activity at different time points after delivery, and focus on describing the details, without being restricted by conceptual or philosophical assumptions [21,22,23]
Summary
Gestational diabetes mellitus (GDM) is associated with a higher risk of maternal type 2 diabetes mellitus (T2DM), metabolic syndrome and cardiovascular disease later in life [1, 2]. A history of GDM increases a woman’s lifetime risk of developing T2DM by at least seven-fold, compared to women who have normoglycemic pregnancies [3]. Pregnancy is often described as a 'teachable moment' to promote health behavior change as the risk perception of most women may increase during this special phase of life, and they may be more. Studies have shown that many women with a history of GDM have increased caloric intake, suboptimal levels of physical activity, increased post-pregnancy weight and body mass index (BMI) after delivery [9,10,11,12], which increases the risks of postpartum T2DM and prediabetes [13]. A woman with a history of GDM has at least seven-fold increased lifetime risk of developing type 2 diabetes mellitus (T2DM), compared to women who have normoglycemic pregnancies. The aim of this study was to explore the postpartum dietary and physical activity-related beliefs and behaviors among women in Singapore who had GDM in their most recent pregnancies
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