Abstract
BackgroundGestational diabetes mellitus (GDM) contributes to the epidemic of diabetes and obesity in mothers and their offspring. The primary objective of this pilot study was to: 1) refine the GDM Management System (GooDMomS), a web-based pregnancy and postpartum behavioral intervention and 2) assess the feasibility of the intervention.MethodsIn phase 1, ten semi-structured interviews were conducted with women experiencing current or recent GDM mellitus GDM to garner pilot data on the web based intervention interface, content, and to solicit recommendations from women about refinements to enhance the GooDMomS intervention site. Interviews were audiotaped, transcribed and independently reviewed to identify major themes with Atlas.ti v7.0. In phase 2, a single-arm feasibility study was conducted and 23 participants were enrolled in the GooDMomS program. Participants received web lessons, self-tracking of weight and glucose, automated feedback and access to a message board for peer support. The primary outcome was feasibility, including recruitment and retention and acceptability. Secondary outcomes included the proportion of women whose gestational weight gain (GWG) was within the Institute of Medicine (IOM) guidelines and who were able to return to their pre-pregnancy weight after delivery.ResultsComments from semi-structured interviews focused on: 1) usability of the on-line self-monitoring diary and tracking system, 2) access to a safe, reliable social network for peer support and 3) ability of prenatal clinicians to access the on-line diary for clinical management. Overall, 21 (91 %) completed the pregnancy phase. 15/21 (71 %) of participants were within the Institute of Medicine (IOM) guidelines for GWG. Sixteen (70 %) completed the postpartum phase. 7/16 (43 %) and 9/16 (56 %) of participants returned to their pre-pregnancy weight at 6 and 30 weeks postpartum, respectively.ConclusionsThis study documents the feasibility of the GooDMomS program. The results can have implications for web technology in perinatal care and inform the current care paradigm for women with GDM. Findings are supportive of further research with recruitment of a larger sample of participants and comparison of the outcomes with the intervention and standard care.Trial registrationThe study was registered at ClinicalTrials.gov on May 15, 2012 under protocol no. NCT01600534.
Highlights
Gestational diabetes mellitus (GDM) contributes to the epidemic of diabetes and obesity in mothers and their offspring
We proposed a novel intervention that begins in pregnancy at the time of GDM diagnosis and extends seamlessly into the postpartum period and has both pregnancy and postpartum-specific maternal and fetal outcomes
Our results show that a web-based, pregnancy and postpartum behavioral intervention for women with GDM is feasible
Summary
Gestational diabetes mellitus (GDM) contributes to the epidemic of diabetes and obesity in mothers and their offspring. Gestational diabetes mellitus (GDM) is part of an endocrine and reproductive cycle that contributes to the epidemic of diabetes and obesity across generations. The expectant mother with GDM is at greater risk for longterm obesity, overt diabetes [1,2] and the metabolic syndrome [3]. Evidence from earlier studies of prenatal nutrition counseling [4], or late prenatal [5] or postpartum [5,6] curricula to prevent postpartum weight retention suggest that women with GDM can benefit from short-term interventions. The Diabetes Prevention Program (DPP) [7] included women with histories of GDM [8], but they were remote from diagnosis at the time of enrollment
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