• Journal of Genetic Medicine
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• 제8권1호
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• pp.71-75
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• 2011

임신성 당뇨 및 조기양막파수를 보인 산모의, 다른 산전 병력 없이 과체중아로 태어난 생후 17일된 남아에서, 분만성 상완 신경총 손상, 선천성근성사경 및 구개열의 병발이 진단 되었다. 동시에 세 질환의 병발이 단순 병발일 수 있으나, 세 질환을 동시에 유발할 수 있는 병인에 의한 것일 수 있으므로, 증례의 분석을 통하여 어머니의 임신성 당뇨에 의하여 이 세 질환의 발생이 가능할 것으로 가정하였다. 모체의고혈당증은 주로 신경능선 조직에서 발생하는 태아구조에 영향을 주는 것으로 알려져 있고, 신경능선 조직에서 분화하는 조직들 중 하나인 구개골의 형성에 영향을 주어 구개열의 발생이 가능할 것으로 보이며, 임신성 당뇨에서 과체중아의 출생 빈도가 증가하므로, 이와 관련된 분만 손상 중 분만성 상완 신경총 손상 및 선천성근성사경의 발생이 가능할 것으로 판단된다. 따라서 임신성 당뇨가 있는 산모의 태아에서 구개열등의 선천성 기형의 위험성이 높으므로 산전 검사 시 유의해야하며, 과체중아에서 분만성 상완 신경총 손상과 선천성근성사경의 위험성이 높으므로 이에 대한 주의와 확인이 필요할 것으로 판단된다. 그러나, 분만성 상완 신경총 손상, 선천성근성사경 및 구개열의 병발이 산모의 임신성 당뇨와 연관된 합병증일 수 있다는 것을 증명하기 위하여 향후 더 많은 증례를 통한 심화된 연구가 필요하다.

• 여성건강간호학회지
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• 제27권2호
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• pp.75-92
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• 2021

Purpose: This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). Methods: The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. Results: Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. Conclusion: Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.

• 대한간호학회지
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• 제54권2호
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• pp.224-236
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• 2024

Purpose: This study aimed to evaluate the effects of a mobile-based breastfeeding promotion program (M-BFGDM) that helps mothers with gestational diabetes. Methods: Forty-seven mothers participated in the study, of whom 22 were in the experimental group and 25 in the control group. To verify the effects, a lag design before and after the non-equivalence control group was used. The data collection for the experimental group was done before and after the intervention. Results: In the results, breastfeeding knowledge showed a significant difference in the interaction between measurement period and group (χ² = 8.14, p = .017), whereas breastfeeding intention did not show a significant difference in the interaction (χ² = 4.73, p = .094). There was no difference in self-efficacy interaction (F = 0.13, p = .856). The breastfeeding method showed no difference in interaction (F = 0.04, p = .952), whereas cross-analysis showed a significant difference in breastfeeding practice rate between the experimental group and the control group at 1 month postpartum (χ² = 7.59, p = .006). Conclusion: A mobile-based breastfeeding promotion program was developed and applied for gestational diabetic mothers, resulting in an increase in breastfeeding knowledge and an improvement in breastfeeding practice rate one month after childbirth. In addition, M-BFGDM managed to create a breastfeeding practice environment with fewer time and place restrictions. A program study that complements motivation is needed to improve breastfeeding in pregnant diabetic mothers in the future.

• Nutrition Research and Practice
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• 제16권1호
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• pp.120-131
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• 2022

BACKGROUND/OBJECTIVES: Low early pregnancy serum 25-hydroxy vitamin D (25[OH]D) levels can increase gestational diabetes mellitus (GDM) risk, although inconsistent findings related to that association have been reported. This study examined the association of serum vitamin D with GDM and the possible influencers on this association. SUBJECTS/METHODS: This study included 259 pregnant women within the Seremban Cohort Study (SECOST). Blood samples at < 14 weeks of gestation were drawn to determine serum 25(OH)D levels. GDM diagnosis was made at 24 to 32 weeks of gestation using a standard procedure. Association between serum vitamin D and GDM was tested using binary logistic regression. RESULTS: Nearly all women (90%) had mild (68.3%) or severe (32.2%) vitamin D deficiency (VDD). Non-GDM women with mild VDD had a significantly higher mean vitamin D intake than GDM women with mild VDD (t = 2.04, p < 0.05). Women with higher early pregnancy serum vitamin D levels had a greater risk of GDM. However, this significant association was only identified among those with a family history of type 2 diabetes mellitus (T2DM) and in women with a body mass index indicating overweight or obese status. CONCLUSIONS: The high prevalence of VDD in this sample of pregnant women underscores the need for effective preventive public health strategies. Further investigation of this unexpected association between serum vitamin D level and GDM risk in predominantly VDD pregnant women and the potential effects of adiposity and family history of T2DM on that association is warranted.

• Clinical and Experimental Pediatrics
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• 제52권2호
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• pp.137-141
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• 2009

Depending on the definition used, between 3% and 10% of live neonates are small for gestational age (SGA). The definition of SGA requires the following: (1) accurate knowledge of gestational age; (2) accurate measurements at birth of weight, length, and head circumference; (3) a cutoff, which has been variably set at the 10th percentile, 3rd percentile, or at less than 2 standard deviation from the mean, and (4) race and ethnicity-specific growth curve. Consensus statements are needed on the management of growth hormone therapy in SGA children, as well as treatment and long-term health outcomes such as impaired cognitive function, increased risk of adult cardiovascular disease, and type 2 diabetes.

• Molecules and Cells
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• 제40권6호
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• pp.434-439
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• 2017

Gestational diabetes mellitus (GDM), one of the common metabolic disorders of pregnancy, leads to functional alterations in various cells including stem cells as well as some abnormalities in fetal development. Perivascular stem cells (PVCs) have gained more attention in recent years, for the treatment of various diseases. However, the effect of GDM on PVC function has not been investigated. In our study, we isolated PVCs from umbilical cord of normal pregnant women and GDM patients and compared their phenotypes and function. There is no significant difference in phenotypic expression, response to bFGF exposure and adipogenic differentiation capacity between normal (N)-PVCs and GDM-PVCs. However, when compared with N-PVCs, early passage GDM-PVCs displayed decreased initial rates of cell yield and proliferation as well as a reduced ability to promote wound closure. These results suggest that maternal metabolic dysregulation during gestation can alter the function of endogenous multipotent stem cells, which may impact their therapeutic effectiveness.

• Nutrition Research and Practice
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• 제10권3호
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• pp.328-335
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• 2016

BACKGROUND/OBJECTIVES: Vitamin D plays an important role in the etiology of gestational diabetes mellitus (GDM). This study evaluated the effect of vitamin D supplementation on metabolic indices and hs-C-reactive protein (CRP) levels in GDM patients. SUBJECTS/METHODS: The study was a randomized, placebo-controlled, double-blinded clinical trial. Seventy-six pregnant women with GDM and gestational age between 24-28 weeks were assigned to receive four oral treatments consisting of 50,000 IU of vitamin $D_3$ (n = 38) or placebo (n = 38) once every 2 weeks for 2 months. Fasting blood glucose (FG), insulin, HbA1c, 25-hydroxyvitamin D, lipid profile, hs-CRP, and homeostasis model assessment-insulin resistance (HOMA-IR) were measured before and after treatment. Independent and paired t-tests were used to determine intra- and intergroup differences, respectively. ANCOVA was used to assess the effects of vitamin D supplementation on biochemical parameters. RESULTS: Compared with the placebo group, in the vitamin D group, the serum level of 25-hydroxyvitamin D increased (19.15 vs. -0.40 ng/ml; P < 0.01) and that of FG (-4.72 vs. 5.27 mg/dl; P = 0.01) as well as HbA1c (-0.18% vs. 0.17%; P = 0.02) decreased. Improvements in the lipid profiles were observed in the vitamin D group, but without statistical significance. Significant increases in concentrations of hs-CRP, FG, HbA1c, total cholesterol, and LDL cholesterol were observed in the placebo group. No significant change in fasting insulin and HOMA-IR was observed in either group. CONCLUSIONS: In GDM patients, vitamin D supplementation improved FG and HbA1c but had no significant effects on lipid profile or hs-CRP.

• 대한간호학회지
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• 제43권1호
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• pp.69-80
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• 2013

Purpose: The purpose of the study was to investigate the effects of an integrated self-management program on self-management, glycemic control, and maternal identity in women with gestational diabetes mellitus (GDM). Methods: A non-equivalent control group non-synchronized quasi-experimental design was used. A total of 55 women with GDM were recruited from Cheil General Hospital, Seoul, Korea and were assigned to an experimental (n=28) or control group (n=27). The participants were 24-30 weeks pregnant women who had been diagnosed with GDM as of July 30, 2010. The program was conducted as a 1 hour small group meeting 3 out of 5 times and by telephone-counseling 2 out of 5 times. The integrated self-management program was verified by an expert panel. Results: Although there was no significant reduction in HbA1c (U= -1.17, p=.238), there were statistically significant increases in self-management (U= -3.80, p<.001) and maternal identity (U= -4.48, p<.001), and decreased 2-h postprandial glucose levels (U= -2.43, p<.015) in the experimental group compared to the control group. Conclusion: These findings suggest that an integrated self-management program for women with GDM improves self-management, maternal identity, and glycemic control. Further studies are needed to identify the effects of an integrated self-management program on pregnancy and neonatal outcomes.

• 여성건강간호학회지
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• 제24권4호
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• pp.367-378
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• 2018

Purpose: To examine effects of a postnatal care program on self-efficacy, self-management, and glycemic control in women with gestational diabetes mellitus (GDM). Methods: A non-equivalent control group non-synchronized quasi-experimental design was used. Sixty-two women with GDM were enrolled and assigned to either an experimental group (n=30) or a control group (n=32). The experimental group received an intervention which was postnatal care program for women with GDM. The postnatal care program for GDM included an individual education with leaflet and mobile web-based video with three times of telephone counseling. Effects of the intervention were measured with self-efficacy, self-management questionnaire, and a 75 g oral glucose tolerance test (75g OGTT). Statistical significance was examined using independent t-test and $x^2-test$. Results: Although there was no significant difference in 75g OGTT ($x^2=.11$, p=.748) or self-management (t=-1.28, p=.206), there was a statistically significant increase in self-efficacy (t=-2.02, p=.048) in the experimental group compared to that in the control group. Conclusion: A postnatal care program is needed for women with GDM to improve their self-efficacy. Further studies are warranted to improve self-management and glycemic control through tailored education for GDM postpartum women.

• 여성건강간호학회지
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• 제27권1호
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• pp.14-26
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• 2021

Purpose: This study aimed to identify the effects of nursing intervention programs for women with gestational diabetes mellitus (GDM) through a critical review of recent studies. Methods: Studies related to effects of nursing intervention programs for women with GDM published in English or Korean between 2000 and 2019 were extracted from 10 electronic databases. The quality of the studies was evaluated and double-checked for accuracy by two reviewers using the Revised Cochrane Risk-of-Bias tool for randomized controlled trials. Results: Twenty studies were selected, of which 19 had a low risk of bias and one had a high risk of bias. Interventions fell into six main groups: (1) integrated interventions, (2) self-monitoring of blood glucose levels, (3) dietary interventions, (4) exercise, (5) psychotherapy, and (6) complementary therapy. This review found that nursing interventions for GDM were of many types, and integrated interventions were the most common. However, low-carbohydrate diets and blood glucose monitoring interventions did not show statistically significant results. Evidence shows that various nursing intervention programs applied to GDM improved diverse aspects of maternal, fetal, and neonatal health, including both physical and psychological aspects. Conclusion: The composition and delivery of integrated interventions continue to evolve, and these interventions affect physical and psychological indicators. Although interventions affecting physical health indicators (e.g., blood glucose levels, diet, and exercise) are important, many studies have shown that programs including psycho-emotional nursing interventions related to anxiety, depression, stress, self- efficacy, and self-management are also highly useful.