Changes in health status experienced by women with gestational diabetes and pregnancy-induced hypertensive disorders.
OBJECTIVE
To examine changes in health status among women with gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH).


METHODS
We examined perceived health status changes from the prepregnancy, as recalled at 12-20 weeks gestation, to the postpartum period in women with GDM (n = 64) vs. unaffected gravidas (n = 1233) and women diagnosed with PIH (n = 148) vs. unaffected gravidas. We used patient survey and medical record data from a prospective cohort study. Health status measures included the Short Form-36 scales for physical function, vitality, and self-rated health and the Center for Epidemiologic Studies-Depression Scale (CES-D). Multivariate logistic regression models controlled for age, parity, race, education, prepregnancy body mass index (BMI) and exercise levels, food insufficiency, and GDM or PIH during a prior pregnancy.


RESULTS
Women with PIH more often reported a significant decline in vitality (odds ratio [OR] 1.51, 95% confidence interval [CI] 1.02-2.23) and self-rated health (OR 2.12, 95% CI 1.19- 3.77) and an increase in depressive symptoms from prepregnancy to postpartum compared with unaffected women (OR 1.84, 95% CI 1.11-3.05). Decline in self-rated health was partially mediated by cesarean birth and preterm delivery. Similar proportions of women with GDM and unaffected women reported declines in health status measures.


CONCLUSIONS
Women with PIH, but not GDM, more often experience significant declines in health status from prepregnancy to postpartum than unaffected women.
Kim
Catherine
C
Division of General Internal Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI 48109, USA. cathkim@umich.edu
Brawarsky
Phyllis
P
Jackson
Rebecca A
RA
Fuentes-Afflick
Elena
E
Haas
Jennifer S
JS
D000328:Adult; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000209:etiology; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology*; D016015:Logistic Models; D008429:Maternal Welfare; D008499:Medical Records; D016017:Odds Ratio; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011446:Prospective Studies