title: Changes in health status experienced by women with gestational diabetes and pregnancy-induced hypertensive disorders.
abstract: 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.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI 48109, USA. cathkim@umich.edu
authors.forename: Catherine
authors.initials: C
authors.lastname: Kim
authors.forename: Phyllis
authors.initials: P
authors.lastname: Brawarsky
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Jackson
authors.forename: Elena
authors.initials: E
authors.lastname: Fuentes-Afflick
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Haas
mesh_terms: 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