Title: The perceived experience of gestational diabetes mellitus (GDM) diagnosis and risk perceptions among Australian women.
Background: Significant controversy surrounds the proposed IADPSG guidelines for GDM diagnosis. It is important to explore the experience of GDM diagnosis and impact on women before the introduction of these guidelines.
Aim: To describe the experience of GDM diagnosis and risk perceptions related to maternal and baby health outcomes.
Method: Cross-sectional study of 51 women attending Monash Health, Victoria, Australia for antenatal care (2008-2010).
Results: The median age of participants was 33 years. Half (51%) were Australian born, with 31% from South East, Southern or Eastern Asia. 37.5% had a previous GDM diagnosis. Almost a third (32.6%) were in their first pregnancy.
Most women (82.6%) were satisfied with the GDM screening test explanation and 67.4% felt the results of screening test were explained well. 80.6 % and 72.2% of women were satisfied with information given about lifestyle management and medical therapy respectively.
Only 17.4% associated complications of maternal anxiety and depression with uncontrolled GDM whilst almost all (89.4%) associated poor control with perinatal complications including macrosomia. Half (54.3%) thought poor control was associated with induction of labour/caesarean birth and 76.1% felt it was linked to neonatal nursery admission, neonatal hypoglycaemia or jaundice. Most (76.1%) thought insulin could reduce macrosomia but only 30.4% thought insulin could reduce induction of labour/caesarean birth.
71.7% perceived an increased risk of diabetes and 80.4% perceived they could reduce their risk. 80.4% perceived a future risk of GDM and 63% perceived they could reduce their risk. Over half (58.7%) thought their baby had an increased risk of diabetes later in life. Most were confident that lifestyle changes could improve GDM (89.1%) and prevent longer-term diabetes (84.4%). Smaller numbers thought that medical therapy would change these outcomes (65.9 and 36.4% respectively).
Conclusion: Women attending Monash Health were largely satisfied with the GDM diagnosis experience and knowledge of risks associated with GDM was fair. Areas for targeted education include explanation of GDM test results and information provision at diagnosis