1.A Review on the Factors Influencing the Attendance of Postpartum Diabetes Screening for Mothers with Gestational Diabetes Mellitus
Puganeswary Thangarajah, Halimatus Sakdiah Minhat, Nor Afiah Mohd Zulkefli, Norliza Ahmad
Malaysian Journal of Medicine and Health Sciences 2019;15(SP3):84-88
Abstract
Women with gestational diabetes mellitus (GDM) during their pregnancy have a greater risk of developing overt diabetes mellitus and dysglycemia (prediabetes, impaired glucose tolerance or impaired fasting glucose) later in future, compared to mothers with normal pregnancy. Postpartum screening is crucial for early identification of type 2 diabetes (T2DM) in women with GDM. Nevertheless, despite various strategies, its rate remains low. A systematic review using databases of PubMed/Medline, Science Direct and CINAHL from 2008 to 2018, was conducted to identify the factors influencing the attendance of postpartum diabetes screening. Open access English articles, focusing on observational studies were reviewed. Primary screening of titles and abstracts of 91 articles were done, secondary screening of 31 articles resulted in 6 articles, included in this manuscript. Various factors identified to be associated with the attendance to postpartum diabetes screening, which are age, education, ethnicity, some obstetric factors like multiparty, and history of insulin usage previously. Many women fail to be screened for diabetes during the postpartum period, and this delays T2DM diagnosis, which in turn gives rise to various complications. Further research that considers these factors is necessary for developing interventions to improve postpartum T2DM screening for mothers with GDM during their pregnancy
2.Anaemia and its associated factors among pregnant women in Malaysia
Halimatus Sakdiah Minhat ; Puganeswary Thangarajah
Malaysian Journal of Nutrition 2022;28(No.1):53-63
Introduction: Despite remarkable improvement in maternal health, anaemia
during pregnancy remains a significant public health threat to Malaysian
women. This study aimed to determine the prevalence, severity, and associated
factors of anaemia in pregnancy among pregnant mothers in Seremban, Negeri
Sembilan. Methods: A total of 482 pregnant mothers were recruited using cluster
sampling. Data were collected using a validated and pre-tested self-administered
questionnaire consisting of four sections, namely socio-demographic and socioeconomic details, obstetric history, nutritional factors, and iron supplementation
status. In this study, anaemia in pregnancy was defined as haemoglobin (Hb) <11.0
g/dL, which was based on blood test taken during the first trimester. The data
were analysed using IBM SPSS version 23.0. Multiple logistic regression analysis
was conducted to determine the predictive model for anaemia during pregnancy
among the respondents. Results: The prevalence of anaemia in pregnancy among
the respondents was 22.0%, with 95.3% respondents mildly anaemic. Respondents
with an intake of iron supplementation of once daily (AOR=0.191, 95% CI: 0.074-
0.914), more than once daily (AOR=0.149, 95%CI: 0.091-0.248), and low intake
of seafood (AOR=0.320, 95% CI: 0.187-0.526) were less likely to develop anaemia
during pregnancy. Conclusion: The findings revealed moderate level of anaemia in
pregnancy, which was dominated by those in the mild category, with increased risk
predicted among young mothers. Iron supplementation (once daily or more) and low
intake of seafood protected mothers from developing anaemia during pregnancy.
3.Effectiveness of a Theory-Based Intervention to Improve Postpartum Type-2 Diabetes Mellitus Screening Uptake Among Women with Gestational Diabetes Mellitus in Malaysia: A Prospective Quasi-Experimental Study
Halimatus Sakdiah Minhat ; Puganeswary Thangarajah ; Norliza Ahmad
Malaysian Journal of Medicine and Health Sciences 2024;20(No.2):99-104
Introduction: Despite the importance of postpartum type-2 diabetes mellitus (T2DM) screening to ensure early
detection and effective management of T2DM among women previously diagnosed with gestational diabetes mellitus, low uptake has been reported. In view of the proven effectiveness of theory-based interventions, this study
aimed to evaluate the effectiveness of Information Motivation Behavioural Skills (IMB)-based intervention to improve
postpartum T2DM screening uptake among pregnant women with GDM in Negeri Sembilan, Malaysia. Methods:
A prospective quasi-experimental study was carried out among comparable respondents in the intervention and
control groups, involving 61 and 55 respondents respectively. Validated and reliable self-administered questionnaire
was used to measure pre- and post-intervention of knowledge, attitude and self-efficacy, based on the constructs of
the IMB model, with postpartum T2DM screening uptake measured at 6-week postpartum. Results: The IMB-based
intervention was effectively improved knowledge on gestational diabetes mellitus (GDM), and attitude as well as
self-efficacy related to the screening, with significant difference in the 6-week postpartum T2DM screening uptake
between the intervention and control groups. Between groups comparison revealed significantly higher mean scores
for knowledge (ηp
2
=0.11), attitude (ηp
2
=0.031) and self-efficacy (ηp
2
=0.52) in the intervention group compared to the
control group, with self-efficacy is showing the largest size effect. Conclusion: The IMB-based health intervention
had effectively improved the 6-week postpartum T2DM screening among women with GDM in the intervention
group, through the significant improvement of knowledge on GDM and attitude as well as self-efficacy related to the
screening.