Gestasyonel Diyabetli Kadınlarda Prenatal Distres ve Depresyon Düzeylerinin Belirlenmesi

Yıl 2019, Cilt: 3 Sayı: 2, 73 - 78, 31.08.2019

Merve Çağlar Ümran Yeşiltepe Oskay

Öz

Amaç: Gestasyonel diabetes mellitus (GDM) gebelikte en yaygın görülen sağlık problemlerinden biridir. Bu çalışmanın amacı gestasyoneldiyabetli kadınlarda prenatal distres ve depresyon düzeylerinin belirlenmesidir.

Gereç ve Yöntemler: Çalışma karşılaştırmalı tanımlayıcı türdedir. İstanbul’da bir üniversite hastanesinde takip edilen 308 gebe (155sağlıklı, 153 gestasyonel diyabetli) dahil edilmiştir. Sosyodemografik, obstetrik ve diyabetik veriler için yarı yapılandırılmış görüşmeformu kullanılmıştır. Ayrıca Çok Boyutlu Algılanan Sosyal Destek Ölçeği (ÇBASDÖ), Perinatal Distres Ölçeği (PDÖ) ve EdinburghDoğum Sonrası Depresyon Ölçeği (EDSDÖ) kullanılmıştır.

Bulgular: PDÖ ve EDSDÖ skoru GDM’li gebelerde sağlıklı gebelere göre anlamlı derecede yüksek bulundu. Her iki grupta da ÇBASDÖile EDSDÖ arasında negatif yönde anlamlı bir ilişki bulundu. PDÖ ve EDSDÖ arasında pozitif yönde anlamlı bir ilişki olduğu belirlendi.

Sonuç: GDM’li kadınlar daha fazla distres ve depresyon belirtileri gösterirler. Gebelikte distres ve depresyon düzeyinin yüksek olması özellikle diyabetli kadınlarda daha fazla tıbbi sorunlar yaşanmasına neden olmaktadır. Bu nedenle sağlık bakım profesyonellerininfarkındalığı artırılmalıdır.

Anahtar Kelimeler

gebelik, gestasyonel diyabet, depresyon, sosyal destek

Assesment of Prenatal Distress and Depressive Symptoms in Women with Gestational Diabetes

Öz

Aim: Diabetes Mellitus is one of the most common health problem in pregnancy. The study was designed to assess the prenatal distress and depression symptoms prevalence during pregnancy with or without gestational diabetes mellitus (GDM).

Material and Methods: This study was a comparative descriptive. Three hundred and eight pregnant women (155 healty and 153 with GDM) attending at The Health Science University Hospital in Istanbul, Turkey, participated in the study. A semi-structured questionnaire form were used for sociodemografic, obstetric and diabetic data. Multidimensional Scale of Perceived Social Support (MSPSS) were used to measure social support, Perinatal Distress Scale (PDS) were used to measure perinatal distress and Edinburgh Postpartum Depression Scale (EPDS) were used to measure depression symptoms.

Results: PDS and EPDS score was significantly higher in GDM subjects compare to healty (without GDM) subjects. A significant negative correlation was found between MSPSS and EPDS scores in both groups. There was a significant positive correlation between the PDS and EPDS scores in both groups.

Conclusion: The women with GDM have more distress and depression symptoms. Higher rate of depression and distress in pregnancy deserves medical attention especially women with GDM, so awareness of health care professional should be increased.

Anahtar Kelimeler

pregnancy, gestational diabetes, depression, social support

Kaynakça

• 1. Aksoy YE, Aslantekin F, Yılmaz, S. Prenatal Attachment and Social Support in Risky Pregnancies. Turkey Clinics 2016.
• 2. Biratu A, Haile D. Prevalence of Antenatal Depression and Associated Factors Among Pregnant Women in Addis Ababa, Ethiopia: A Cross-Sectional Study. Reproductive Health 2015; 12, 99.
• 3. Bitew T, Hanlon C, Kebede E, Honikman S, Onah MN, Fekadu A. Antenatal Depressive Symptoms and Utilisation of Delivery and Postnatal Care: A Prospective Study in Rural Ethiopia. BMC Pregnancy and Childbirth 2017; 17,206.
• 4. Byrn MA, Penckofer S. Antenatal Depresion and Gestational Diabetes. Nursing for Women’s Health 2013; 17(1), 24-33.
• 5. Carolan-Olah M, Barry M. Antenatal Stress: An Irish Case Study. Midwifery 2013; 30(3), 310-316.
• 6. Çelik F, Nadirgül Köken G, Yılmazer M. Factors Affecting Development of Depression Symptoms and Depression in Pregnancy. Anatolian Medical Research Journal 2013;7(2), 110-117.
• 7. Daglar G, Nur N. The Relation Between Stress Coping Styles with Anxiety and Depression. Cumhuriyet Medical Journal 2014; 36, 429-441.
• 8. Fışkın G, Mecdi Kaydırak M, Yeşiltepe Oskay Ü. Psychosocial Adaptation and Depressive Manifestations in High-Risk Pregnant Women: Implications for Clinical Practice. Worldviews on Evidence-Based Nursing 2017; 14(1), 55-64.
• 9. Giurgescu C, Penckofer S, Maurer MC, Bryant FB. Impact of Uncertainty, Social support, and Prenatal Coping on the Psychological Well-being of High-risk Pregnant Women. Nursing Research 2006; 55(5), 356-365.
• 10. Golden SH, Lazo M, Carnethon M, Bertoni AG, Schreiner PJ, Diez Roux AV. et al. Examining a Bidirectional Association Between Depressive Symptoms and Diabetes. Journal of the American Medical Association 2008; 299(23), 2751–2759.
• 11. Grandi C, Tapia JL, Cardoso VC. Impact of Maternal Diabetes Mellitus on Mortality and Morbidity of very Low Birth Weight İnfants: A Multicenter Latin America Study. Jornal de Pediatria 2014; 91(3), 234-241.
• 12. Gümüşdağ M, Apay SE, Özorhan EY. Comparison of Psycho-Social Health of Pregnant and Non-Risky Patients. Journal of Health Sciences and Professions 2014; 1(2), 32-42.
• 13. Hilden K, Hanson U, Persson M, Fadl H. Overweight and Obesity: A Remaining Problem in Women Treated for Severe Gestational Diabetes. Diabetic Medicine 2016; 33, 1045-1051.
• 14. Huang T, Rifas-Shiman SL, Ertel KA, Rich-Edwards J, Kleinmen K, Gillman MW et al. Pregnancy Hyperglycemia and Risk of Prenatal and Postpartum Depressive Symptoms. Paediatric and Perinatal Epidemiology Journal 2015; 29(4), 281–289.
• 15. Kampmann U, Madsen LR, Skajaa GO, Iversen DS, Moeller N, Ovesen P. Gestational Diabetes: A clinical update. World Journal of Diabetes 2015; 6(8), 1065-1072.
• 16. Karaçam Z, Ançel G. Depression, Anxiety and İnfluencing Factors in Pregnancy: A Study in a Turkish Population. Midwifery 2007; 25, 344–356.
• 17. Kozhimannil KB, Pereira MA, Harlow BL. Association Between Diabetes and Perinatal Depression Among Low-income Mothers. Journal of the American Medical Association 2009; 301(8), 842-847.
• 18. Mermer G, Bilge A, Yücel U, Çeber E. Examination of Social Support Perception Levels During Pregnancy and Postpartum Period. Journal of Psychiatric Nursing 2010; 1(2), 71-76.
• 19. Moshki M, Cheravi K. Relationships Among Depression During Pregnancy, Social Support and Health Locus of Control Among Iranian Pregnant Women. İnternational Journal of Social Psyciatry 2016; 62(2), 148-155.
• 20. Natasha K, Hussain A, Azad Khan AK. Prevalence of Depression Among Subjects with and without Gestational Diabetes Mellitus in Bangladesh: A hospital based study. Journal of Diabetes & Metabolic Disorders 2015; 14, 64.
• 21. Ölçer Z, Bakır N, Oskay Ü. Self-Sufficiency and Social Support Perceptions of High Risk Pregnants. Anatolian Nursing and Health Sciences Journal 2016; 19(1), 25-33.
• 22. Özyurt R, Aşıcıoğlu O, Gültekin T, Güngördük K, Boran B. Gestational Diabetes Mellitus Prevalance in Pregnant Women Who Attended Istanbul Medical Education and Research Hospital Obstetrics and Gynecology Clinic.Gynecology Obstetric Pediatrics and Pediatric Surgery Journal 2013; 5(1), 7-12.
• 23. Silveira ML, Whitcomb BW, Pekow P, Braun B, Markenson G, Dole N et al. Perceived Psychosocial Stress and Glucose İntolerance Among Pregnant Hispanic Women. Diabetes and Metabolism Journal 2014; 40(6), 466-475.
• 24. Şen E, Yağcan H, Dönmez S, Sevil Ü, Şirin A. Gestational Diabetes and Nursing Care Management. Gynecology and Obstetrics Magazine 2008; 22(2),140-146.
• 25. Vırıt O, Akbaş E, Savaş HA, Sertbaş G, Kandemir H. Relation of Depression and Anxiety Levels to Social Support in Pregnancy. Archives of Neuropsychiatry 2008; 45, 9-13.
• 26. Yüksel F, Akın S, Durna, Z. Adaptation of Prenatal Distress Scale to Turkish and Factor Analysis. Society for Research and Development in Nursing 2012; 8 (3), 43-5.