Effect of Educational Programme for recently diagnosed Gestational Diabetic Women on their Knowledge and clinical outcomes

Background: Gestational diabetes is defined as any degree of glucose intolerance with onset or first recognition during pregnancy; and it affects 11% of all pregnancies. Aim of this study is to : Evaluate the effect of educational programme for recently diagnosed Gestational Diabetic Women on their Knowledge and clinical outcome.Research Design: Quasiexperimental research design (One group pre-test, post-test). Subject: purposive sampleof (74) recruited pregnant women from Minia university hospital for maternity and child at antenatal care Department. Tools of data collection:three tools used as; self-administered Questionnaire,knowledge assessment,and clinical outcome assessment.Results:the majority of gestational diabetic women (93.2%, 97.3%) had good knowledge in immediate and Post 3 months respectively as compared in pre-educational program(23.0%) with highly statistically significance differences in which (P=0.000.);and there were highly statistically significance differences between pre and post educational program among gestational diabetes women regarding their clinical outcome random blood glucose and amniotic fluid amount in which (P=0.002, 0.001). Conclusion: study of educational programme is an effective method for improving women knowledge regarding gestational diabetes. Current study revealed that the gestational diabetic women had higher level of knowledge scores as well as improvement of clinical outcomes (random blood glucose and BMI) post-test significantly after education program as compared to their values at pretest.Recommendation: Providing educational program for recently diagnosed gestational diabetic women about proper management of GDM. Applying Counseling tips in gestational diabetic women discharge teaching plan to maintain healthy life style and maximum glycemic control prior to a future conception. Keywards: Gestational diabetes mellitus, Maternal and Neonatal consequences, Clinical outcome Introduction Gestational diabetes mellitus (GDM) is described as a glucose intolerance which is first diagnosed in pregnancy. Gestational diabetes mellitus is diagnosed in second and third trimesters of pregnancy, GDM has emerged as a global public health problem even though symptomatic in its specialized medical course, and the oral glucose tolerance test is recommended for screening of GDM between the 24thand 28thweek of pregnancy, but for high risk pregnancy the screening should be conducted earlier in pregnancy (1). Gestational diabetes mellitus (GDM) is a type of diabetes that affects pregnant women during the second and third trimester due to insulin resistance that has resulted from hormone production by the placenta. There are several factors have shown to have a role in developing of GDM. The most common risk factors include previous personal and family history of GDM, history of the macrocosmic baby, unexplained stillbirths, and family history of type 2 of diabetes. In-between pregnancy, weight gain is considered one of the most common modifiable risk factor for GDM. Advanced maternal age and cigarette smoking are also risk factors for GDM(2). (GDM) has been estimated that 75–90% of cases of high blood glucose during pregnancy are GDM. A major part of GDM management involves educating patients about diet, exercise, self-monitoring, and insulin treatment to decrease its morbidity and mortality(3). Knowledge and awareness about this chronic disease will be translated to an increase in selfcare as a result of early diagnosis and treatment, which ultimately will contribute to complication reduction. Undiagnosed or inadequately treated GDM can lead to significant maternal and fetal complications. Moreover, women with GDM and their offspring's are at increased risk of developing type 2 diabetes later in life(4). Gestational diabetes mellitus knowledge allows patients and those at risk to undertake early interference and thus prevent many complications by making simple lifestyle changes that include an increase in physical activity and diet control(5). Thus, pregnant women need to have a good knowledge on GDM and the lifestyle interventions that manage or reduce GDM and future T2DM; in which this education will improve pregnant women Knowledgeand clinical outcome (6). Significance of the study The prevalence of gestational diabetes mellitus in the worldwide has been increased. According to the Centers for Disease Control and Prevention (2014), the incidence of gestational diabetes varies by states and by race/ethnicity. The incidence of gestational diabetes mellitus increased from 8.1% to 9.2% between 2009 and 2010. Accordingly, the impact is felt on the amount of money spent on diagnoses and treatment as well as disability and research. Subsequently,the risk of gestational diabetes mellitus in mothers and the neonate is the increased risk of developing Type 2 diabetes as well as excessive birth weight of the infant [7]. Some studies have established that GDM may increase the chance for birth defects. Other studies have linked autism, schizophrenia, depression, and obesity gestational diabetes mellitus complication in later life there is an increased risk for both mother and the neonate to have urinary tract infection, preeclampsia, neonatal hypoglycemia, jaundice and high cesarean sections as a result of these complications [8]. According to the study done by El Sagheer and Hamdi (2018) (9) who assessed the prevalence of GDM in ElMinia city, Egypt by using the Diabetes in Pregnancy Study Group India (DIPSI) in comparison to the International Association of the Diabetes and Pregnancy Study Groups Minia Scientific Nursing Journal (Print) (ISSN 2537-012X) Vol. (6) No. (1) December 2019 P a g e | 150 Abeer M. , et al (IADPSG) criteria, found that the risk factors for GDM in this locality reported that 156\GDM prevalence in El-Minia city was 8.86% by DIPSbI versus 7.43% by IADPSG. Moreover, mothers with prior knowledge of GDM preventive measures are shown to had low risk of susceptibility of diagnoses; thereby reducing the possibility of prenatal complications. The importance of GDM knowledge among women is vital in reducing birth complications and outcomes. This is because mothers are the most vital component to reducing health complications and birth outcomes through gestational diabetes mellitus awareness(10). Aim of the study is to: Evaluate the Effect of Educational Programme for recently diagnosed Gestational Diabetic Women on their Knowledge and clinical outcome. Research hypothesis 1) 1-Post-test knowledge score will be significantly higher than pre -test knowledge scors among recently diagnosed Gestational Diabetic Women 2) 2-There will be significant association between knowledge scores of pregnant women and their clinical outcome. 3) 3-There will be significant association between pretest knowledge scores of pregnant women and their demographic characteristics regarding gestational diabetes. Subjects and Methods Research Design Quasi experimental research design (one group pretest and post-test)was utilized to fulfill the aim of this study. Research Setting: This study was conducted at Minia university hospital for maternity and child at antenatal care Department. Subjects: Purposive sample was utilized in this research. The sample size was 74 pregnant women according to the following formula