Health Related Quality of Life and Associated Factors among Pregnant Women with Gestational Diabetes Mellitus: A Cross-sectional Study

Abstract

Background: Gestational diabetes mellitus (GDM) is a prevalent metabolic disorder during pregnancy affecting 13.9% of women in Sri Lanka. Owing to potential risks to mother, fetus and child’s development, GDM may detrimentally impact on health-related quality of life (HRQoL) of pregnant women. Objective: To examine HRQoL and associated factors among pregnant women with GDM attending to antenatal clinics in District General Hospital, Matara Methods: A descriptive cross-sectional study was conducted at the District General Hospital, Matara with conveniently recruited 230 pregnant women with GDM from August – October 2023. Participants completed validated European Quality of Life Five Dimension Three Level (EQ5D3L) instrument along with socio-demographic questionnaire. HRQoL was ascertained using the EQ5D3L index score, range between one (perfect health) and -0.73 with a negative score indicating worse health than death. Data were analysed using descriptive statistics and linear regressions analysis. Results: More than half of participants were between 18-29 years (n=130, 56.5%) and were living in urban areas (n=141, 61.3%). Nearly, half of participants had monthly income between 50,000 100,000 LKR (n=113, 49.1%) while 10.5% (n=24) had <20,000 LKR. Majority of participants were in the third trimester of the pregnancy (n=138, 60%). Of those having comorbidities (n=88, 38.3%), most had pregnancy induced hypertension (n=32, 36.4%). The mean EQ5D3L index score was 0.47±0.38 (range: -0.72 to 1) indicating lower HRQoL. Most of the participants experienced problems with mobility (n=123, 53.5%), undertaking self-care (n=127, 55.2%), and performing usual activities (n=140, 60.9%). Over 64% and 81% of participants experienced moderate level of discomfort and anxiety, respectively. Living in rural areas (B=-0.118, p=0.031), low socio-economic status (<20,000 LKR; B=-0.284, p=0.003) and pregnancy induced hypertension were significantly and negatively associated with HRQoL (B=-0.468, p=0.008). Conclusions: Pregnant women with GDM experience lower HRQoL. Early assessment of HRQoL and identification of multiple associated factors will assist nurses to proactively design interventions targeted at improving HRQoL of pregnant women. Keywords: Gestational diabetes mellitus, Health related quality of life 70