Impact of Self-Management Clustered Care on Psychological and Birth Outcomes in Gestational Diabetes.

Abstract

Purposes: To investigate the effects of a self-management-cluster-based pregnancy care model (SMB-CPCM) on the psychological status and delivery outcomes of pregnant women with gestational diabetes mellitus (GDM).

Patients and methods: A total of 120 pregnant women with GDM who had been filed and had regular obstetric examinations in a tertiary-level hospital in Bengbu City between 1 April 2023 and 1 April 2024 were included in the study using the convenience sampling method. Sixty women each were grouped into a study group and a control group using the randomised numeric table method. The study group implemented the SMB-CPCM and the control group used the conventional pregnancy healthcare model. We compared the differences in self-management ability, blood glucose concentration, delivery outcome, and psychological status.

Results: Self-management ability scores were higher in both groups following the intervention than before the intervention (P<0.001), and the increase was more notable in the study group (t=9.237, P<0.001). Anxiety scale (63.31±4.73, 48.29±4.20) and depression self-assessment scale scores(60.70±3.49, 41.69±4.76) in the study group were lower after the intervention than before the intervention(t=13.322, 18.115, P<0.001). Following the intervention, fasting blood glucose(5.39±0.42, 4.92±0.45) and postprandial 2-h blood glucose(6.70±0.71, 5.92±0.64) exhibited a reduction compared to the pre-intervention period (P<0.001). Furthermore, this decline was more pronounced in the study group (t=4.267, 4.584, P<0.001). The study group demonstrated an elevated spontaneous delivery rate compared to the control group (χ² =5.168, P<0.05). Additionally, the rates of gestational hypertension (χ² =4.941), pre-term labour (χ² =3.890), and macrosomia (χ² =4.050) were reduced in the study group when compared to the control group (P<0.05).

Conclusion: SMB-CPCM can effectively control the blood glucose levels of pregnant women with GDM and improve their self-management ability, psychological status, and delivery outcomes. SMB-CPCM shows a good prospect in the management of gestational diabetes and is worth promoting. Future research can explore the impact of SMB-CPCM on long-term health outcomes of pregnant women with diabetes, so as to comprehensively evaluate its clinical value.