Polish Women Have Moderate Knowledge of Gestational Diabetes Mellitus and Breastfeeding Benefits
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Questionnaire Development
2.3. Data Source and Study Population
2.4. Variables
2.4.1. Sociodemographic Variables
2.4.2. Obstetric Variables
2.4.3. Women’s Knowledge concerning Gestational Diabetes Mellitus
2.4.4. Risk Factors for Gestational Diabetes Mellitus and Neonatal Adverse Outcomes
2.4.5. Management of Pregnancy
2.4.6. Women’s Knowledge concerning Breastfeeding
2.4.7. Assessment of Women’s Knowledge Level concerning GDM and Breastfeeding
2.5. Statistical Analysis
3. Results
3.1. Sociodemographic Variables
3.2. Obstetric Variables
3.3. Management of Pregnancy
3.4. Women’s Knowledge concerning Gestational Diabetes Mellitus
3.5. Risk Factors for Gestational Diabetes Mellitus and Adverse Neonatal Outcomes
3.6. Women’s Knowledge concerning Breastfeeding
3.7. Predictors of Good Knowledge of GDM
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
BMI | body mass index |
GDM | gestational diabetes mellitus |
GDM G1 | diet-controlled GDM |
GDM G2 | diet- and insulin-controlled GDM |
IADPSG | International Association of Diabetes and Pregnancy Study Groups |
OGTT | oral glucose tolerance test |
PCOS | polycystic ovary syndrome |
PGDM | pregestational diabetes mellitus |
WHO | World Health Organization |
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Sociodemographic Variable | n/N | % | |
---|---|---|---|
Age (years) | 18–25 | 56/409 | 13.7 |
26–30 | 163/409 | 39.9 | |
31–35 | 113/409 | 27.6 | |
36–40 | 61/409 | 14.9 | |
41–45 | 16/409 | 3.9 | |
Pre-pregnancy BMI, kg/m2 | underweight (<18.5) | 26/407 | 6.4 |
normal weight (18.5–24.9) | 233/407 | 57.2 | |
overweight (25–29.9) | 91/407 | 22.4 | |
class 1 obesity (30–34.9) | 41/407 | 10.1 | |
class 2 obesity (35–39.9) | 12/407 | 2.9 | |
class 3 obesity (≥40) | 4/407 | 1.0 | |
Residence | urban, above 100,000 residents | 178/410 | 43.4 |
urban, 10,000–100,000 residents | 95/410 | 23.2 | |
urban, <10,000 residents | 28/410 | 6.8 | |
rural | 109/410 | 26.6 | |
Education | primary | 1/410 | 0.2 |
vocational | 13/410 | 3.2 | |
high school | 93/410 | 22.7 | |
university | 303/410 | 73.9 | |
Marital status | married | 318/410 | 77.6 |
divorced | 5/410 | 1.2 | |
cohabiting | 77/410 | 18.8 | |
single parent | 10/410 | 2.4 | |
Monthly income per person (PLN) | <1500 | 70/406 | 17.2 |
1500–2999 | 177/406 | 43.6 | |
3000–4500 | 97/406 | 23.9 | |
>4500 | 62/406 | 15.3 | |
Social status | Higher grade professionals | 61/400 | 15.3 |
Lower grade professionals | 42/400 | 10.5 | |
Routine non-manual employers, higher grade of administration and commerce | 152/400 | 38.0 | |
Small business owners with employees | 11/400 | 2.8 | |
Small business owners without employees | 18/400 | 4.5 | |
Farmers and small holders | 8/400 | 2.0 | |
Lower grade technicians | 9/400 | 2.3 | |
Skilled manual workers (outside agriculture) | 78/400 | 19.5 | |
Unskilled workers (outside agriculture) | 19/400 | 4.8 | |
Agricultural workers | 2/400 | 0.5 |
Sociodemographic Variable | Detailed N = 43 (% (n/N)) | Moderate N = 194 (% (n/N)) | Poor N = 143 (% (n/N)) | None N = 28 (% (n/N)) | p-Value |
---|---|---|---|---|---|
Age (years) (mean ± SD) | 30.2 ± 4.2 | 31.2 ± 4.9 | 30.2 ± 5.4 | 31.6 ± 5.4 | 0.12 |
Pre-pregnancy BMI, kg/m2 (mean ± SD) | 24.6 ± 5.2 | 24.9 ± 5.5 | 23.7 ± 4.2 | 21.7 ± 3.3 | 0.02 |
Sociodemographic Variable | Detailed N = 43 (% (n/N)) | Moderate N = 194 (% (n/N)) | Poor N = 143 (% (n/N)) | None N = 28 (% (n/N)) | Chi-Square Test χ2 | p-Value | |
---|---|---|---|---|---|---|---|
Residence | urban, above 100,000 residents | 49.0% (21/43) | 47.4% (92/194) | 39.2% (56/143) | 25.0% (7/28) | 18.06 | 0.03 |
urban, 10,000–100,000 residents | 14.0% (6/43) | 18.6% (36/194) | 28.7% (41/143) | 42.9% (12/28) | |||
urban, <10,000 residents | 7.0% (3/43) | 6.2% (12/194) | 9.1% (13/143) | 0.0% (0/28) | |||
rural | 30.2% (13/43) | 27.8% (54/194) | 23.1% (33/143) | 32.1% (9/28) | |||
Education | primary | 0.0% (0/43) | 0.0% (0/194) | 0.7% (1/143) | 0.0% (0/28) | 9.87 | 0.36 |
vocational | 0.0% (0/43) | 2.1% (4/194) | 4.9% (7/143) | 7.1% (2/28) | |||
high school | 14.0% (6/43) | 23.2% (45/194) | 25.2% (36/143) | 21.4% (6/28) | |||
university | 86.0% (37/43) | 74.7% (145/194) | 69.2% (99/143) | 71.4% (20/28) | |||
Marital status | married | 79.1% (34/43) | 82.5% (160/194) | 74.1% (106/143) | 60.7% (17/28) | 18.61 | 0.02 |
divorced | 0.0% (0/43) | 0.5% (1/194) | 2.1% (3/143) | 3.6% (1/28) | |||
cohabiting | 20.9% (9/43) | 16.5% (32/194) | 18.2% (26/143) | 32.1% (9/28) | |||
single parent | 0.0% (0/43) | 0.5% (1/194) | 5.6% (8/143) | 3.6% (1/28) | |||
Monthly income per person (PLN) | <1500 | 4.7% (2/43) | 14.6% (28/192) | 23.4% (33/141) | 25.0% (7/28 | 18.66 | 0.02 |
1500–2999 | 55.8% (24/43) | 44.3% (85/192) | 41.8% (59/141) | 25.0% (7/28 | |||
3000–4500 | 30.2% (13/43) | 22.9% (44/192) | 23.4% (33/141) | 25.0% (7/28 | |||
>4500 | 9.3% (4/43) | 18.2% (35/192) | 11.3% (16/141) | 25.0% (7/28 | |||
Social status | Higher grade professionals | 16.3% (7/43) | 18.2% (35/192) | 10.3% (14/136) | 17.6% (5/28) | 34.00 | 0.16 |
Lower grade professionals | 2.3% (1/43) | 12.6% (24/190) | 11.0% (15/136) | 7.1% (2/28) | |||
Routine non-manual employers, higher grade of administration and commerce | 39.5% (17/43) | 34.7% (66/190) | 43.4% (59/136) | 28.6% (8/28) | |||
Small business owners with employees | 4.7% (2/43) | 1.6% (3/190) | 2.9% (4/136) | 7.1% (2/28) | |||
Small business owners without employees | 2.3% (1/43) | 5.3% (10/190) | 5.1% (7/136) | 0.0% (0/28) | |||
Farmers and small holders | 0.0% (0/43) | 3.2% (6/190) | 1.5% (2/136) | 0.0% (0/28) | |||
Lower grade technicians | 2.3% (1/43) | 2.1% (4/190) | 2.2% (3/136) | 3.6% (1/28) | |||
Skilled manual workers (outside agriculture) | 30.2% (13/43) | 18.4% (35/190) | 16.2% (22/136) | 25.0% (7/28) | |||
Unskilled workers (outside agriculture) | 0.0% (0/43) | 3.2% (6/190) | 7.4% (10/136) | 7.1% (2/28) | |||
Agricultural workers | 0.0% (0/43) | 0.5% (1/190) | 0.0% (0/136) | 3.6% (1/28) |
Variable | Normoglycemic N = 258 (% (n/N)) | Hyperglycemic N = 143 (% (n/N)) | Chi-Square Test χ2 | p-Value | ||
---|---|---|---|---|---|---|
Physical activity | Yes | 22.5% (58/258) | 17.5% (25/143) | 8.17 | 0.01 | |
Moderate | 69.8% (180/258) | 65.7% (94/143) | ||||
No | 7.8% (20/258) | 16.8% (24/143) | ||||
Childbirth education | Yes | 40.7% (105/258) | 41.3% (59/143) | 0.01 | 0.91 | |
No | 59.3% (153/258) | 58.7% (84/143) | ||||
Supplements and medications for pregnant women | Supplements | Yes | 90.9% (231/254) | 95.0% (133/140) | 2.11 | 0.14 |
No | 9.1% (23/254) | 5.0% (7/140) | ||||
Folic acid | Yes | 95.2% (236/248) | 95.6% (129/135) | 0.03 | 0.86 | |
No | 4.8% (12/248) | 4.4% (6/135) | ||||
Vitamin D | Yes | 77.5% (179/231) | 72.2% (91/126) | 1.23 | 0.27 | |
No | 22.5% (52/231) | 27.8% (35/126) | ||||
Drugs to treat allergy symptoms | Yes | 5.7% (11/194) | 2.2% (2/93) | 1.80 | 0.18 | |
No | 94.3% (183/194) | 97.8% (91/93) | ||||
Drugs to treat upper respiratory tract infections | Yes | 15.8% (32/203) | 11.7% (11/94) | 0.86 | 0.35 | |
No | 84.2% (171/203) | 88.3% (83/94) | ||||
Drugs to treat urinary tract infections | Yes | 33.8% (70/207) | 32.7% (35/107) | 0.04 | 0.84 | |
No | 66.2% (137/207) | 67.3% (72/107) | ||||
Drugs to treat genital tract infections | Yes | 34.1% (70/205) | 37.4% (40/107) | 0.32 | 0.57 | |
No | 65.9% (135/205) | 62.6% (67/107) | ||||
Drugs to treat thyroid disease | Yes | 37.6% (80/213) | 47.4% (55/116) | 3.01 | 0.08 | |
No | 62.4% (133/213) | 52.6% (61/116) | ||||
Drugs to treat high blood pressure | Yes | 4.1% (8/197) | 20.0% (20/100) | 19.74 | 0.00 | |
No | 95.9% (189/197) | 80.0% (80/100) | ||||
Drugs to treat venous thromboembolism | Yes | 13.9% (28/202) | 24.3% (25/103) | 5.15 | 0.02 | |
No | 86.1% (174/202) | 75.7% (78/103) | ||||
Alcohol consumption | Yes | 0.8% (2/258) | 0.7% (1/143) | 1.11 | 0.58 | |
Occasionally | 3.1% (8/258) | 1.4% (2/143) | ||||
No | 96.1% (248/258) | 97.9% (140/143) | ||||
Cigarettes/Smoking | Yes | 3.9% (10/258) | 1.4% (2/143) | 2.57 | 0.27 | |
Occasionally | 4.3% (11/258) | 2.8% (4/143) | ||||
No | 91.8% (237/258) | 95.8% (137/143) |
Variable | n/N | % | |
---|---|---|---|
Glycemic status during pregnancy | Normoglycemic | 258/401 | 64.3 |
Hyperglycemic | 143/401 | 35.7 | |
Gestational diabetes treatment method | Hyperglycemia compensated by diet (GDM G1) | 89/141 | 63.1 |
Hyperglycemia compensated by diet and insulin treatment (GDM G2) | 52/141 | 36.9 | |
Timing of diagnosis of gestational diabetes mellitus | ≤12 weeks of gestation | 43/140 | 30.7 |
13–23 weeks of gestation | 33/140 | 23.6 | |
Recommended period, between 24 and 28 weeks of gestation | 53/140 | 37.9 | |
After 28 week of gestation | 11/140 | 7.9 | |
Blood glucose concentration, tested while fasting | Normal: Abnormal: | 45/109 64/109 | 41.3 58.7 |
Glucose tolerance test (OGTT) | |||
Glucose concentration after 1 h | Normal: Abnormal: | 69/100 31/100 | 69.0 31.0 |
Glucose concentration after 2 h | Normal: Abnormal: | 68/100 32/100 | 68.0 32.0 |
Women’s knowledge concerning gestational diabetes mellitus | Detailed | 43/408 | 10.5 |
Moderate | 194/408 | 47.5 | |
Poor | 143/408 | 35.0 | |
None | 28/408 | 6.9 | |
Sources of awareness of GDM | Doctor | 205/398 | 51.5 |
Midwife | 57/398 | 14.3 | |
Television/internet | 216/398 | 54.3 | |
Books/parental magazine | 108/398 | 27.1 | |
Family members/friends | 99/398 | 24.9 | |
Education | 14/398 | 3.5 | |
Science publications | 8/398 | 2.0 |
Variable | Normoglycemic N = 258 (% (n/N)) | Hyperglycemic N = 143 (% (n/N)) | Chi-Square Test χ2 | p-Value | |
---|---|---|---|---|---|
Declaration of breastfeeding by mothers | Yes | 91.9%5 (237/258) | 93.7% (134/143) | 0.60 | 0.74 |
No | 3.9% (10/258) | 3.5% (5/143) | |||
I do not know | 4.3% (11/258) | 2.8% (4/143) | |||
Breastfeeding period | 1 month | 5.4% (14/258) | 11.7% (16/137) | 10.79 | 0.09 |
3 months | 7.5% (20/258) | 11.7% (16/137) | |||
6 months | 8.9% (23/258) | 8.8% (12/137) | |||
7–12 months | 13.2% (34/258) | 10.9% (15/137) | |||
>1 year | 16.3% (42/258) | 9.5% (13/137) | |||
>2 years | 17.4% (45/258) | 13.1% (18/137) | |||
not applicable | 3.1% (80/258) | 34.3% (47/137) | |||
Have you been informed about the health benefits of breastfeeding for the baby and mother? | Yes | 91.5% (236/258) | 92.3% (131/142) | 0.07 | 0.78 |
No | 8.5% (22/258) | 7.7% (11/142) | |||
Do you think that a woman with diagnosed gestational diabetes can breastfeed her baby? | Yes | 81.4% (210/258) | 96.5% (137/142) | 18.34 | 0.00 |
No | 1.9% (5/258) | 0.0% (0/142) | |||
I do not know | 16.7% (43/258) | 3.5% (5/142) | |||
Have you been informed that breastfeeding strengthens your emotional bonds? | Yes | 93.4% (241/258) | 95.8% (137/143) | 0.97 | 0.32 |
No | 6.6% (17/258) | 4.2% (6/143) | |||
Have you been informed that breastfeeding affects the intellectual development of the child? | Yes | 81.4% (210/258) | 86.6% (123/142) | 1.79 | 0.18 |
No | 18.6% (48/258) | 13.4% (19/142) | |||
Have you been informed that breastfeeding reduces the risk of respiratory diseases in a child? | Yes | 75.2% (194/258) | 75.0% (105/140) | 0.00 | 0.97 |
No | 24.8% (64/258) | 25.0% (35/140) | |||
Have you been informed that breastfeeding reduces the risk of your baby developing diabetes? | Yes | 58.4% (150/257) | 64.1% (91/142) | 1.25 | 0.26 |
No | 41.6% (107/257) | 35.9% (51/142) | |||
Have you been informed that breastfeeding reduces the risk of childhood obesity? | Yes | 67.1% (171/255) | 63.8% (90/141) | 0.42 | 0.51 |
No | 32.9% (84/255) | 36.2% (51/141) | |||
Have you been informed that breastfeeding reduces the risk of breast cancer in the mother? | Yes | 67.2% (172/256) | 73.6% (103/140) | 1.74 | 0.18 |
No | 32.8% (84/256) | 26.4% (37/140) | |||
Have you been informed that breastfeeding reduces the risk of maternal ovarian cancer? | Yes | 59.8% (153/256) | 61.9% (86/139) | 0.17 | 0.68 |
No | 40.2% (103/256) | 38.1% (53/139) | |||
Do you know that the nutrition of newborns and infants in the first 6 months of life has an impact on the child’s development in the later period (so-called metabolic programming)? | Yes | 86.8% (224/258) | 81.8% (117/143) | 1.81 | 0.17 |
No | 13.2% (34/258) | 18.2% (26/143) |
Sociodemographic Variable | |||||||
---|---|---|---|---|---|---|---|
Continuous Variables | Categorical Variables | ||||||
Age | BMI | Residence | Education | Marital Status | Monthly Income Per Person | Social Status | |
Have you been informed that breastfeeding strengthens your emotional bonds? | p = 0.16 | p = 0.66 | χ2 5.02 p = 0.17 | χ2 3.05 p = 0.38 | χ2 17.91 p = 0.00 | χ2 5.55 p = 0.13 | χ2 6.73 p = 0.66 |
Have you been informed that breastfeeding affects the intellectual development of the child? | p = 0.56 | p = 0.62 | χ2 2.78 p = 0.42 | χ2 0.39 p = 0.94 | χ2 4.87 p = 0.18 | χ2 1.89 p = 0.59 | χ2 19.79 p = 0.01 |
Have you been informed that breastfeeding reduces the risk of respiratory diseases in a child? | p = 0.64 | p = 0.81 | χ2 7.47 p = 0.06 | χ2 0.34 p = 0.95 | χ2 8.35 p = 0.03 | χ2 0.38 p = 0.94 | χ2 27.82 p = 0.00 |
Have you been informed that breastfeeding reduces the risk of your baby developing diabetes? | p = 0.46 | p = 0.49 | χ2 9.44 p = 0.02 | χ2 1.94 p = 0.58 | χ2 4.27 p = 0.23 | χ2 1.06 p = 0.78 | χ2 8.59 p = 0.47 |
Have you been informed that breastfeeding reduces the risk of childhood obesity? | p = 0.43 | p = 0.47 | χ2 4.90 p = 0.17 | χ2 0.66 p = 0.88 | χ2 8.54 p = 0.03 | χ2 2.16 p = 0.53 | χ2 15.40 p = 0.08 |
Have you been informed that breastfeeding reduces the risk of breast cancer in the mother? | p = 0.28 | p = 0.66 | χ2 1.66 p = 0.64 | χ2 2.72 p = 0.43 | χ2 10.80 p = 0.01 | χ2 1.77 p = 0.62 | χ2 16.08 p = 0.06 |
Have you been informed that breastfeeding reduces the risk of maternal ovarian cancer? | p = 0.69 | p = 0.61 | χ2 2.04 p = 0.56 | χ2 0.88 p = 0.83 | χ2 6.84 p = 0.07 | χ2 1.59 p = 0.66 | χ2 13.70 p = 0.13 |
Variable | Odds Ratio (OR) (95% Lower—Upper Confidence Interval (CI)) | p-Value |
---|---|---|
Pre-Pregnancy BMI | 1.09 (1.05–1.14) | 0.00 |
Residence | ||
Urban, above 100,000 residents (ref) | ||
Rural | 1.33 (0.82–2.17) | 0.09 |
Urban, <10,000 residents | 1.07 (0.46–2.49) | 0.73 |
Urban, 10,000–100,000 residents | 0.61 (0.35–1.07) | 0.03 |
Marital status | ||
Married (ref) | ||
Cohabiting | 0.91 (0.54–1.54) | 0.44 |
Single parent | 0.51 (0.10–2.50) | 0.68 |
Divorced | 0.45 (0.05–4.05) | 0.63 |
Obstetric condition | ||
A woman in her first pregnancy (ref) | ||
A woman who is planning to get pregnant | NA | - |
Mother in subsequent pregnancy | 1.38 (0.77–2.49) | 0.12 |
Breastfeeding mother | 1.32 (0.77–2.28) | 0.14 |
Non-breastfeeding mother | 0.59 (0.33–1.05) | 0.00 |
Monthly income per person (PLN) | ||
1500–2999 (ref) | ||
<1500 | 1.18 (0.67–2.07) | 0.12 |
3000–4500 | 0.77 (0.45–1.31) | 0.60 |
>4500 | 0.58 (0.30–1.11) | 0.10 |
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Lis-Kuberka, J.; Orczyk-Pawiłowicz, M. Polish Women Have Moderate Knowledge of Gestational Diabetes Mellitus and Breastfeeding Benefits. Int. J. Environ. Res. Public Health 2021, 18, 10409. https://doi.org/10.3390/ijerph181910409
Lis-Kuberka J, Orczyk-Pawiłowicz M. Polish Women Have Moderate Knowledge of Gestational Diabetes Mellitus and Breastfeeding Benefits. International Journal of Environmental Research and Public Health. 2021; 18(19):10409. https://doi.org/10.3390/ijerph181910409
Chicago/Turabian StyleLis-Kuberka, Jolanta, and Magdalena Orczyk-Pawiłowicz. 2021. "Polish Women Have Moderate Knowledge of Gestational Diabetes Mellitus and Breastfeeding Benefits" International Journal of Environmental Research and Public Health 18, no. 19: 10409. https://doi.org/10.3390/ijerph181910409