Abstract
Background
Gestational diabetes mellitus (GDM) represents a growing challenge worldwide, with
significant risks to both the mother and baby that extend beyond the duration of the
pregnancy and immediate post-partum period. Women from ethnic minority groups who
access GDM care in high-income settings face particular challenges. The aim of this
systematic integrative review is to explore the experiences and needs of women with
GDM from select ethnic groups in high-income healthcare settings.
Methods
For the purposes of this systematic integrative review, a comprehensive search strategy
explored the electronic databases CINAHL, Medline, Web of Science, and Scopus were
searched for primary studies that explored the needs and experiences of women with
gestational diabetes from select ethnic minority groups living in high-income nations.
The ethnicity of the women in the study included: East, South and Southeast Asian,
Indian subcontinent, Aboriginal/First Nations, Torres Strait Islander, Pacific Islander,
Māori, Middle Eastern, African, or South/Latina American. Studies were assessed with
the Crowe Critical Appraisal Tool and findings were synthesised with thematic analysis.
Results
This review included 15 qualitative studies, one mixed method, and one cross-sectional
study. Six high-income nations were represented. The voices and experiences of 843
women who originated from at least one ethnic minority group are represented. Four
major themes were constructed: psychological impact of GDM, GDM care and education,
GDM and sociocultural impact, and GDM and lifestyle changes.
Discussion and conclusion
Limitations exist in the provision of culturally appropriate care to support the management
of GDM in women from select ethnic groups in high-income healthcare settings. Women
require care that is culturally appropriate, considering the individual needs and
cultural practices of the woman. Engaging a woman’s partner and family ensures good
support is provided. Culturally appropriate care needs to be co-designed with communities
so that women are at the centre of their care, avoiding a one-size-fits-all approach.
Keywords
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References
- Gestational diabetes.Obstetr. Gynaecol. Reprod. Med. 2011; 21: 41-46
World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. World Health Organization. 2013 [Available from: 〈https://apps.who.int/iris/handle/10665/85975〉.
- Screening for gestational diabetes mellitus based on different risk profiles and settings for improving maternal and infant health.Cochrane Database Syst. Rev. 2017;
- Gestational diabetes mellitus.Nat. Rev. Dis. Prim. 2019; 5: 47
AIHW: Australian Institute of Health and Welfare. Incidence of gestational diabetes in Australia 2019 [Available from: 〈https://www.aihw.gov.au/reports/diabetes/incidence-of-gestational-diabetes-in-australia/contents/changing-trends#Trends%20discussion〉.
- Prevalence of gestational diabetes and risk of progression to type 2.Diabetes: a Glob. Perspect. Curr. Diabetes Rep. 2016; 16: 7
Diabetes Australia. Position Statement. Gestational Diabetes in Australia 2020 [Available from: 〈https://www.diabetesaustralia.com.au/wp-content/uploads/Gestational-Diabetes-in-Australia-Position-Statement-2020.pdf〉.
- Gestational diabetes in high-risk populations.Clin. Diabetes. 2013; 31: 90-94
- Adverse pregnancy outcomes in women with diabetes.Diabetol. Metab. Syndr. 2012; 4: 41
- Type 2 diabetes after gestational diabetes: The influence of changing diagnostic criteria.World J. Diabetes. 2015; 6: 234-244
- Gestational diabetes risk factors and long-term consequences for both mother and offspring: a literature review.Expert Rev. Endocrinol. Metab. 2019; 14: 63-74
- Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years.Pediatr. Obes. 2017; 12: 171-178
- Association of gestational diabetes and type 2 diabetes exposure in utero with the development of type 2 diabetes in first nations and non-first nations offspring.JAMA Pediatr. 2018; 172: 724-731
- The inter- and intragenerational impact of gestational diabetes on the epidemic of type 2 diabetes.Am. J. Public Health. 2011; 101: 173-179
- Women with gestational diabetes mellitus want clear and practical messages from credible sources about physical activity during pregnancy: a qualitative study.J. Physiother. 2019; 65: 37-42
- A multicenter, randomized trial of treatment for mild gestational diabetes.New Engl. J. Med. 2009; 361: 1339-1348
Nankervis A., McIntyre H.D., Moses R., Ross G.P., Callaway L., Porter C., et al. Australasian Diabetes in Pregnancy Society consensus guidelines for the testing and diagnosis of gestational diabetes mellitus in Australia Sydney 2014 [Available from: 〈http://www.adips.org/downloads/ADIPSConsensusGuidelinesGDM-03.05.13VersionACCEPTEDFINAL.pdf〉.
- Disparities in the risk of gestational diabetes by race-ethnicity and country of birth.Paediatr. Perinat. Epidemiol. 2010; 24: 441-448
- Real-world experience of metformin use in pregnancy: observational data from the northern territory diabetes in pregnancy clinical register.J. Diabetes. 2019; 11: 761-770
- A population-based observational study of diabetes during pregnancy in Victoria, Australia, 1999–2008.BMJ Open. 2014; 4e005394
- Prediabetes and pregnancy: early pregnancy HbA1c identifies Australian Aboriginal women with high-risk of gestational diabetes mellitus and adverse perinatal outcomes.Diabetes Res. Clin. Pract. 2021; : 176
Australian Bureau of Statistics. Migration, Australia Statistics on Australia's international migration, internal migration (interstate and intrastate), and the population by country of birth 2021 [Available from: 〈https://www.abs.gov.au/statistics/people/population/migration-australia/2019–20〉.
- The integrative review: updated methodology.J. Adv. Nurs. (Wiley-Black ). 2005; 52: 546-553
The World Bank. World Bank Country and Lending Groups 2022 [cited 2022 28 January]. Available from: 〈https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups〉.
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ.Br. Med. J. (Online). 2009; : 339
- Product Review: Covidence (Systematic Review Software).Canadian Health Libraries Association, Toronto, Ontario2014: 1708-6892 (Report No.)
- Reliability analysis for a proposed critical appraisal tool demonstrated value for diverse research designs.J. Clin. Epidemiol. 2012; 65: 375-383
- Methods for the thematic synthesis of qualitative research in systematic reviews.BMC Med. Res. Methodol. 2008; 8: 45
- The experience of gestational diabetes mellitus (GDM) among Hispanic women in a U.S. border region.Sex. Reprod. Healthc.: Off. J. Swed. Assoc. Midwives. 2017; 12: 16-23
- A qualitative study about the experiences of ethnic minority pregnant women with gestational diabetes.Scand. J. Caring Sci. 2019; 33: 621-631
- A qualitative study of developing beliefs about health, illness and healthcare in migrant African women with gestational diabetes living in Sweden.BMC Women’s. Health. 2018; : 18
- Socio-cultural influences on the behaviour of South Asian women with diabetes in pregnancy: qualitative study using a multi-level theoretical approach.BMC Med. 2015; 13: 120
- Women's experiences of factors that facilitate or inhibit gestational diabetes self-management.BMC Pregnancy Childbirth. 2012; : 12
- Going up, going down: the experience, control and management of gestational diabetes mellitus among Southeast Asian migrant women living in urban Australia.Health Promot. J. Aust. 2017; 28: 123-131
- 'No sugar', 'no junk food', 'do more exercise' - moving beyond simple messages to improve the health of Aboriginal women with Hyperglycaemia in Pregnancy in the Northern Territory - a phenomenological study.Women Birth. 2021; 34: 578-584
- Aboriginal women's experiences with gestational diabetes mellitus a participatory study with mi'kmaq women in Canada.Adv. Nurs. Sci. 2016; 39: 181-198
- Lived experience of gestational diabetes mellitus among immigrant South Asian women in Australia.Aust. N. Z. J. Obstet. Gynaecol. 2011; 51: 360-364
- Gestational diabetes mellitus: a qualitative study of lived experiences of South Asian immigrant women and perspectives of their health care providers in Melbourne, Australia.BMC Pregnancy Childbirth. 2021; 21: 1
- Perspectives on prevention of type 2 diabetes after gestational diabetes: a qualitative study of Hispanic, African-American and White women.Matern. Child Health J. 2015; 19: 1526-1534
- Self-management of gestational diabetes among Chinese migrants: a qualitative study.Women Birth. 2019; 32: E17-E23
- Understanding the experiences of East African immigrant women with gestational diabetes mellitus.Can. J. Diabetes. 2018; 42: 632-638
- Ethnic differences in dietary management of gestational diabetes mellitus: a mixed methods study comparing ethnic Chinese immigrants and Australian women.J. Acad. Nutr. Diet. 2020; 120: 86-102
- Culturally tailored resources for South Asian immigrant women with gestational diabetes: do they work and what's missing? a qualitative study.Can. J. Diabetes. 2019; 43: 573-579
- Incorporating aboriginal women's voices in improving care and reducing risk for women with diabetes in pregnancy - a phenomenological study.BMC Pregnancy Childbirth. 2021; 21: 624
- Reported health behaviour changes after a diagnosis of gestational diabetes mellitus among ethnic minority women living in Canada.J. Immigr. Minor. Health. 2016; 18: 1334-1342
- Barriers to, and facilitators of, lifestyle changes to prevent gestational diabetes: an interpretive description of south asian women and health-care providers living and working in Southern Ontario, Canada.Can. J. Diabetes. 2021; 45: 144-154
- Physical activity patterns and gestational diabetes outcomes - the wings project.Diabetes Res. Clin. Pract. 2016; 116: 253-262
- Independent and combined effects of age, body mass index and gestational weight gain on the risk of gestational diabetes mellitus.Sci. Rep. 2020; 10: 8486
- Food perceptions and concerns of aboriginal women coping with gestational diabetes in Winnipeg, Manitoba.J. Nutr. Educ. Behav. 2011; 43: 482-491
- An evaluation of dietary intakes of a selected group of South Asian migrant women with gestational diabetes mellitus.Ethn. Health. 2021; 26: 487-503
- Contradictions and conflict: a meta-ethnographic study of migrant women’s experiences of breastfeeding in a new country.BMC Pregnancy Childbirth. 2012; 12: 1-15
- Barriers and facilitators of maternal healthcare utilisation in the perinatal period among women with social disadvantage: a theory-guided systematic review.Midwifery. 2022; 105103237
- Cultural competence and experiences of maternity health care providers on care for migrant women: a qualitative meta‐synthesis.Birth. 2021; 48: 458-469
Article Info
Publication History
Published online: August 26, 2022
Accepted:
August 13,
2022
Received in revised form:
August 11,
2022
Received:
April 10,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
