دیابت بارداری و ارتباط تعیین‌کننده‌های اجتماعی سلامت با آن بر اساس مدل سازمان جهانی بهداشت در ایران: مرور سیستماتیک

نوع مقاله: مروری

نویسندگان

1 دانشجوی دکتری تخصصی بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استادیار گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استادیار گروه مامایی، دانشکده پرستاری مامایی، دانشگاه علوم پزشکی البرز، کرج، ایران.

4 استادیار گروه تغذیه، دانشکده علوم تغذیه، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: دیابت بارداری یک مشکل بهداشتی در حال افزایش در سراسر دنیا و یکی از شایع‌ترین عوارض بارداری می‌باشد که آثار متعددی بر مادر و جنین می‌گذارد. مطالعه حاضر با هدف بررسی مقالات انجام شده در ارتباط با دیابت بارداری و ارتباط تعیین‌کننده‌های ‌اجتماعی سلامت با آن در ایران انجام شد.
روش‌کار: در این مطالعه مرور سیستماتیک مقالات چاپ شده موجود در پایگاه‌های ‌اطلاعاتی Iranmedex، Magiran، SID، Irandoc، pubmed و Google Scholar جستجو شدند. جستجو کامل با استفاده از کلید واژه‌های دیابت بارداری، عوامل خطر، تعیین‌کننده ساختاری، تعیین کننده بینابینی، شیوع، ایران برای مقالات فارسی و معادل آن‌ها برای مقالات انگلیسی انجام شد. پس از تکمیل جستجو و ارزیابی مقالات با استفاده از چک لیست، تعداد 42 مقاله که در سال‌های 2000- 2016 در ایران انجام شده بود، وارد مطالعه شدند.
یافته‌ها: از مجموع42 مطالعه مورد بررسی، 14 مطالعه عوامل مرتبط با دیابت بارداری، 8 مطالعه عوامل مرتبط با دیابت بارداری و شیوع دیابت بارداری و 20 مطالعه تنها شیوع دیابت بارداری را گزارش کرده بودند. شیوع دیابت بارداری بین 9/29-25/1% گزارش شده است. عوامل مرتبط با دیابت بارداری در مقالات شامل: عوامل ساختاری (تحصیلات، شغل، درآمد، طبقه اجتماعی و قومیت)، عوامل بینابینی (استرس، حمایت اجتماعی، خشونت، ناامنی غذایی، رفتارهای بهداشتی نادرست) و مراقبت‌های بهداشتی بودند.
نتیجه‌گیری: دیابت بارداری یک مشکل شایع است که فاکتورهای متعددی از عوامل تعیین‌کننده اجتماعی سلامت با آن در ارتباط هستند. لذا در بسیاری از موارد اتخاذ مداخلات مناسب از جمله آموزش، خودمراقبتی و افزایش مراقبت‌های دوران بارداری برای کاهش این پیامد و عوارض بعدی آن‌ها در افراد پرخطر ضروری به نظر می‌رسد.

کلیدواژه‌ها


عنوان مقاله [English]

Gestational diabetes and its relationship with social determinants of health according to World Health Organization Model: Systematic Review

نویسندگان [English]

  • Nasibeh sharifi 1
  • Mahrokh Dolatian 2
  • Zohreh Mahmoodi 3
  • Fatemeh Mohammadi Nasrabadi 4
1 PhD Student of Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Assistant Professor, Department of Midwifery & Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Assistant Professor, Department of Midwifery, School of Nursing & Midwifery, Alborz University of Medical Sciences, Karaj, Iran.
4 Assistant Professor, Department of Nutrition, School of Nutrition Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Gestational diabetes is a growing health problem around the world and is one of the most common complications of pregnancy which have many negative impacts on mother and fetus. This study was performed with aim to investigate the articles which have been published on gestational diabetes and the relationship of gestational diabetes with social determinants of health in Iran.
Methods: In this systematic review, the published articles in databases such as Iranmedex, Magiran, SID, Irandoc, Pubmed and Google Scholar were searched. Comprehensive search was done with the keywords of Gestational Diabetes, Risk factors, structural determinants, Intermediary determinants, Prevalence, Iran for Persian articles and their English equivalents for English article.  After completion of searching and evaluation of the articles by a checklist, 42 articles which were performed from 2000 to 2015 in Iran were enrolled in study.
Results: Among 42 assessed articles, 14 articles reported GDM related factors, 8 articles reported GDM related factors and prevalence of GDM and 20 articles only reported the prevalence of gestational diabetes. The prevalence of GDM has been reported between 1.25 to 29.9%. GDM related factors in the articles included structural determinants (education, occupation, income, social class and ethnicity), intermediate determinants (stress, social support, violence, food insecurity and incorrect health behaviors) and health cares.
Conclusion: Gestational diabetes is a common problem which is associated with several factors of social determinants of health. Therefore, adopting appropriate interventions in many cases including training, self-care and increasing pregnancy care seems to be necessary to reduce theses consequences and their following complications in high risk people.         

کلیدواژه‌ها [English]

  • Gestational diabetes
  • Risk factors
  • Structural determinant
  • Intermediary determinants
  • Prevalence
  • Iran
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