اثربخشی استفاده از تله‌مدیسین بر کنترل قند خون و عوارض مادر و پیامدهای نوزادی زنان مبتلا به دیابت بارداری در طی کووید-19: یک مطالعه نیمه‌تجربی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار طب نوزادی و پیرامون تولد، گروه بیماری‌های کودکان، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

2 کارشناس ارشد علوم تشریح، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

3 استادیار گروه بیهوشی، مرکز تحقیقات سل و بیماری‌های ریوی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: زنان با بارداری ­های پرخطر از جمله زنان مبتلا به دیابت بارداری در ابتلاء به کووید-19 بسیار مستعدتر از سایر زنان باردار هستند، بنابراین استفاده از برنامه ­های پزشکی از راه دور (تله‌مدیسین) برای این زنان در خودمراقبتی بیماریشان در طی پاندمی کووید-19 بسیار ضرورت دارد؛ لذا مطالعه حاضر با هدف تعیین اثربخشی استفاده از تله‌مدیسین بر کنترل قندخون و عوارض مادر و پیامدهای نوزادی زنان مبتلا به دیابت بارداری در طی کووید-19 انجام شد.
روش‌کار: این مطالعه نیمه‌تجربی قبل و بعد از مداخله در طی سال‌های 1400-1399 با مشارکت 88 زن مبتلا به دیابت بارداری در بیمارستان طالقانی تبریز انجام شد. شرکت‌کنندگان به‌صورت تصادفی در دو گروه مداخله (استفاده از فناوری تله‌مدیسین) و کنترل (روش معمولی) قرار گرفتند. کنترل وزن، قند خون و عوارض مادر و پیامدهای نوزادی بین دو گروه مقایسه شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 25) و آزمون­ های تی تست و کای اسکوئر انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته­ ها: میانگین قندخون ناشتا در طی مطالعه (045/0=p) و میزان HA1C قبل از زایمان (034/0=p) در گروه مداخله به‌طور معناداری کمتر از گروه کنترل بود. در گروه کنترل تعداد زایمان­ های ابزاری (045/0=p) و سزارین (041/0=p) به‌طور معناداری بیشتر از گروه مداخله بود. همچنین هیپوگلیسمی نوزاد (033/0=p) و وزن بالای نوزاد (044/0=p) در گروه کنترل به‌صورت معناداری بیشتر از گروه مداخله بود.
نتیجه ­گیری: تله‌مدیسین توانست منجر به کنترل قندخون، کاهش HA1C قبل از زایمان، کاهش تعداد زایمان­ های غیرفیزیولوژیک، کاهش هیپوگلیسمی و کاهش وزن بالای نوزاد در زنان مبتلا به دیابت بارداری در طی پاندمی کووید-19 شود.

کلیدواژه‌ها

عنوان مقاله [English]

The effectiveness of using telemedicine on blood sugar control and maternal complications and neonatal outcomes of women with gestational diabetes during covid-19: a quasi-experimental study

نویسندگان [English]

  • Sanaz Yasrebinia 1
  • Mina Zeynalzade 2
  • Mansour Rezaei 3
1 Assistant Professor of Neonatal-Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2 M.Sc. of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Assistant Professor, Department of Anesthesiology, Tuberculosis and Lung Disease Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: Women with high-risk pregnancies, including women with gestational diabetes, are much more prone to COVID-19 than other pregnant women, so the use of telemedicine programs is very necessary for these women in self-care of their disease during the Covid-19 pandemic; Therefore, the present study was performed with aim to determine the effectiveness of using telemedicine on blood sugar control and maternal complications and neonatal outcomes of women with gestational diabetes during covid-19.
Methods: This quasi-experimental study was conducted with the participation of 88 women with gestational diabetes in Taleghani Hospital, Tabriz in 2020-2021. The participants were randomly assigned to two groups of intervention (use of telemedicine technology) and control (conventional method). Weight control, blood sugar, maternal complications and neonatal outcomes were compared between the two groups. Data analysis was done using SPSS statistical software (version 25) and t-test and chi-square test. P<0.05 was considered statistically significant.
Results: The mean fasting blood sugar during the study (P=0.045) and HA1C level before delivery (P=0.034) were significantly lower in the intervention group than the control group. In the control group, the number of instrumental deliveries (P=0.045) and cesarean section (P=0.041) was significantly higher than the intervention group. Also, infant hypoglycemia (P=0.033) and high infant weight (P=0.044) were significantly higher in the control group than the intervention group.
Conclusion: Telemedicine was able to control blood sugar, reduce HA1C before delivery, reduce the number of non-physiological births, reduce hypoglycemia and reduce high birth weight in women with gestational diabetes during the covid-19 pandemic.

کلیدواژه‌ها [English]

  • Covid-19
  • Gestational diabetes
  • Neonatal outcomes
  • Pregnancy complications
  • Telemedicine

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مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 5
مرداد 1402
صفحه 22-30

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