ABSTRACT
BACKGROUND: This study aimed to evaluate the influence of maternal diabetes in the risk of neurodevelopmental disorders in offspring in the prenatal and postnatal periods. METHODS: This cohort study included singleton gestational diabetes mellitus (GDM) pregnancies >22 weeks' gestation with live newborns between 1991 and 2008. The control group was randomly selected and matched (1:2) for maternal age, weeks of gestation and birth year. Cox regression models estimated the effect of GDM on the risk of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and maternal type 2 diabetes mellitus (T2DM). Moreover, interaction between maternal T2DM and GDM-ADHD relationship was evaluated. RESULTS: Children (n=3,123) were included (1,073 GDM; 2,050 control group). The median follow-up was 18.2 years (interquartile range, 14.2 to 22.3) (n=323 with ADHD, n=36 with ASD, and n=275 from women who developed T2DM). GDM exposure was associated with ADHD (hazard ratio [HR]crude, 1.67; 95% confidence interval [CI], 1.33 to 2.07) (HRadjusted, 1.64; 95% CI, 1.31 to 2.05). This association remained significant regardless of the treatment (diet or insulin) and diagnosis after 26 weeks of gestation. Children of mothers who developed T2DM presented higher rates of ADHD (14.2 vs. 10%, P=0.029). However, no interaction was found when T2DM was included in the GDM and ADHD models (P>0.05). GDM was not associated with an increased risk of ASD (HRadjusted, 1.46; 95% CI, 0.74 to 2.84). CONCLUSION: Prenatal exposure to GDM increases the risk of ADHD in offspring, regardless of GDM treatment complexity. However, postnatal exposure to maternal T2DM was not related to the development of ADHD.
Subject(s)
Autism Spectrum Disorder , Diabetes Mellitus, Type 2 , Diabetes, Gestational , Neurodevelopmental Disorders , Pregnancy , Child , Infant, Newborn , Female , Humans , Diabetes, Gestational/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/complications , Autism Spectrum Disorder/etiology , Autism Spectrum Disorder/complications , Cohort Studies , Neurodevelopmental Disorders/etiology , Neurodevelopmental Disorders/complicationsABSTRACT
Objetivo: Valorar el proceso de prescripción y la mejora de la autoestima y la calidad de vida relacionada con la salud en un estudio piloto de prescripción de activos de actividad física durante 3 meses. Método: Estudio cuasiexperimental antes-después sin grupo control, para la valoración del proyecto piloto (noviembre de 2017 y mayo de 2018) del programa Conecta Actius per a la Salut en seis centros de salud de la Comunitat Valenciana. Quienes aceptaron participar cumplimentaron un cuestionario con datos sociales, la escala de autoestima de Rosemberg y el cuestionario de calidad de vida EQ-5D al inicio (T0) y a los 3 meses (T1). Se realizó un análisis descriptivo por sexo, nivel educativo y oferta de activos, en el que se calcularon las diferencias de medianas entre T0 y T1 mediante el test de Wilconxon para dos muestras relacionadas. Resultados: Respondieron 82 personas en T0 y 78 en T1. Se observa una mejora de la calidad de vida (7%; p ≤0,001), la percepción de salud (12,5% p ≤0,001) y la autoestima (5,9%; p ≤0,001) entre T0 y T1. Las mujeres mejoran en mayor proporción que los hombres para las tres escalas medidas, y quienes tienen mayor nivel educativo o les han realizado la prescripción en los centros que ofertan un único activo. Conclusión: Se han obtenido beneficios en salud a corto plazo tras la prescripción de actividad física. En concreto, se observa una mejora en la calidad de vida, la percepción de salud y la autoestima. (AU)
Objective: Assess the prescription process, adherence and impact on health measured in improvement of self-esteem and health-related quality of life, as short-term health indicators, from a pilot study of prescription of physical activity assets for 3 months. Method: Quasi-experimental study before-after without a control group, for the evaluation of the pilot phase (November 2017 and May 2018) of the program Conecta Actius per a la Salut in the Valencian Community (Spain). The physical activity prescription was performed and a questionnaire was completed at the beginning (T0) and at 3 months (T1). A descriptive analysis was carried out by sex and educational level where the differences between T0 and T1 were calculated using chi square and the Wilcoxon test of two dependent samples. Results: The sample was 82 in T0 and 78 people in T1. The analysis shows an improvement between quality of life (7%; p ≤0.001), health perception (12,5%; p ≤0.001) and self-esteem (5,9%; p ≤0.001) between T0 and T1. The improvement proportion in Health perception is greater in women than in men for the three measured scales and in those who have a higher educational level or have been prescribed in centers that offer a single asset. Conclusion: Pilot study shows short-term health benefits after the physical activity prescription. Specifically, there is an improvement in the quality of life, health perception and self-esteem of the population. (AU)
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Quality of Life , Exercise , Surveys and Questionnaires , Spain , Motor Activity , Pilot Projects , First Aid , PrescriptionsABSTRACT
OBJECTIVE: Assess the prescription process, adherence and impact on health measured in improvement of self-esteem and health-related quality of life, as short-term health indicators, from a pilot study of prescription of physical activity assets for 3 months. METHOD: Quasi-experimental study before-after without a control group, for the evaluation of the pilot phase (November 2017 and May 2018) of the program Conecta Actius per a la Salut in the Valencian Community (Spain). The physical activity prescription was performed and a questionnaire was completed at the beginning (T0) and at 3 months (T1). A descriptive analysis was carried out by sex and educational level where the differences between T0 and T1 were calculated using chi square and the Wilcoxon test of two dependent samples. RESULTS: The sample was 82 in T0 and 78 people in T1. The analysis shows an improvement between quality of life (7%; p ≤0.001), health perception (12,5%; p ≤0.001) and self-esteem (5,9%; p ≤0.001) between T0 and T1. The improvement proportion in Health perception is greater in women than in men for the three measured scales and in those who have a higher educational level or have been prescribed in centers that offer a single asset. CONCLUSION: Pilot study shows short-term health benefits after the physical activity prescription. Specifically, there is an improvement in the quality of life, health perception and self-esteem of the population.
