Determinants of health literacy and its impact on glycemic control among women with gestational diabetes mellitus in a tertiary care hospital, Puducherry - A cross-sectional analytical study.

BACKGROUND: Health literacy is vital during pregnancy, as maternal health knowledge and behavior have a significant impact on the health of both mother and child. Hence, this study aimed to assess the health literacy status of pregnant women diagnosed with gestational diabetes mellitus (GDM), as well as its associated factors and impact on glycemic control. MATERIALS AND METHODS: The facility-based Cross-sectional analytical study was conducted among 200 pregnant women with GDM in a tertiary care hospital. The eligible participants were consecutively selected for the study. The study was conducted from September 2022 to March 2023. A validated semi-structured questionnaire, the Health Literacy Questionnaire (HLQ) for GDM, was used to measure health literacy status. Stata V.17 software was used for data analysis. RESULTS: Out of 200 pregnant women with GDM, the mean (SD) age of the participants is 29.5 (±5.5) years. It was observed that 164 (82%) of the participants had adequate health literacy, whereas 36 (18%) had inadequate health literacy about Gestational Diabetes. Adequate health literacy (HL) was observed among 88.5% of women with controlled blood sugar and 55.1% of women with uncontrolled blood sugar. Results of multivariate logistic regression analysis revealed that pregnant mothers' educational status (PR: 1.8; 95% CI: 1.2-2.5) and glycemic control (PR: 1.4; 95% CI (1.2-1.7) were associated with adequate HL. CONCLUSIONS: In conclusion, this study supports the association between adequate HL and glycemic control in pregnant women with GDM. Addressing this gap is essential for healthcare officials and planners to implement programs that promote women's HL during pregnancy, with a focus on low-educated groups.

Association between common mental disorder and glycemic control in women with gestational diabetes: A mixed-method study.

Background: Gestational diabetes mellitus (GDM) is associated with an increased risk of mental health disorders among pregnant women. Poor mental health can negatively impact glycemic control in women with GDM, leading to adverse outcomes for both the mother and the baby. Aim: To determine the prevalence of common mental disorder (CMD) in women with GDM and its association with poor glycemic control. Additionally, to explore the reasons and coping strategies for CMD in women with GDM. Methods: A sequential explanatory mixed-method study was conducted among 351 women with GDM visiting a tertiary care hospital. The prevalence of CMD was assessed using Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Perceived Stress Scale (PSS). Glycemic control was determined based on two-hour postprandial blood glucose levels. In-depth interviews were conducted with six women who screened positive for CMD and had poor glycemic control. Data were analyzed using SPSS v23 and stats v12. Chi-square test and Poisson regression were performed, and adjusted prevalence ratios (aPRs) were reported. Results: The prevalence of CMD was found to be 19.08% (95% CI: 15.32%-23.52%), with 18.2% (95% CI: 14.5%-22.6%) anxiety symptoms 8.3% (95% CI: 5.8%-11.6%) depressive symptoms and stress each. CMD was significantly related to poor glycemic control (aPR: 1.58; 95% CI: 1.23-2.03; P value <0.001). The qualitative analysis revealed individual, family, health, and facility factors influencing mental health and glycemic control. Conclusion: Common mental health disorders are prevalent in women with GDM. It has a negative association with glycemic control. Implementing a routine screening program in the ANC clinic can aid in early identification and prompt management of the CMD and its associated complications.

Prevalence and predictors of positive mental health among adolescents in rural Puducherry, South India.

OBJECTIVES: Most of the adult mental health disorder occurs either during childhood or adolescent stage. Assessment of positive mental health among adolescents will help in predicting the future physical and mental health outcome. Hence, this study was done to determine the prevalence and factors associated with positive mental health among adolescents in rural Puducherry. METHODS: A cross-sectional study was conducted among adolescents (10-19 years) during April and May 2018. Mental Health Continuum-Short Form (MHC-SF), a validated questionnaire was used for the assessment of positive mental health. Prevalence of positive mental health was expressed as proportion with 95% confidence interval. RESULTS: Of the total 245 adolescents interviewed, almost half of them belonged to the age group of mid-adolescence (14-16 years). Majority (66.5%) were boys and more than one third were studying in secondary class.Prevalence of positive mental health was 51.8% (95% CI: 45.6-58.1). Mother's education between primary and secondary (aPR-0.77 95% CI: 0.60-0.98), upper middle (aPR-1.74 95% CI: 1.03-2.94) and middle socioeconomic status (aPR-1.80 95% CI: 1.11-2.87) were significantly associated with positive mental health. CONCLUSION: Current study found that more than half of the rural adolescents had positive mental health. Maternal education and upper socioeconomic status were found to be significant predictors of positive mental health. Our findings on the burden and risk factors as well as protective factors of mental health can contribute to the mental health strategy in public health action.

Prevalence and factors related to second hand smoking exposure, knowledge and response among adolescents in rural Puducherry.

OBJECTIVES: To determine the prevalence of Second Hand Smoking (SHS) and assess the factors related to exposure, knowledge and response to SHS among adolescents in rural Puducherry, South India. METHODS: A community based cross-sectional study was conducted among adolescents during March and April 2018. Two out of four villages were selected randomly and all the adolescents were contacted through household visit and questionnaire was administered. Semi structured questionnaire contained three sections: sociodemographic details, environmental assessment and third section contained knowledge about SHS, COTPA and response towards being exposed to SHS, as well as exposure history. Continuous variables like age were summarized as mean (SD). Categorical variables such as awareness, attitude and practise towards SHS were summarized as proportions with 95% confidence interval. RESULTS: Total number of adolescents interviewed was 789. The mean age of the study participants were 14.1 (2.4) years and majority, 440 (55.8%) were boys and 684 (86.7%) belonged to nuclear family. More than one fourth, 210 (26.6%) belonged to middle class of socio-economic status. Environmental assessment of household showed more than half, 456 (57.8%) were staying in pucca house and majority 642 (81.4%) had adequate cross ventilation. It was found that about 70.1% had adequate knowledge about SHS and its harmful effects. Prevalence of exposure to SHS was 49%. Majority (40.5%) told that they will scold or advice the family member to stop smoking if they are exposed to SHS in the living place. However, almost 80% of adolescents mentioned that they will no't react if they see someone smoking in a public place. CONCLUSIONS: Current study found that almost half of the adolescents were exposed to SHS. Even though, almost three fourth had adequate knowledge, attitude towards preventing SHS in public place was found to be poor. Hence, adolescents need to be motivated enough to address the problem in the public place through motivational counselling in adolescent clinics by health care workers.

Prevalence and determinants of poor quality of sleep among adolescents in rural Puducherry, South India.

BACKGROUND: Adolescence is a critical stage of life which is characterized by rapid biological, social and emotional development. India has the highest adolescent population, however, there is paucity of literature reporting the sleep quality among adolescents. OBJECTIVE: To determine the sleep quality and its associated factors among adolescents residing in selected villages of rural Puducherry. MATERIALS AND METHODS: A community-based cross-sectional study was conducted among adolescents during March and April 2018. Two out of four villages were randomly selected and all the adolescents were contacted through a household visit and a questionnaire was administered. The semi-structured questionnaire contained socio-demographic details of adolescents and details on living environment. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) scale. Sleep quality is expressed as a proportion with a 95% confidence interval (CI). The association of socio-demographic characteristics with poor sleep quality is reported as a prevalence ratio. RESULTS: The total number of adolescents interviewed was 789. The mean age of the study participants was 14.1 (±2.4) years and the majority, 440 (55.8%) were boys and 684 (86.7%) belonged to a nuclear family. More than a quarter, 210 (26.6%) belonged to the middle class as regards socio-economic status. Environmental assessment of households showed more than half, 456 (57.8%) were staying in a "pucca" house and the majority, 642 (81.4%) had adequate cross ventilation. The prevalence of poor quality of sleep among the adolescents was 2.5% (95% CI: 1.6%-3.9%). It was found that higher educational level [adjusted prevalence ratio (aPR) - 3.43] and belonging to higher socio-economic class (aPR - 5.48) were found to be significant determinants for poor quality of sleep among adolescents. CONCLUSION: The current study found that only 2.5% of the adolescents have poor sleep quality. Adolescents with higher educational level and higher socio-economic status were more prone to have poor quality of sleep.

A longitudinal study on high risk pregnancy and its outcome among antenatal women attending rural primary health centre in Puducherry, South India.

BACKGROUND: Almost 15% of all pregnant women can develop potentially life-threatening complications. As a result, identification of high-risk pregnancy at earliest stage will be useful in directing appropriate intervention. Hence, the current study was done to determine the prevalence and outcome of high-risk pregnancy among antenatal women in rural Puducherry. MATERIALS AND METHODS: A record-based longitudinal study was done during March 2018 among 569 antenatal women who have attended rural health center of tertiary care institute. High-risk pregnancy was classified based on the guidelines from Pradhan Mantri Surakshit Matritva Abhiyan and outcome assessment based on the obstetric and neonatal outcomes. RESULTS: Among 569 antenatal case record reviewed, 315 (55.3%) were in the age group of 20-25 years and majority (463, 81.4%) belonged to below poverty line families; 410 (74.3%) registered their current pregnancy within the first trimester. The prevalence of high-risk pregnancy among study participants was 18.3% (95% confidence interval: 15.3%-21.7%). Majority (81.9%) had term delivery. Regarding obstetric and neonatal outcomes, majority had spontaneous vaginal delivery (73.9%); about 10.4% gave birth to low-birth weight baby, and only 1.7% had stillbirth. Parity, socioeconomic status, and unfavorable outcomes such as low-birth weight, preterm, and postterm delivery were associated with high-risk pregnancy. CONCLUSION: The current study found that almost one-fifth of the pregnant women in rural area have high-risk pregnancy. Unfavorable obstetric and neonatal outcomes were common among high-risk cases. Hence, early detection of high-risk pregnancy needs to be done at primary health-care level to improve the maternal, obstetric, and neonatal outcomes.