Dre Leah Gilbert, doctorante de Prof. Puder et Prof. Horsch, a brillamment défendu sa thèse en janvier 2021
Sa thèse avait pour titre: "MATERNAL MENTAL AND METABOLIC HEALTH DURING THE PERINATAL PERIOD"
Son abstract:
Aims: This thesis aimed to understand the role of psychosocial well-being (self-efficacy, social support and mental health; comprised of both depression and well-being scores) in women with gestational diabetes mellitus (GDM) by 1: conducting an integrative review synthetizing previous research on how diet, physical activity and psychosocial well-being interact and which type of intervention (psychosocial well-being, diet or physical activity) lowers adverse outcomes associated with GDM, 2: testing the effects of a novel interdisciplinary and psychosocial well-being intervention created on the basis of the results of 1, in the form of a randomized controlled trial (RCT) protocol and, 3: investigating the evolution of mental health and, 4: its association with weight, weight gain and the need for glucose-lowering medication in two prospective clinical cohort studies.
Methods: The search strategy for aim 1 included carefully selected terms that corresponded to domains of interest in women with GDM. For aim 2, the efficacy of a the new intervention is tested by comparing its health outcomes to a control group. Aims 3 and 4 are based on a prospective clinical cohort of women diagnosed with GDM attending a Swiss University Hospital. The outcomes include self-report questionnaires and data which was extracted from the patient’s medical records.
Results: The review showed that even if psychosocial well-being was positively associated with lifestyle behaviors, it was not a part of previous lifestyle interventions. These lifestyle interventions mostly improved diet and physical activity, psychological factors and some metabolic outcomes. The data collection for the RCT is still ongoing. Mental health evolved positively between GDM diagnosis and 6-8 weeks postpartum. Only clinically relevant symptoms of depression after GDM diagnosis were associated to subsequent weight gain in pregnancy. There were no other association between mental health and weight or weight gain in pregnancy. Mental health symptoms and glucose-lowering medication did not influence each other in an unfavorable way.
Clinical implications: This thesis focused on the field of psychosocial well-being in women with GDM, which is still insufficiently studied today. The results demonstrate that psychosocial well-being has an impact on lifestyle behaviors and on some of the investigated metabolic outcomes (i.e. weight gain). Hence, women with GDM should be screened for mental health symptoms and treated accordingly.
Mots clés : GDM, mental health, lifestyle behavior.
Nous remercions vivement les personnes suivantes ayant participé à sa défense en tant que Jury :
Prof. Nicole Sekarski, Présidente
Prof. Jardena Puder, Directrice de thèse
Prof. Antje Horsch, Co-directrice de thèse
Prof. Nadine Messerli, experte
Prof. François Jornayvaz, expert