Effectiveness of the Information–Motivation–Behavioral Skills Model-Based Nursing Intervention on Maternal and Neonatal Outcomes in Women with Gestational Diabetes Mellitus: A Randomized Controlled Trial

TL;DR

A nursing intervention based on the IMB model improved outcomes for pregnant women with gestational diabetes compared to traditional education.

Contribution

Demonstrated the effectiveness of the IMB model in managing gestational diabetes and improving maternal-neonatal outcomes.

Findings

The IMB group had significantly lower fasting glucose and HbA1c levels after intervention.

The IMB group required less insulin treatment and had fewer cesarean sections and neonatal complications.

Postpartum glucose metabolism abnormalities were reduced in the IMB group.

Abstract

This study aimed to evaluate the effectiveness of the information–motivation–behavioral skills (IMB) model-based nursing intervention in improving maternal and neonatal outcomes in patients with gestational diabetes mellitus (GDM).

A total of 240 pregnant women with GDM were enrolled and randomly assigned to either the IMB group or the traditional health education group between June 2023 and May 2024. The IMB group received a 6-week intervention incorporating information support, motivational enhancement, and behavioral skill development. The control group received standard health education. Outcomes assessed included fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), insulin treatment rates, adverse delivery outcomes, and postpartum glucose metabolism abnormalities.

The IMB group showed a significant reduction in FPG from 8.05 mmol/L (145.05 mg/dL) to 4.95 mmol/L (89.19 mg/dL) (p < 0.001) and HbA1c from 6.60% to 4.98% (p < 0.001) postintervention, compared with the control group’s reduction to 6.00 mmol/L (108.11 mg/dL) (p < 0.001) and 5.78% (p < 0.001), respectively. The rate of insulin treatment was 2.5% in the IMB group versus 13.3% in the control group (p = 0.003). The IMB group had a lower cesarean section rate (15.0% vs. 40.0%, p < 0.001) and neonatal respiratory distress syndrome incidence (1.67% vs. 10.0%, p = 0.007). Postpartum, the IMB group exhibited a lower total incidence of abnormal glucose metabolism (12.5%) compared to the control group (25.0%, p < 0.001).

The IMB model-based nursing intervention was more effective in managing blood glucose levels, reducing the need for insulin therapy, and improving both maternal and neonatal outcomes compared to traditional health education. This intervention may offer a promising approach to enhance the care of women with GDM.

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