Sleep and emotional disturbances are common among women with gestational diabetes mellitus (GDM) and are associated with poor glycemic control and adverse pregnancy outcomes (APOs). Mind–body approaches have been proposed as supportive strategies to improve psychological and metabolic health; however, longitudinal evidence during pregnancy remains limited. In this prospective controlled cohort study, 200 women with GDM were enrolled at 24 to 28 gestational weeks. Participants were classified into a mind–body integrative care group (routine prenatal care supplemented with structured mindfulness, relaxation, and sleep management components) or a routine-care group (routine prenatal care alone), according to the care pathway received under routine clinical practice. Outcomes were assessed at baseline, after 8 weeks, and at delivery. Sleep quality (Pittsburgh Sleep Quality Index), anxiety (7-item Generalized Anxiety Disorder Scale), depression (9-item Patient Health Questionnaire), and metabolic indicators (glycated hemoglobin HbA1c, homeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein) were measured. Multivariable logistic regression, Cox proportional hazards models, and counterfactual-based parallel mediation analyses were applied. After 8 weeks, exposure to mind–body integrative care was associated with lower odds of sleep disturbance (odds ratio = 0.61, 95% confidence interval = 0.38–0.98, P = .041) and more favorable metabolic profiles, including lower HbA1c, homeostasis model assessment of insulin resistance, and high-sensitivity C-reactive protein levels. The overall incidence of APOs was lower in the mind–body integrative care group than in the routine-care group (28.0% vs 42.0%, P = .038), corresponding to a directionally consistent reduction in APO risk in Cox analysis (hazard ratio ≈ 0.70). Mediation analyses suggested that changes in sleep quality (ΔPittsburgh Sleep Quality Index) and glycemic control (ΔHbA1c) represented the primary indirect pathways, jointly accounting for approximately 67% of the observed association. Exposure to mind–body integrative care was associated with better sleep quality, more favorable metabolic profiles, and a lower incidence of APOs among women with GDM. The observed psychological–metabolic mediation pattern supports the potential relevance of integrative, nonpharmacological approaches in prenatal care while underscoring the need for further randomized studies to establish causality.
Xiaowei et al. (Fri,) studied this question.