Background. Optimal adherence to prescribed medications in women with gestational diabetes is relevant for perinatal outcomes. Objective. To summarize available information on the prevalence and factors contributing to medication adherence in women with gestational diabetes from the biological and psychosocial perspectives. Methods. A literature search on adherence in gestational diabetes was conducted in PubMed/MEDLINE, CINAHL, Scopus, and the Directory of Open Access Journals for studies published on the topic. The Arksey and O’Malley framework for scoping reviews was used to explore and summarize the evidence. Results. A total of 2395 studies were retrieved of which 13 fully met the eligibility criteria. The studies were reported in Zimbabwe (), Iran (), Mexico (), South India (), the United States of America (), and one multinational study covering Australia, Europe, North and South America. The main types of antidiabetic medications used were insulin (), metformin (), and glyburide (). The prevalence of adherence ranged from 35.6% to 97%, with the assessment tool being self-report measures (). The main factors associated with nonadherence included worsening pregnancy symptoms, side effects of medications, perceived risks, mental health symptoms, poor social support, and socioeconomic status. Recommendations that evolved from the studies to improve adherence included education, counselling, improved support networks, and social interventions, while the main reported interventional study employed continuous education on the impact of adherence on perinatal outcomes. Conclusion. Medication nonadherence in gestational diabetes seems to be influenced by multiple factors with some educational interventions positively impacting adherence behaviours. Thus, future research in women with gestational diabetes could consider interventions from a multifactorial perspective to improve therapeutic outcomes.

中文翻译：

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妊娠期糖尿病妇女对降糖药物的依从性

背景。妊娠期糖尿病女性对处方药物的最佳依从性与围产期结局相关。客观。从生物学和心理社会的角度总结有关妊娠期糖尿病妇女服药依从性的患病率和因素的现有信息。方法。在 PubMed/MEDLINE、CINAHL、Scopus 和开放存取期刊目录中进行了关于妊娠糖尿病依从性的文献检索，以获取有关该主题的研究。用于范围审查的 Arksey 和 O'Malley 框架用于探索和总结证据。结果。共检索到 2395 项研究，其中 13 项完全符合资格标准。这些研究报告在津巴布韦（),伊朗 (),墨西哥 (),印度南部 ()、美利坚合众国 ()，以及一项涵盖澳大利亚、欧洲、北美和南美的跨国研究。使用的主要抗糖尿病药物类型是胰岛素（),二甲双胍 ()和格列本脲 (）。依从率从 35.6% 到 97% 不等，评估工具是自我报告措施（）。与不依从性相关的主要因素包括妊娠症状恶化、药物副作用、感知风险、心理健康症状、社会支持差和社会经济地位。从研究中得出的提高依从性的建议包括教育、咨询、改进的支持网络和社会干预，而主要报告的干预研究采用持续教育来了解依从性对围产期结局的影响。结论. 妊娠糖尿病的药物不依从性似乎受到多种因素的影响，其中一些教育干预对依从性行为产生积极影响。因此，未来对妊娠糖尿病女性的研究可以从多因素的角度考虑干预措施，以改善治疗结果。