Prenatal depressive symptoms and abnormalities of glucose tolerance during pregnancy among Hispanic women

Abstract

The aim of this study is to prospectively examine the association between maternal depressive symptoms in early pregnancy and risk of abnormal glucose tolerance (AGT) and impaired glucose tolerance (IGT) in mid-pregnancy. We evaluated this association among 934 participants in Proyecto Buena Salud, a prospective cohort study of Hispanic (predominantly Puerto Rican) women in Western Massachusetts. Depressive symptoms were assessed in early pregnancy using the 10-item Edinburgh Postnatal Depression Scale. Scores ≥13 indicated at least probable minor depression and scores ≥15 indicated probable major depression. AGT and IGT were diagnosed using American Diabetes Association criteria. In early pregnancy, 247 (26.5 %) participants experienced at least minor depression and 163 (17.4 %) experienced major depression. A total of 123 (13.2 %) were classified with AGT and 56 (6.0 %) were classified with IGT. In fully-adjusted models, the odds ratio for AGTassociated with minor depression was 1.20 (95 % CI 0.77-1.89) and for major depression was 1.34 (95 % CI 0.81-2.23). The odds ratio for IGT associated with minor depression was 1.22 (95 % CI 0.62-2.40) and for major depression was ). We did not observe an association with continuous screening glucose measures. Findings in this prospective cohort of Hispanic women did not indicate a statistically significant association between minor or major depression in early pregnancy and AGT or screening glucose K. A. Ertel

Relationship between depression and diabetes in pregnancy: A systematic review

“…Overall, 48 publications were included in this review (Figure 1, Table 1, Table 2, Table 3, Supplementary Table 1). Of these, 30 described prospective observational studies[20,21,23,24,26,27,29-31,34,35,37,38,41,43-45,47-49,51,54,57,58,60-62,65-67], 15 described retrospective observational studies[22,25,28,32,39,40,42,46,50,53,55,56,59,63,64], and three described randomized controlled trials (RCTs)[33,36,52], two of which reported only baseline data[36,52]. Two publications described the same study, but reported different subgroup analyses[23,29].…”

“…There were 22 studies that measured depression only during pregnancy[22,24,26,30,31,36,37,40,41,43,45,51,53-55,57-59,61,64,66,67]. Conversely, 11 studies focussed on postpartum depression, most commonly measured within the first 3 mo[20,21,23,25,27,29,33,47,52,62,63].…”

“…Two studies of the same national database reported a greater prevalence[55,56] and one study reported a greater risk (OR[28]) of GDM among women with a pre-pregnancy history of depression. In contrast, two studies reported no difference in the prevalence of GDM (or abnormal glucose levels) among women with depression early in pregnancy compared with women without depression[37,53], and a third study reported similar prevalence rates of GDM in women with and without pre-pregnancy depression[50]. …”

Roles of Inflammation and Depression in the Development of Gestational Diabetes

“…Racial disparities may also play a role, with Hispanic populations less likely than Caucasian populations to display this association 79,81 . Conversely, the available studies examining GDM as a risk factor for postpartum depression have either not found an association 75,82 or else found that when a relationship is present, it is explained by adjustment for medical comorbidities 83,84 .…”

Abuse in Childhood or Adolescence and Gestational Diabetes

“…GDM risk factors include overweight/obesity 4 and sociodemographic factors such as minority race and low SES. 5 Psychosocial factors, such as stress 6 and prenatal depression, 7,8 may also contribute to GDM.…”