Changes in Health Status Experienced by Women with Gestational Diabetes and Pregnancy-Induced Hypertensive Disorders

Kim, Catherine; Brawarsky, Phyllis; Jackson, Rebecca; Fuentes-Afflick, Elena; Haas, Jennifer S.

doi:10.1089/jwh.2005.14.729

Cited by 62 publications

(71 citation statements)

References 25 publications

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“…2,4 Moreover, if women with preexisting diabetes or GDM are more likely to be diagnosed with perinatal depression because of a greater number of healthcare visits, this might explain the observed increased odds of depression among women with preexisting diabetes and GDM in the study by Kozhimannil et al 11 With respect to the lack of association between GDM and antenatal depression, our findings were similar to those of three prior smaller studies. [12][13][14] However, evidence from the Australian Carbohydrate Intolerance Study in Pregnant Women, a randomized trial of treatment of hyperglycemia in pregnancy, suggests that treatment of hyperglycemia in pregnancy may improve mood profile, 26 and if women with GDM in our study were screened for depression after beginning treatment for GDM, this could explain our null findings. Therefore, we conducted a sensitivity analysis excluding women screened for depression after 4 months of gestation.…”

Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 97%

“…[11][12][13][14] Three earlier studies found that the mood profile of women with GDM did not differ significantly from that of women without diabetes in pregnancy. [12][13][14] These were relatively small studies that measured antenatal depressive symptoms rather than using diagnostic criteria for major depression. In contrast, using a large sample of pregnant women enrolled in Medicaid, Kozhimannil et al 11 reported a 2-fold increase in odds of receiving a diagnosis of perinatal depression (defined as depression in the 6 months before delivery and in the first year postpartum) among women with prepregnancy diabetes and GDM compared to women with no diabetes.…”

Section: Introductionmentioning

confidence: 97%

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Diabetes and Depression in Pregnancy: Is There an Association?

Katon

Russo

Gavin

et al. 2011

Journal of Women's Health

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Background: Prior studies have reported inconsistent findings regarding the association of antenatal depression with pregnancy-related diabetes. This study examined the association of diabetes and antenatal depression. Methods: We conducted a cross-sectional analysis of baseline data from a prospective cohort study of pregnant women receiving prenatal care at a single University of Washington Medical Center clinic between January 2004 and January 2009. The primary exposure was diabetes in pregnancy (no diabetes, preexisting diabetes, or gestational diabetes [GDM]). Antenatal depression was defined by the Patient Health Questionnaire-9 (PHQ-9) score or current use of antidepressants. Antenatal depression was coded as (1) any depression (probable major or minor depression by PHQ-9 or current antidepressant use) and (2) major depression (probable major depression by PHQ-9 or current antidepressant use). Logistic regression was used to quantify the association between diabetes in pregnancy and antenatal depression. Results: The prevalences of preexisting diabetes, GDM, any antenatal depression, and major antenatal depression were 9%, 18%, 13.6%, and 9.8%, respectively. In the unadjusted analysis, women with preexisting diabetes had 54% higher odds of any antenatal depression compared to those without diabetes (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.08-2.21). After adjusting for important covariates the association was attenuated (OR 1.16, 95% CI 0.79-1.71). Results were similar for antenatal major depression. GDM was not associated with increased odds for any antenatal depression or antenatal major depression. Conclusions: Neither preexisting diabetes nor GDM was independently associated with increased risk of antenatal depression.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

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Diabetes and Depression in Pregnancy: Is There an Association?

Katon

Russo

Gavin

et al. 2011

Journal of Women's Health

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“…Although explanations are speculative, women may have not had optimal levels of physical activity because of the presence of multiple other barriers. Previous studies suggest that the condition of pregnancy itself may not decrease activity, 21 but the presence of young children may eventually have a detrimental effect on physical activity. 22 Therefore, incontinence may not have been a significant barrier in and of itself.…”

Section: Discussionmentioning

confidence: 98%

Stress Urinary Incontinence in Women with a History of Gestational Diabetes Mellitus

Kim

McEwen

Sarma

et al. 2008

Journal of Women's Health

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Objective: Stress urinary incontinence may serve as a barrier to lifestyle modification among women at high risk for diabetes, but the prevalence of stress urinary incontinence among women with histories of gestational diabetes mellitus (hGDM) is unknown. The purpose of this study was to examine the prevalence of stress incontinence among women with hGDM and to examine its association with their current physical activity.Methods: We surveyed women with hGDM within the past 5 years who were currently enrolled in a managed care plan (n ‫؍‬ 228). In a cross-sectional analysis, self-reported weekly or more frequent stress incontinence was the primary independent variable and measures of physical activity and body mass index (BMI) were the outcomes of interest. We constructed multivariable models that adjusted for participant characteristics associated with the measure of incontinence or outcomes in bivariate analyses.Results: Of the 228 women with hGDM, 49% reported weekly or more frequent incontinence during pregnancy, and 28% reported that incontinence affected their activities during pregnancy. Fifty percent reported weekly or more frequent incontinence after delivery, with 27% reporting interference of incontinence with activity. Less than a third of women reported optimal physical activity, and 42% were obese. After adjustment for characteristics associated with measures of activity and incontinence, there was minimal association between levels of activity and stress urinary incontinence; similarly, there was no association between BMI and measures of stress incontinence.Conclusions: Stress urinary incontinence is common among women with hGDM but does not appear to be associated with physical activity levels or BMI. 783

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“…These behavioral patterns may have continued after pregnancy. In another prospective cohort study, women with hGDM had significantly poorer physical functioning before pregnancy than unaffected women before pregnancy but not after delivery (9). Studies from Australia (n ϭ 226) and Denmark (n ϭ 121) suggest that onethird or fewer women with hGDM undertake adequate physical activity after delivery (10,11), and most women with hGDM had poor diets (11).…”

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confidence: 99%

Health Behaviors Among Women of Reproductive Age With and Without a History of Gestational Diabetes Mellitus

2006

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OBJECTIVE -To estimate the prevalence of several health-related behaviors among women of reproductive age with and without a history of gestational diabetes mellitus (hGDM).RESEARCH DESIGN AND METHODS -We performed a cross-sectional study using the [2001][2002][2003] Behavioral Risk Factor Surveillance System, a national population-based random sample telephone survey. Participants were 177,420 women aged 18 -44 years with and without self-reported hGDM. Outcome measures included meeting physical activity and fruit and vegetable guidelines, sedentary activity level, and current smoking.RESULTS -Approximately 3% (n ϭ 4,718) of women aged 18 -44 years reported physiciandiagnosed hGDM. Women with hGDM had higher BMIs, were significantly older, were less often educated or employed, and were more often Hispanic or African American, married, and living with children. Women with hGDM reported worse self-rated health than women without hGDM. In unadjusted and multivariate adjusted comparisons, there were no significant differences in levels of physical activity, fruit and vegetable consumption, or smoking among women with and without hGDM. However, women with hGDM who lived with children were significantly less likely to meet fruit and vegetable consumption guidelines (odds ratio 0.78 [95% CI 0.63-0.97]; P Ͻ 0.05) and more likely to smoke (1.21 [1.01-1.47]; P Ͻ 0.05) than their counterparts without hGDM.CONCLUSIONS -Despite their elevated risk for future diabetes, women with hGDM who lived with children were less likely to meet fruit and vegetable consumption guidelines and more likely to smoke than women with children who did not have hGDM. Diabetes Care 29:1788 -1793, 2006G estational diabetes mellitus (GDM), or glucose intolerance first recognized during pregnancy, affects 3-8% of pregnancies in the U.S. (1). The incidence of GDM is increasing, fueled by maternal obesity and advancing maternal age (2). Although most women with GDM return to normal glucose tolerance after delivery, as many as 10 -50% of women with GDM are diagnosed with type 2 diabetes within 5 years (3-5). Better characterization of women with a history of gestational diabetes mellitus (hGDM) has taken on heightened urgency after the Diabetes Prevention Program (DPP) found that its lifestyle intervention prevented or delayed the onset of type 2 diabetes (6). The DPP specifically recruited women with self-reported hGDM and current glucose intolerance, among other risk factors (7). The DPP lifestyle intervention successfully prevented or delayed the onset of type 2 diabetes among women with and without hGDM (R. Ratner, personal communication).To our knowledge, there have been no population-based studies of health behavior for U.S. women with hGDM. In the Nurses Health Study II, women who eventually developed GDM had poorer health behaviors than unaffected women before pregnancy (8). These behavioral patterns may have continued after pregnancy. In another prospective cohort study, women with hGDM had significantly poorer physical functioning before preg...

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Changes in Health Status Experienced by Women with Gestational Diabetes and Pregnancy-Induced Hypertensive Disorders

Abstract: Women with PIH, but not GDM, more often experience significant declines in health status from prepregnancy to postpartum than unaffected women.

Cited by 62 publications

References 25 publications

Diabetes and Depression in Pregnancy: Is There an Association?

Diabetes and Depression in Pregnancy: Is There an Association?

Stress Urinary Incontinence in Women with a History of Gestational Diabetes Mellitus

Health Behaviors Among Women of Reproductive Age With and Without a History of Gestational Diabetes Mellitus

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