Depression precedes, but does not follow, gestational diabetes

Abstract

Objectives To determine whether past history of depression is associated with increased rates of gestational diabetes, and whether history of gestational diabetes is associated with increased rates of postpartum depression. Research design Data for this case–control study consisted of de‐identified chart records for 1439 women who received pregnancy care at a large university hospital between 1998 and 2017. Results A history of depression prior to pregnancy was associated with gestational diabetes requiring insulin, although not with subtler degrees of gestational hyperglycemia. Diabetes in pregnancy was not associated with an increased risk of postpartum depression. Trauma history was associated with both impaired glucose tolerance in pregnancy and postpartum depression. Conclusions Past episodes of depression increase risk for the most severe form of gestational diabetes; however, gestational diabetes does not contribute significantly to risk for postpartum depression. This suggests a unidirectional association, unlike the bidirectional association of diabetes with depression among the general population. History of trauma increases risk for both gestational hyperglycemia and postpartum depression, suggesting important health effects of trauma that may differ measurably from those associated with depression.

A systematic review and meta-analysis of gestational diabetes mellitus and mental health among BAME populations

“…An initial search identified 20,040 studies, of which, those with limited discussions in relation to MH outcomes and of poor quality, were excluded, resulting in a final dataset of 69 studies ( Table 1a ) of which 46 studies were systematically included and thematically analysed ( Table 2 ). These 46 studies included 26 qualitative [ 12 , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ], 17 cohort [ 7 , 18 , 21 , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] ], 6 controlled [61] , [62] , [63] , [64] , [65] , [66] , 2 randomised controlled trials [ 19 , 67 ] and 2 mixed methods [ 68 , 69 ] studies. Based on the eligibility criteria, and the quality assessment, 21 studies were selected for the meta-analysis.…”

“…On the contrary, Nicklas and colleagues reported that ethnicity did not alter the risk of PPD [9] , following adjustments for demographic variables. 2 studies reported that GDM did not alter the risk of PND in Hispanic [55] and Iranian [65] women. Another large cohort study reported that African American women with GDM had a lower risk of PPD in comparison with Caucasians [21] .…”

Is there an association between anxiety and depression prior to and during pregnancy and gestational diabetes? An analysis of the Born in Bradford cohort

“…Research to date on the relationship between GDM and CMD during pregnancy has yielded mixed results; some studies have found evidence of an association, while others have not ( Byrn and Penckofer, 2013 ; Ross et al., 2016 ). The smaller number of studies examining the association between CMD prior to pregnancy and subsequent GDM have provided evidence supporting a relationship ( Beka et al., 2018 ; Bowers et al., 2013 ; Clark et al., 2019 ). Our own meta-analysis of studies during pregnancy and up to one year postpartum, while finding an increased risk of depression in women with GDM during pregnancy, found substantial heterogeneity between studies measuring both symptoms and diagnoses of depression and anxiety ( Wilson et al., 2020 ).…”

“…None of the studies were of a UK population and despite an increasing awareness of the influence of preconception mental health on pregnancy outcomes ( Patton et al., 2018 ; Wilson et al., 2018 ) there have been few studies investigating the risk of GDM in women with preconception mental disorders. A small number of North American cohorts have found an increased risk of GDM in women with anxiety and depression prior to pregnancy ( Beka et al., 2018 ; Bowers et al., 2013 ; Clark et al., 2019 ) but it is not clear the extent to which these findings generalise to a UK population.…”

The German Gestational Diabetes Study (PREG): Rationale, Methodology and Design

“…This has been shown by a multitude of studies and meta analyses which demonstrated that GDM increases the risk to develop not only type 2 diabetes [8,9] but also the metabolic syndrome [10,11], cardiovascular disease [12] and some form of cancer [13]. A potential association with depression is currently controversially discussed [14,15].…”