Prevalence of depression among subjects with and without gestational diabetes mellitus in Bangladesh: a hospital based study

Abstract

BackgroundData on association between depression and diabetes during the pregnancy period in Asia, specifically in Bangladesh are scarce. The study was designed to measure the prevalence of depression during pregnancy with or without Gestational Diabetes Mellitus (GDM).MethodsSeven hundred and forty eight pregnant women (382 with GDM, 366 without-GDM) attending at the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, participated in the study. Blood glucose was measured following both WHO and ACOG criteria; GDM was diagnosed within 24–28 weeks. Depressive symptoms were assessed following MADRS scale. Semi-structured questionnaire was used to record their socio-demographic status and clinical and family history. Blood pressure, height, weight were also measured.ResultsOverall prevalence of depression was 18.32 %. Depression was higher in GDM subjects (25.92 %) compared to without-GDM subjects (10.38 %) with mean age of of 28.34 and 27.17 years respectively. Prevalence of depression was alarming in both the extreme of age. Dwelling place (P < 0.009) and past history of GDM (P < 0.018) had strong association with Depression. Higher prevalence of depression was found in Primipara whereas the risk of GDM increased with parity. Other obstetrical factors did not show any significant association with depression and GDM. Income (self and total family), physical exercise, sedentary lifestyle and workload had no significant statistical association with depression or GDM.ConclusionHigher rate of depression in pregnancy deserves medical attention especially women diagnosed with GDM. Further studies should estimate adverse pregnancy outcome for untreated depression especially in GDM cases.

Prevalence of antenatal depression in South Asia: a systematic review and meta-analysis

“…Edinburgh Postnatal Depression Scale (EPDS) was the most frequently used screening tool reported in 17 studies 26 27 29 30 32 34 35 37 40 42 43 47–49 51 53 54. Other tools included Beck Depression Inventory (BDI),41 Hospital Anxiety Depression Scale (HADS),28 38 44 45 56 the Aga Khan University Anxiety Depression Scale (AKUADS),46 55 Kessler Psychological Distress Scale (K-10),25 39 the Montogomery and Asberg Depression Rating Scale (MADRS),36 Hamilton Depression Scale (HAM-D),50 57 Centre for Epidemiological Studies—Depression (CES-D) Scale,52 Patient Health Questionnaire (PHQ-9)33 and Depression Anxiety Stress Scale (DASS-42) 31. There were variations in the threshold scores for identifying antenatal depression both among the tools used and among the studies that used the same tool.…”

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].…”

“…A total of 28 studies included only women with GDM[20,23,26-29,31,33,35-38,40,43-45,47-49,51-53,57,58,60,61,63,64], 14 included women with either GDM or pre-existing diabetes (although the type was not always reported)[22,25,39,41,42,46,50,54-56,59,62,65,66], one included women with either GDM or type 1 diabetes[34], one included only women with type 1 diabetes[67], one included only women with pre-existing diabetes (type not reported)[30] and three did not report the type of diabetes[21,24,32] (Tables 1-3, Supplementary Table 1). Sample sizes ranged from 36[65] to more than 32 million in a retrospective analysis of a nationwide hospital database[22] (Tables 1-3, Supplementary Table 1).…”

“…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].…”

“…Among women with GDM (Table 1, Figure 3), the reported prevalence of depression during or after pregnancy ranged widely, from 4.1% to 80% (16 studies[26,31,33,35,39-41,43,44,46,51,52,54,57,58,61], median 14.7%). Heterogeneity in sample size, the definition of depression, and the timing of its assessment is likely to have contributed to this wide range of prevalence rates.…”