The Association Between Depression and Diabetes in the Perinatal Period

Rasmussen‐Torvik, Laura J.; Harlow, Bernard L.

doi:10.1007/s11892-010-0108-4

Cited by 8 publications

(6 citation statements)

References 43 publications

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“…Such guidance, however, should be based on sound research evidence, which, as our review demonstrates, is currently lacking. In agreement with the results of our systematic review, two narrative reviews[5,6] and a systematic review focussing on the transition to motherhood in women with type 1 diabetes[79] have recognized that rigorous research into DIP and depression (and other psychosocial issues) is much needed. In addition, greater awareness of depression is needed among clinicians who treat women with diabetes, which will allow for better planning and management of pregnancy.…”

Section: Discussionsupporting

confidence: 83%

“…Indeed, between 2000 and 2010, the age-standardized prevalence of pregnancies in the United States affected by type 1 or type 2 diabetes increased by 37%[3] and the prevalence of GDM increased by 56%[4]. Diabetes in pregnancy can have adverse effects on both the mother and child, including increased risk of miscarriage, stillbirth, preterm delivery, pre-eclampsia, cesarean section delivery, postpartum development of type 2 diabetes in women with GDM, congenital malformations, fetal macrosomia, neonatal hypoglycemia, neonatal respiratory distress, and obesity and insulin resistance in childhood, followed by impaired glucose tolerance and type 2 diabetes later in life[1,5,6]. …”

Section: Introductionmentioning

confidence: 99%

“…Depression during pregnancy is associated with poorer maternal health, increased likelihood of obstetric complications, preterm birth, and neonatal complications[5,6]. Postpartum depression is associated with difficulties with maternal-child bonding, inadequate care of the child, and lower rates of breastfeeding[7].…”

Section: Introductionmentioning

confidence: 99%

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Relationship between depression and diabetes in pregnancy: A systematic review

Ross

Falhammar

Chen

et al. 2016

WJD

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AIMTo systematically review the literature on women with both diabetes in pregnancy (DIP) and depression during or after pregnancy.METHODSIn this systematic literature review, PubMed/MEDLINE and EMBASE were searched (13 November 2015) using terms for diabetes (type 1, type 2, or gestational), depression, and pregnancy (no language or date restrictions). Publications that reported on women who had both DIP (any type) and depression or depressive symptoms before, during, or within one year after pregnancy were considered for inclusion. All study types were eligible for inclusion; conference abstracts, narrative reviews, nonclinical letters, editorials, and commentaries were excluded, unless they provided treatment guidance.RESULTSOf 1189 articles identified, 48 articles describing women with both DIP and depression were included (sample sizes 36 to > 32 million). Overall study quality was poor; most studies were observational, and only 12 studies (mostly retrospective database studies) required clinical depression diagnosis. The prevalence of concurrent DIP (any type) and depression in general populations of pregnant women ranged from 0% to 1.6% (median 0.61%; 12 studies). The prevalence of depression among women with gestational diabetes ranged from 4.1% to 80% (median 14.7%; 16 studies). Many studies examined whether DIP was a risk factor for depression or depression was a risk factor for DIP. However, there was no clear consensus for either relationship. Importantly, we found limited guidance on the management of women with both DIP and depression.CONCLUSIONGiven the increasing prevalence of diabetes and depression, high-quality research and specific guidance for management of pregnant women with both conditions are warranted.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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Relationship between depression and diabetes in pregnancy: A systematic review

Ross

Falhammar

Chen

et al. 2016

WJD

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“…These instruments have been used to assess postnatal depression in women with gestational diabetes [30], however we could not identify published studies in women with T1DM. In contrast to the large numbers of papers reporting on the association between diabetes and depression, there is a lack of research investigating postnatal depression in women with T1DM.…”

Section: Resultsmentioning

confidence: 99%

Transition to motherhood in type 1 diabetes: design of the pregnancy and postnatal well-being in transition questionnaires

Rasmussen

Dunning

Hendrieckx

et al. 2013

BMC Pregnancy Childbirth

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BackgroundLife transitions are associated with high levels of stress affecting health behaviours among people with Type 1 diabetes. Transition to motherhood is a major transition with potential complications accelerated by pregnancy with risks of adverse childbirth outcomes and added anxiety and worries about pregnancy outcomes. Further, preparing and going through pregnancy requires vigilant attention to a diabetes management regimen and detailed planning of everyday activities with added stress on women. Psychological and social well-being during and after pregnancy are integral for good pregnancy outcomes for both mother and baby. The aim of this study is to establish the face and content validity of two novel measures assessing the well-being of women with type 1 diabetes in their transition to motherhood, 1) during pregnancy and 2) during the postnatal period.MethodsThe approach to the development of the Pregnancy and Postnatal Well-being in T1DM Transition questionnaires was based on a four-stage pre-testing process; systematic overview of literature, items development, piloting testing of questionnaire and refinement of questionnaire. The questionnaire was reviewed at every stage by expert clinicians, researchers and representatives from consumer groups. The cognitive debriefing approach confirmed relevance of issues and identified additional items.ResultsThe literature review and interviews identified three main areas impacting on the women’s postnatal self-management; (1) psychological well-being; (2) social environment, (3) physical (maternal and fetal) well-being. The cognitive debriefing in pilot testing of the questionnaire identified that immediate postnatal period was difficult, particularly when the women were breastfeeding and felt depressed.ConclusionsThe questionnaires fill an important gap by systematically assessing the psychosocial needs of women with type 1 diabetes during pregnancy and in the immediate postnatal period. The questionnaires can be used in larger data collection to establish psychometric properties. The questionnaires potentially play a key role in prospective research to determine the self-management and psychological needs of women with type 1 diabetes transitioning to motherhood and to evaluate health education interventions.

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“…The study has several limitations. Although we attempted to focus on incident pregnancy hyperglycaemia (including GDM) and incident prenatal depressive symptoms, it is difficult to establish the temporality for these two dynamic conditions that we assessed almost concurrently within a short period. Therefore, the association between pregnancy hyperglycaemia and prenatal depressive symptoms was essentially cross‐sectional, and could be explained by either direction of the association or both.…”

Section: Commentsmentioning

confidence: 99%

Pregnancy Hyperglycaemia and Risk of Prenatal and Postpartum Depressive Symptoms

Huang

Rifas‐Shiman

Ertel

et al. 2015

Paediatric Perinatal Epid

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Background Glucose dysregulation in pregnancy may affect maternal depressive symptoms during the prenatal and postpartum periods via both physiologic and psychological pathways. Methods During mid-pregnancy, a combination of 50-gram 1-h non-fasting glucose challenge test (GCT) and 100-gram 3-h fasting oral glucose tolerance test (OGTT) was used to determine pregnancy glycemic status among women participating in Project Viva: normal glucose tolerance (NGT), isolated hyperglycemia (IHG), impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM). Using the Edinburgh Postnatal Depression Scale (EPDS), we assessed depressive symptoms at mid-pregnancy and again at 6 months postpartum. We used logistic regression, adjusted for sociodemographic, anthropometric and lifestyle factors, to estimate the risk of elevated prenatal and postpartum depressive symptoms (EPDS ≥ 13 on 0–30 scale) in relation to GCT glucose levels and GDM status in separate models. Results 9.6% of women showed prenatal and 8.4% postpartum depressive symptoms. Women with higher GCT glucose levels were at greater odds of elevated prenatal depressive symptoms (multivariable-adjusted OR per SD increase in glucose levels (27 mg/dL): 1.25; 95%: 1.07, 1.48). Compared with NGT women, the association appeared stronger among women with IHG (OR: 1.80; 95% CI: 1.08, 3.00) than among those with GDM (OR: 1.45; 95% CI: 0.72, 2.91) or IGT (OR: 1.43; 95% CI: 0.59, 3.46). Neither glucose levels assessed from the GCT nor pregnancy glycemic status were significantly associated with elevated postpartum depressive symptoms. Conclusion Pregnancy hyperglycemia was cross-sectionally associated with higher risk of prenatal depressive symptoms, but not with postpartum depressive symptoms.

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The Association Between Depression and Diabetes in the Perinatal Period

Cited by 8 publications

References 43 publications

Relationship between depression and diabetes in pregnancy: A systematic review

Relationship between depression and diabetes in pregnancy: A systematic review

Transition to motherhood in type 1 diabetes: design of the pregnancy and postnatal well-being in transition questionnaires

Pregnancy Hyperglycaemia and Risk of Prenatal and Postpartum Depressive Symptoms

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