Friday, September 23, 2016

Depression in Early Pregnancy Linked to Gestational Diabetes, Postpartum Depression


Depression early in pregnancy appears to increase the risk for gestational diabetes, which in turn increases the risk for postpartum depression, according to a report appearing online in Diabetologia.

Stephanie Hinkle, Ph.D., and colleagues at the National Institute of Child Health and Human Development assessed longitudinal associations between depression early in pregnancy and the risk for gestational diabetes (GDM), as well as GDM and subsequent risk of postpartum depression. They analysed data from the prospective National Institute of Child Health and Human Development Fetal Growth Studies-Singleton cohort (2009–2013), which had been collected at 12 U.S. clinical centers.

The sample consisted of 2,477 pregnant women without psychiatric disorders, diabetes, or other chronic conditions before pregnancy. Depression was assessed in the first (8–13 gestational weeks) and second (16–22 weeks) trimesters and at 6 weeks postpartum using the Edinburgh Postnatal Depression Scale.

Comparing the highest and lowest quartiles of first-trimester depression scores, the researchers found that the scores from the highest quartile were associated with a significant 1.72-fold increased risk for GDM after adjusting for confounding factors; the second-trimester results were similar. The risk was stronger and significant in both trimesters among nonobese women, and women with persistently high depression scores in both trimesters had the greatest risk of GDM.

The researches then matched 162 women with GDM and healthy controls and followed them up at 6 weeks postpartum. Postpartum depression was defined as a depressive symptom score of 10 or greater or antidepressant medicine use after delivery.

They found that GDM was associated with an adjusted 4.62-fold increased risk of subsequent postpartum depression.

“Our data suggest that screening early in pregnancy may be particularly important even among women without a history of mental health conditions,” the researchers wrote. “In addition, women with GDM may require closer monitoring postpartum given their elevated risk of postpartum depression. Taken together, our work extends previous data supporting depression and glucose intolerance as comorbid conditions among nonpregnant individuals to women during pregnancy and postpartum, a critical time window for the health and well-being of both women and their offspring.”

For related information see the Psychiatric News article "Link Seen Between Mental Disorders, Diabetes in New Study."

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