According to recent findings published in Diabetic Medicine, women who develop gestational diabetes may be more likely to experience depression during pregnancy and after delivery, compared to women without gestational diabetes. Over the years, we have reviewed several studies looking at the association between GDM and risk for depression.   

In a systematic review and meta-analysis, Wilson and colleagues analyzed data from 62 studies.  They observed that the prevalence of elevated levels of depressive symptoms around the time of GDM diagnosis was 28% (pooled OR 2.08); the prevalence following of depressive symptoms after the diagnosis of GDM was 26% (pooled OR 1.41). Thus the prevalence of GDM is higher than what would be expected in the general population of pregnant women. During the postpartum period, the prevalence of depression in women diagnosed with GDM was 13% (pooled OR 1.59). 

These findings suggest that women with GDM are at increased risk for depression during pregnancy and after delivery.  The finding that rates of depression were elevated before or near the time of GDM diagnosis suggests that there may be a bidirectional relationship between GDM and perinatal depression. In other words, women with depression may be more likely to develop GDM, and women with GDM may be more vulnerable to depression.  The authors point to a growing body of literature indicating a bidirectional relationship between type 2 diabetes and psychiatric illness, in particular depression, in non-perinatal populations.  While it is not exactly clear how depression may modulate risk for type 2 diabetes, inflammation and dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, as well as shared socio?environmental risk factors, such as obesity and poverty, have been implicated. 

All women are screened for gestational diabetes after 24  weeks of gestation. Given that the prevalence of depressive symptoms is high in women who are diagnosed with GDM, we must consider this population at increased risk for both antenatal and postpartum depression.  Further studies are needed to determine if specific interventions in this population, in addition to the medical management of GDM, may be helpful in reducing the risk of depression in this group of women.   

Ruta Nonacs, MD PhD

 

Wilson CA, Newham J, Rankin J, Ismail K, Simonoff E, Reynolds RM, Stoll N, Howard LM.  Is there an increased risk of perinatal mental disorder in women with gestational diabetes? A systematic review and meta-analysis.  Diabet Med. 2019 Nov 6.

 

Diabetes, gestational diabetes, GDM, depression depression during pregnancy, antenatal depression, postpartum depression, PPD, postnatal depression, type 2 diabetes, obesity, HPA, inflammation, pregnancy complications


Category: pregnancy, postparutm