499: Depression is associated with increased rates of adverse perinatal outcomes in women with gestational diabetes

Abstract

There is a known relationship of depression and pre-existing diabetes. We sought to determine the rates adverse perinatal outcomes in patients with gestational diabetes (GDM) and depressive disorder in comparison to non-depressed women. A retrospective cohort study comparing the rate of maternal and neonatal outcomes among singleton, non-anomalous births in California to women with or without the diagnosis of depression between 2007 and 2011. Among women with GDM, perinatal outcomes were analyzed using Chi square and multivariate logistic regression to compare frequencies of characteristics and outcomes and to determine the strength of association of depression and adverse perinatal outcomes. Statistical comparisons and a p-value of less than 0.05 was used to indicate statistical significance. Of the 170,572 women with GDM who delivered in California, 2,090 (1.22%) were diagnosed with depression. Depressed women with GDM had significantly increased rates of perinatal adverse outcomes including hypertensive disorders of pregnancy (preeclampsia or gHTN) (Adjusted Odds Ratio [aOR] 1.25, 95% CI 1.09- 1.43), cesarean delivery (aOR 0.99, 95% CI 0.88-1.11), stillbirths (aOR 1.28, 95% CI 0.68-2.42), and preterm delivery at <37, <34, and <32 weeks gestational age (aOR 1.33, 95% CI 1.18-1.50; 1.36, 95% CI 1.15-1.61; 1.22, 95% CI 0.99-1.51 respectively) (Table 1 and Figure 1). Women with GDM and a diagnosis of depression have higher frequencies of perinatal adverse outcomes. Whether early testing and diagnosis of GDM in this population can improve perinatal outcomes is unknown but should be considered a high-risk population for GDM.View Large Image Figure ViewerDownload Hi-res image Download (PPT)