A Systematic Review and Meta-Analysis of Gestational Diabetes and Mental Health Among BAME Populations

Abstract

Backgrounds: Gestational diabetes mellitus (GDM) is a common complication of pregnancy and is associated with an increased risk of mental health (MH) disorders. These include both antenatal and postnatal depression (PND), anxiety, psychological distress and post-traumatic-stress-disorder (PTSD). Both GDM and MH disorders have been shown to disproportionately affect individuals from Black, Asian and Minority Ethnic (BAME) backgrounds. Methods: A systematic methodology was developed, and a protocol was published in PROSPERO (CRD42020210863). Multiple electronic databases were explored using keywords and MeSH terms. The finalised dataset was analysed using statistical methods such as random-effect models, subgroup analysis and sensitivity analysis. These were used to determine odds ratio (OR) and 95% confidence intervals (CI) to establish prevalence. Findings: Sixty studies were finalised from the 20,040 data pool. Forty-six studies were included systematically with 14 used to meta-analyse GDM and MH outcomes. A second meta-analysis was conducted using 7 studies to determine GDM risk among BAME women with pre-existing MH disorders. The results indicate an increased risk with pooled adjusted OR for both reflected at 1.23, 95% CI of 1.00-1.50 and 1.29, 95% CI of 1.11-1.50 respectively. Interpretation: The available studies suggest a MH sequalae with GDM as well as a sequalae of GDM with MH among BAME populations. These findings warrant further exploration to better manage these patients clinically. Funding Statement: Not applicable Declaration of Interests: PP has received research grant from Novo Nordisk, and other, educational from Queen Mary University of London, other from John Wiley & Sons, other from Otsuka, outside the submitted work. SR reports other from Janssen, 691 Lundbeck and Otsuka outside the submitted work. All other authors report no conflict of interest.