Antenatal Depression and Risk of Gestational Diabetes, Adverse Pregnancy Outcomes, and Postpartum Quality of Life

Abstract

To determine the impact of depressive symptoms on pregnancy outcomes and postpartum quality of life in women with gestational diabetes mellitus (GDM) and normal glucose tolerance (NGT). 1843 women from a prospective cohort study received universal GDM screening with an oral glucose tolerance test (OGTT). The Center for Epidemiologic Studies - Depression questionnaire was completed before GDM diagnosis was communicated, and in GDM women in early postpartum. All participants completed the SF-36 health survey postpartum. Women who developed GDM (231; 12.5%) had significantly more often depressive symptoms than NGT (1612; 87.5%) women [21.3% (48) vs. 15.1% (239), OR 1.52, 95% CI (1.08-2.16), p=0.017]. Compared to GDM women without depressive symptoms, depressed GDM women attended less often the postpartum OGTT [68.7% (33) vs. 87.6% (155), p=0.002], remained more often depressed [37.1% (13) vs. 12.4% (19), p<0.001] and had lower SF-36 scores postpartum. There were no significant differences in pregnancy outcomes between both groups. Rates of labor inductions were significantly higher in the NGT group with depressive symptoms compared to the non-depressed NGT group [31.7% (75) vs. 24.7% (330), aOR 1.40, 95% CI (1.01-1.93), p=0.041]. NGT women with depressive symptoms had lower SF-36 scores (p<0.001) postpartum compared to non-depressed NGT women. Women with antenatal symptoms of depression develop more often GDM. GDM women with depressive symptoms remain more often depressed postpartum with lower quality of life. NGT women with depressive symptoms have higher rates of labor inductions and lower quality of life postpartum compared to non-depressed NGT women.