Prevalence and factors associated with depressive, anxiety and stress symptoms among women with gestational diabetes mellitus in tertiary care centres in Malaysia: a cross-sectional study

Kai Wei Lee,Siew Mooi Ching,Maiza Tusimin,Vasudevan Ramachandran,Fan Kee Hoo,Noraihan Mohd Nordin,Seng Choi Chong

doi:10.1186/s12884-019-2519-9

Kai Wei Lee, Siew Mooi Ching + Show 5 more

Open Access

https://doi.org/10.1186/s12884-019-2519-9

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Abstract

BackgroundResearch on antenatal depressive, anxiety and stress symptoms among women with gestational diabetes mellitus (GDM) is lacking in Malaysia. This study aimed to determine the prevalence and factors associated with antenatal depressive, anxiety and stress symptoms among Malaysian women with GDM.MethodsThis was a descriptive, cross-sectional study of 526 women with GDM. Depressive, anxiety and stress symptoms are defined as the final score in mild to extremely severe risk in the severity rating scale. Data analysis was performed using SPSS v.21, while multiple logistic regression was used to identify predictors of depressive, anxiety and stress symptoms.ResultsPrevalence of anxiety symptoms was highest (39.9%), followed by depressive symptoms (12.5%) and stress symptoms (10.6%) among women with GDM. According to multiple logistic regression analyses, younger age (OR = 0.955, 95% CI = 0.919–0.993), comorbidity with asthma (OR = 2.436, 95% CI = 1.219–4.870) and a family history of depression and anxiety (OR = 4.782, 95% CI = 1.281–17.853) had significant associations with antenatal anxiety symptoms. Being non-Muslim (OR = 2.937, 95% CI = 1.434–6.018) and having a family history of depression and anxiety (OR = 4.706, 95% CI = 1.362–16.254) had significant associations with antenatal depressive symptoms. Furthermore, being non-Muslim (OR = 2.451, 95% CI = 1.273–4.718) had a significant association with antenatal stress symptoms.ConclusionsWithin a population of women with GDM in Malaysia, those at higher risk of having depressive, anxiety and stress symptoms can be identified from several baseline clinical characteristics. Clinicians should be more alert so that the high-risk patients can be referred earlier for further intervention.

Highlights

Gestational diabetes mellitus (GDM) is one of the most common medical conditions encountered by pregnant women in Asia [1]
This study aimed to determine the prevalence and factors associated with depressive, anxiety and stress symptoms among women with gestational diabetes mellitus (GDM) in tertiary care centres in Malaysia
The diagnosis of GDM is defined as fasting plasma glucose ≥5.1 mmol/L or 75-g two-hour Oral glucose tolerance test (OGTT) ≥7.8 mmol/L according to Malaysian Clinical Practice Guidelines [30, 31]

Summary

Introduction

Gestational diabetes mellitus (GDM) is one of the most common medical conditions encountered by pregnant women in Asia [1]. The transition to motherhood is already a major life-changing event and a stressful condition; when this transition is associated with diabetes, it will further exaggerate psychological stress on women [4, 8] This is due to the disease of GDM always requiring patients’ self-determination to overcome the underlying shock of diagnosis and to strictly adhere to lifestyle modifications to prevent further disease complications [9]. Women with GDM are aware of the fact that uncontrolled diabetes can lead to pregnancy-related complications and poor neonatal outcome [7, 10] They suffer from a higher propensity for the development of antenatal depression, anxiety and stress [8, 11]. This study aimed to determine the prevalence and factors associated with antenatal depressive, anxiety and stress symptoms among Malaysian women with GDM

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