The Effect of Depression on Pregnant Patients with Gestational Diabetes: Maternal and Neonatal Outcomes [13N

Abstract

INTRODUCTION: We sought to determine the differences in pregnancy outcomes seen in patients with major depressive disorder and gestational diabetes (GDM) in comparison to women with GDM and no diagnosis of depression. METHODS: A retrospective cohort study of 114,483 women with gestational diabetes with singleton, vertex, non-anomalous gestations was performed to assess maternal and neonatal outcomes in women with depression as compared to women without depression. Maternal outcomes included preeclampsia, placental abruption, cesarean delivery, postpartum hemorrhage (PPH) and endometritis. Neonatal outcomes included preterm, respiratory distress syndrome (RDS), jaundice, and neonatal death (NND). Multivariate regression analyses and chi-square tests were employed for statistical comparisons and a p-value of less than 0.05 was used to indicate statistical significance. RESULTS: Women with GDM and depression had an increased risk of a range of complications of pregnancy when compared to women with GDM who did not have depression. It was associated with a statistically significant increase in preeclampsia (odds ratio [OR] 1.23), cesarean delivery (OR 1.10), PPH (OR 1.85), Preterm delivery (OR 1.25), and jaundice (OR 1.16). CONCLUSION: In women who have gestational diabetes, presence of major depressive disorder is associated with an increased risk of adverse maternal and neonatal outcomes in pregnancy. Whether this increased risk was due to other confounding factors, pharmacologic impact of treatment of depression, or from disease pathophysiology deserves future research. Further, how these risks can be mitigated through health care prior to and during pregnancy needs to be determined. Women should be counseled about these risks and managed accordingly during their pregnancies.