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Paediatr Perinat Epidemiol. 2015 Jul;29(4):281-9. doi: 10.1111/ppe.12199. Epub 2015 Jun 8.

Pregnancy Hyperglycaemia and Risk of Prenatal and Postpartum Depressive Symptoms.

Author information

1
Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
2
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
3
Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
4
Division of Biostatistics and Epidemiology, Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA.
5
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.

Abstract

BACKGROUND:

Glucose dysregulation in pregnancy may affect maternal depressive symptoms during the prenatal and postpartum periods via both physiologic and psychological pathways.

METHODS:

During mid-pregnancy, a combination of 50-g 1-h non-fasting glucose challenge test (GCT) and 100-g 3-h fasting oral glucose tolerance test was used to determine pregnancy glycaemic status among women participating in Project Viva: normal glucose tolerance (NGT), isolated hyperglycaemia (IHG), impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM). Using the Edinburgh Postnatal Depression Scale (EPDS), we assessed depressive symptoms at mid-pregnancy and again at 6 months postpartum. We used logistic regression, adjusted for sociodemographic, anthropometric and lifestyle factors, to estimate the odds of elevated prenatal and postpartum depressive symptoms (EPDS ≥ 13 on 0-30 scale) in relation to GCT glucose levels and GDM status in separate models.

RESULTS:

A total of 9.6% of women showed prenatal and 8.4% postpartum depressive symptoms. Women with higher GCT glucose levels were at greater odds of elevated prenatal depressive symptoms [multivariable-adjusted odds ratio (OR) per standard deviation (SD) increase in glucose levels (27 mg/dL): 1.25; 95%: 1.07, 1.48]. Compared with NGT women, the association appeared stronger among women with IHG [OR: 1.80; 95% confidence interval (CI): 1.08, 3.00] than among those with GDM (OR: 1.45; 95% CI: 0.72, 2.91) or IGT (OR: 1.43; 95% CI: 0.59, 3.46). Neither glucose levels assessed from the GCT nor pregnancy glycaemic status were significantly associated with elevated postpartum depressive symptoms.

CONCLUSION:

Pregnancy hyperglycaemia was cross-sectionally associated with higher risk of prenatal depressive symptoms, but not with postpartum depressive symptoms.

KEYWORDS:

gestational diabetes; hyperglycaemia; impaired glucose tolerance; postpartum depression; prenatal depression

PMID:
26058318
PMCID:
PMC4642439
DOI:
10.1111/ppe.12199
[Indexed for MEDLINE]
Free PMC Article

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