Anxiety and Depression in Early Gestation and the Association with Subsequent Gestational Diabetes Mellitus in a Disadvantaged Population

ObjectivesEvaluate the association between poor mental health and risk of developing gestational diabetes mellitus (GDM) in a cohort of women from a socioeconomically disadvantaged community.MethodsA total of 1363 nulliparous women with singleton pregnancies recruited to the Screening Tests to Predict Poor Outcomes of Pregnancy study in Adelaide, Australia. Women were assessed for mental health in the first trimester, including likelihood of depression, high functioning anxiety, perceived stress and risk of developing a mental health disorder. GDM was diagnosed based on the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria. Socioeconomic status was measured using the New Zealand Socioeconomic Index (NZSEI).ResultsComplete mental health data was available for 1281 participants. There was no statistically significant difference in SEI, depression, risk of mental health issues, high functioning anxiety and perceived stress between women who developed GDM and those who did not. There was no difference in history of depression nor risk of developing a high mental health disorder in first trimester after adjusting for SEI, BMI in first trimester, smoking status in first trimester and maternal age between women with a GDM pregnancy and those who did not.Conclusions for PracticeThere was no difference in markers of poor mental health in early pregnancy between women who subsequently did or did not develop GDM. Cohort participants were socioeconomically disadvantaged, potentially contributing to the lack of apparent differences in depression observed between groups. Socioeconomically disadvantaged women should be targeted in pre-conception planning to reduce risk of GDM. The literature on the association between common mental disorders and development of gestational diabetes mellitus (GDM) is inconsistent. Furthermore, this association has not been looked at in the context of a socioeconomically disadvantaged community.What this study adds: There was no association seen between markers of poor mental health and GDM. The association between history of depression and development of GDM was attenuated by covariates such as SEI and maternal age. As the cohort is socioeconomically disadvantaged, it may be difficult to detect an association between poor mental health and development of GDM and therefore this indicates a need to explore this association further in similar cohorts, particularly as they are vulnerable to both poor physical health and psychological stress.