Background The association between gestational diabetes mellitus (GDM) and perinatal depression (PND) remains controversial. Our study aimed to comprehensively assess this association in a longitudinal cohort study with repeated measurements of depression. Methods Our cohort study was nested in a pilot study of an implementation study aiming to screen and manage perinatal depression within the primary health system in China. Women were recruited in the first trimester from May–September 2019 and followed four times up to 1 year postpartum. Data on sociodemographic characteristics and depression were collected using self-developed questionnaires incorporating the Edinburgh Postnatal Depression Scale (EPDS). Oral glucose tolerance test at 24 ~ 28 weeks and fasting plasma glucose (FPG) data were extracted from medical records. Depression throughout the whole period was divided into different trajectories. Associations of GDM with PND at different time periods and PND of different trajectories were determined by logistic regression. The path of association between blood glucose and depression over time was estimated with an autoregressive cross-lagged model. Results In total, 1043 women were included in this analysis and 313 (30.0%) were diagnosed with GDM. The prevalence of depression in the first, second, and third trimesters and postpartum period were 17.2, 6.9, 6.8 and 9.0%, respectively. GDM was neither significantly associated with PND at any time point nor with any specific trajectory of depression. Except for autoregressive paths, no cross-lagged path of FPG and scores of EPDS was significant. Conclusions Our study indicates no association between GDM/blood glucose and PND.

Background Stressful life events (SLEs) and adverse childhood experiences (ACEs) have been reported to be associated with perinatal depression (PND) or perinatal anxiety (PNA) alone; however, in most cases, majority of PND and PNA coexist and could lead to more serious health consequences. The independent effect of recent SLEs and their joint effects with ACEs on perinatal comorbid anxiety and depression (CAD) remain inadequately explored. Methods Based on a longitudinal study, 1082 participants receiving prenatal care in Ma’anshan, China were included. Women were recruited in the first trimester (T1: ≤14+ 6 weeks) and followed up at 15 ~ 27 weeks (T2), 28 ~ 40 weeks (T3), and postpartum (T4). Depression and anxiety status were assessed at all time points, while recent SLEs and ACEs were measured at T1. Logistic regression was conducted to examine the associations of SLEs with the risks of CAD at different time points, as well as their joint effects with ACEs on CAD. Results Approximately 38.5% of women experienced at least one SLE, which was significantly associated with higher risks of CAD at all time points (p < 0.05). As the number of SLEs increased, the risk of CAD increased (p for trend < 0.05). Specific types of SLEs were associated with CAD in different periods, while only interpersonal events were consistently associated with risks of CAD throughout the whole perinatal period. The joint effects of SLEs with ACEs on CAD were identified throughout the perinatal period, with the highest observed in the first trimester (aOR = 7.47, 95% CI: 3.73–14.95; p for trend < 0.001). Conclusion Our study demonstrated independent associations of recent SLEs and their joint effects with ACEs with risks of perinatal CAD. SLEs combined with ACEs should be recognized as a major risk factor for perinatal CAD and managed at the earliest time to prevent and control CAD.

the Yangtze River estuary (YRe) is one of the world's largest river-tidal systems with rapidly changing hydrology and morphology following the construction of multiple dams. The effects of dam construction may extend to the region close to the coast, where channel stability depends on the asymmetry of the tide. Here, we focus on the possible effects of changing discharge regimes on tidal asymmetry in the YRE. Specifically, we focus on the difference in duration between ebb and flood, quantified as tidal duration asymmetry, because it has strong implications for residual sediment transport and can be derived from available water level data. To cope with nonstationary tides under the influence of a time-varying river discharge, a nonstationary harmonic analysis tool (NS_TIDE) is applied to explore the spatiotemporal variations in tidal duration asymmetry, under the influence of different combinations of tidal constituents. Tidal duration asymmetry initially increases, then slightly decreases, in an upstream direction. It experiences significant seasonal variations in response to rapidly varying discharge: tides are more asymmetric upstream of Zhenjiang in the dry season and more asymmetric downstream in the wet season. The combined effects of discharge regulation and morphological changes cause seasonal alterations in tidal duration asymmetry. In the wet season, reduced river discharge caused by water storage and climate change enhance the asymmetry upstream (+11.74% at Wuhu, +7.19 at Nanjing) while the asymmetry is weakened downstream (−2.90% at Zhenjiang, −7.19 at Jiangyin) following the TGD's operation. Downstream channel erosion caused by post-TGD lower sediment loads has become the dominant factor weakening tidal asymmetry in most parts of the YRe in the dry season. Understanding these evolutions of tidal duration asymmetry under the hydrological and morphological effects has important implications for the management of estuarine ecosystem and navigation. Dams are built for various purposes, such as irrigation, flood control and power generation 1. The various impacts of dams have been subject to study and debated for decades. The changes in river and sediment discharges due to dam constructions have long been recognized as far-reaching 2-4. Dams play an important role in eliminating peak river discharge and stabilizing low river discharge 5. Beyond discharge regulation, dams also lead to a drop in sediment loads, thereby impacting estuarine morphology 4,6-9 , which is crucially dependent on tidal asymmetry 10,11. Here, we focus on tidal duration asymmetry, which quantifies the periodic difference between the durations of falling and rising tidal water level 12,13. Tidal duration asymmetry characterizes flood and ebb dominance 14-16 , and can directly be derived from long-term water level data. Tidal asymmetry can be produced when tides propagate into shallow-water areas, where tidal distortion results in rising high-frequency harmonic constituents 14,17. The physical mechanisms responsible for tidal duration ...