Diabetes in pregnancy: worse medical outcomes in type 1 diabetes but worse psychological outcomes in gestational diabetes

Egan, Aoife M.; Dunne, Fidelma; Lydon, K; Conneely, Sinéad; Sarma, Kiran; McGuire, Brian E.

doi:10.1093/qjmed/hcx106

Cited by 42 publications

(39 citation statements)

References 23 publications

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“…A total sample of 71,036 pregnant women were included in the analyses. Among the 10 studies, six studies were conducted in USA [15,18,20,22], two studies were conducted in Australia [16,26], and one study conducted each in Brazil [11], Canada [24], Greece [27] and Ireland [17], respectively.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…However, diabetes in pregnancy (DIP) was not included in that systematic review. In fact, there has been literature reporting data on the occurrence of antepartum depression among women with and without DIP [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Furthermore, DIP could be associated with the onset of antepartum depression.…”

Section: Introductionmentioning

confidence: 99%

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Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies

Lee

Ching

Chong

et al. 2020

IJERPH

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Previous literature has reported that patients with diabetes in pregnancy (DIP) are at risk of developing antepartum depression but the results have been inconsistent in cohort studies. We conducted a systematic review and performed a meta-analysis to quantify the association between DIP and risk of antepartum depression in cohort studies. Medline, Cinahl, and PubMed databases were searched for studies investigating DIP involving pregnant women with pre-existing diabetes and gestational diabetes mellitus and their risk of antepartum depression that were published in journals from inception to 27 December 2019. We derived the summary estimates using a random-effects model and reported the findings as pooled relative risks (RR) and confidence interval (CI). Publication bias was assessed using a funnel plot and was quantified by Egger and Begg’s tests. Ten studies, involving 71,036 pregnant women were included in this meta-analysis. The pooled RR to develop antepartum depression was (RR = 1.430, 95% CI: 1.251–1.636) among women with gestational diabetes mellitus. Combining pregnant women with pre-existing diabetes mellitus and gestational diabetes mellitus, they had a significant increased risk of developing antepartum depression (RR = 1.431, 95% CI: 1.205–1.699) compared with those without it. In comparison, we found no association between pre-existing diabetes mellitus in pregnancy (RR = 1.300, 95% CI: 0.736–2.297) and the risk of developing antepartum depression. This study has a few limitations: first, different questionnaire and cut-off points were used in evaluation of depression across the studies. Second, there was a lack of data on history of depression prior to pregnancy, which lead to confounding bias that could not be solved by this meta-analysis. Third, data were dominated by studies in Western countries; this is due to the studies from Eastern countries failing to meet our inclusion criteria for statistical analysis. Women with gestational diabetes mellitus have an increased risk of developing antepartum depression compared to those without the disease. Therefore, more attention on the mental health status should be given on pregnant women diagnosed with pre-existing diabetes mellitus and gestational diabetes mellitus.

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Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies

Lee

Ching

Chong

et al. 2020

IJERPH

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“…But a review of the few studies done in this population found that the diagnosis is accompanied by a range of negative emotions such as fear, anxiety, a loss of control, and a mourning of not having a normal pregnancy, which is not well addressed by midwives or other maternal health care providers . A study of pregnant women with type 1 diabetes, GDM, and no diabetes found that women with GDM had higher levels of stress and anxiety than those with type 1 diabetes . It is well known that stress is associated with adverse pregnancy outcomes such as preterm labor…”

Section: Screening For Gestational Diabetes: One‐step Versus 2‐step Amentioning

confidence: 99%

Current Resources for Evidence‐Based Practice, March/April, 2019

Barger

2019

J Midwife Womens Health

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“…Additionally, a diagnosis of GDM is a stressful life event [5][6][7][8] which has an adverse impact on self-perception towards health and quality of life [6,9]; as well as increased odds of experiencing emotional distress. Previous studies reported that the prevalence of depression among women sufferers from GDM stood at 56.7%, while anxiety was 57.7%, and stress was even higher at 62.8% [10][11][12]. GDM and perinatal mental problems undeniably affect all members of the family [13].…”

Section: Introductionmentioning

confidence: 97%

Association Analysis of 14 Candidate Gene Polymorphism with Depression and Stress among Gestational Diabetes Mellitus

Lee

Ching

Ramachandran

et al. 2019

Genes

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The association of candidate genes and psychological symptoms of depression, anxiety, and stress among women with gestational diabetes mellitus (GDM) in Malaysia was determined in this study, followed by the determination of their odds of getting psychological symptoms, adjusted for socio-demographical background, maternal, and clinical characteristics. Single nucleotide polymorphisms (SNPs) recorded a significant association between SNP of EPHX2 (rs17466684) and depression symptoms (AOR = 7.854, 95% CI = 1.330-46.360) and stress symptoms (AOR = 7.664, 95% CI = 1. 579-37.197). Associations were also observed between stress symptoms and SNP of OXTR (rs53576) and (AOR = 2.981, 95% CI = 1.058-8.402) and SNP of NRG1 (rs2919375) (AOR = 9.894, 95% CI = 1.159-84.427). The SNP of EPHX2 (rs17466684) gene polymorphism is associated with depression symptoms among Malaysian women with GDM. SNP of EPHX2 (rs17466684), OXTR (rs53576) and NRG1 (rs2919375) are also associated with stress symptoms.

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Diabetes in pregnancy: worse medical outcomes in type 1 diabetes but worse psychological outcomes in gestational diabetes

Abstract: This work highlights a potential role for targeted psychological interventions to address and relieve symptoms of anxiety and depression among pregnant women with diabetes.

Cited by 42 publications

References 23 publications

Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies

Diabetes in Pregnancy and Risk of Antepartum Depression: A Systematic Review and Meta-Analysis of Cohort Studies

Current Resources for Evidence‐Based Practice, March/April, 2019

Association Analysis of 14 Candidate Gene Polymorphism with Depression and Stress among Gestational Diabetes Mellitus

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