Gestational diabetes may increase risk for postpartum depression

Mothers with gestational diabetes mellitus (GDM) have an increased risk of developing postpartum depression symptoms, according to a new study published in the Journal of Affective Disorders.

Aleksi Ruohomäki, Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland, and colleagues conducted the study to determine an association between GDM and postpartum depressive symptomatology (PPDS).

Gestational diabetes mellitus is a condition in which a woman develops high blood sugar levels due to impaired glucose metabolism during pregnancy. GDM predisposes the fetus to various adverse effects. Moreover, GDM increases the mother's risk of developing type 2 diabetes later in life.

Postpartum depression symptoms are experienced by 10–15 percent of mothers after childbirth.

The study pooled data from the Kuopio Birth Cohort, which is an ongoing follow-up of women from the beginning of their pregnancy. Altogether, 1,066 mothers with no previous mental health issues were selected for the study. Edinburgh Postnatal Depression Scale was used to assess depression symptoms during the third trimester of pregnancy and eight weeks after delivery.

Statistical methods were used to adjust the results for other factors contributing to the risk of GDM and postpartum depression symptoms, such as maternal age at delivery, body mass index and depression symptoms experienced during pregnancy.

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Key Findings:

• The prevalence rates of GDM and PPDS in the whole study population were 14.1% and 10.3%, respectively.


• Postpartum depression symptoms were observed in 16 percent of mothers diagnosed with GDM, and in approximately nine percent of mothers without GDM.


• GDM was associated with an increased likelihood of belonging to the PPDS group (OR 2.23, 95% CI 1.23–4.05; adjusted for maternal age at delivery, BMI in the first trimester, smoking before pregnancy, relationship status, nulliparity, delivery by caesarean section, gestational age at delivery, neonatal intensive care unit admission and third-trimester EPDS scores).


• A significant association between GDM and PPDS was found in the subgroup of women with available data on first-trimester depression (n = 505).

"Psychological mechanisms may partially explain the observed association between GDM and postpartum depression symptoms," said Ruohomäki. "Being diagnosed during pregnancy with a disease that might harm the fetus can be a stressful experience, which may predispose to depression symptoms."

"Furthermore, physiological mechanisms may also contribute to this association," adds Dr. Soili Lehto, Group Leader of Kuopio Birth Cohort's mental well-being section. "Impaired glucose metabolism may increase cytokine-mediated low-grade inflammation, which has also been associated with depression. Previous studies have also shown that type 2 diabetes predisposes to depression, and depression to type 2 diabetes".

"Women with GDM may be at increased risk of PPDS. Future studies should investigate whether these women would benefit from a closer follow-up and possible supportive interventions during pregnancy and the postpartum period to avoid PPDS," concluded the authors.

For further reference log on to https://doi.org/10.1016/j.jad.2018.08.070