School of Public Health, Curtin University, Perth, WA, Australia.
School of Public Health, Curtin University, Perth, WA, Australia.
Women Birth. 2019 Jun;32(3):e427-e431. doi: 10.1016/j.wombi.2018.08.171. Epub 2018 Sep 6.
Gestational diabetes mellitus (GDM) can lead to adverse birth outcomes, but its effect on postnatal depression has not been thoroughly investigated, especially in Asian populations.
To determine the prospective association between GDM and postnatal depressive symptoms in Western China.
A prospective cohort study of 1449 mothers was conducted in Chengdu, capital city of Sichuan Province. GDM was diagnosed during pregnancy using oral glucose tolerance tests. Maternal depressive symptoms were measured at 32-37weeks of gestation, then at one and three months after giving birth using a validated Chinese version of the Edinburgh Postnatal Depression Scale (EPDS). Associations between the postnatal EPDS scores, GDM status and blood glucose levels were assessed by multivariable mixed-effects regression models, accounting for baseline EPDS scores of the cohort and other confounding factors.
Compared to the non-GDM group (n=1220), women with GDM (n=229, 15.8%) reported significantly higher mean EPDS scores at both 1-month (p=0.02) and 3-month (p<0.01) postpartum. Similarly, high levels of fasting, 1-h and 2-h blood glucose levels during pregnancy were associated with increased EPDS scores. Mixed-effects models further confirmed the positive association between GDM status and postnatal depressive symptoms, even though the mean EPDS scores decreased substantially over the three time points.
Chinese women with GDM were more susceptible to postnatal depression than others without the condition, despite their depressive symptoms reducing over time after childbirth. It is thus important to raise awareness of postnatal depression amongst healthcare professionals who care for women with GDM.
妊娠期糖尿病（GDM）可导致不良的分娩结局，但它对产后抑郁症的影响尚未得到充分研究，尤其是在亚洲人群中。
在我国西部地区，确定 GDM 与产后抑郁症状之间的前瞻性关联。
在四川省省会成都进行了一项前瞻性队列研究，共纳入了 1449 名产妇。在妊娠期间，通过口服葡萄糖耐量试验诊断 GDM。使用经过验证的中文版爱丁堡产后抑郁量表（EPDS），在妊娠 32-37 周时、分娩后 1 个月和 3 个月测量产妇的抑郁症状。采用多变量混合效应回归模型评估产后 EPDS 评分、GDM 状态和血糖水平之间的关联，该模型考虑了队列的基线 EPDS 评分和其他混杂因素。
与非 GDM 组（n=1220）相比，GDM 组（n=229，15.8%）的产妇在产后 1 个月（p=0.02）和 3 个月（p<0.01）时报告的 EPDS 评分均值显著更高。同样，怀孕期间空腹、1 小时和 2 小时血糖水平升高与 EPDS 评分升高相关。混合效应模型进一步证实了 GDM 状态与产后抑郁症状之间的正相关关系，尽管 EPDS 评分在三个时间点均显著下降。
与没有 GDM 的女性相比，中国患有 GDM 的女性更容易发生产后抑郁，尽管她们在分娩后抑郁症状会逐渐减轻。因此，有必要提高照顾 GDM 女性的医护人员对产后抑郁的认识。
