Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium.
Medicine, KU Leuven, Leuven, Belgium.
J Clin Endocrinol Metab. 2021 Jul 13;106(8):e3110-e3124. doi: 10.1210/clinem/dgab156.
To determine the impact of depressive symptoms on pregnancy outcomes and postpartum quality of life in women with gestational diabetes mellitus (GDM) and normal glucose tolerance (NGT).
1843 women from a prospective cohort study received universal GDM screening with an oral glucose tolerance test (OGTT). The Center for Epidemiologic Studies-Depression questionnaire was completed before GDM diagnosis was communicated and in GDM women in early postpartum. All participants completed the 36-Item Short Form Health Survey (SF-36) health survey postpartum.
Women who developed GDM (231; 12.5%) had significantly more often depressive symptoms than NGT (1612; 87.5%) women [21.3% (48) vs 15.1% (239), odds ratio (OR) 1.52, 95% confidence interval (CI) (1.08-2.16), P = 0.017]. Compared to GDM women without depressive symptoms, depressed GDM women attended less often the postpartum OGTT [68.7% (33) vs 87.6% (155), P = 0.002], remained more often depressed [37.1% (13) vs 12.4% (19), P < 0.001], and had lower SF-36 scores postpartum. There were no significant differences in pregnancy outcomes between both groups. Rates of labor inductions were significantly higher in the NGT group with depressive symptoms compared to the nondepressed NGT group [31.7% (75) vs 24.7% (330), adjusted OR (aOR) 1.40, 95% CI (1.01-1.93), P = 0.041]. NGT women with depressive symptoms had lower SF-36 scores (P < 0.001) postpartum compared to nondepressed NGT women.
Women with antenatal symptoms of depression develop more often GDM. GDM women with depressive symptoms remain more often depressed postpartum with lower quality of life. NGT women with depressive symptoms have higher rates of labor inductions and lower quality of life postpartum compared to nondepressed NGT women.
确定抑郁症状对患有妊娠期糖尿病（GDM）和正常葡萄糖耐量（NGT）的女性的妊娠结局和产后生活质量的影响。
1843 名来自前瞻性队列研究的女性接受了口服葡萄糖耐量试验（OGTT）的普遍 GDM 筛查。在 GDM 诊断沟通之前和 GDM 女性产后早期完成了流行病学研究中心抑郁问卷。所有参与者在产后完成了 36 项简短健康调查问卷（SF-36）健康调查。
患有 GDM（231；12.5%）的女性出现抑郁症状的频率明显高于 NGT（1612；87.5%）女性[21.3%（48）比 15.1%（239），比值比（OR）1.52，95%置信区间（CI）（1.08-2.16），P=0.017]。与无抑郁症状的 GDM 女性相比，抑郁的 GDM 女性产后 OGTT 的就诊率较低[68.7%（33）比 87.6%（155），P=0.002]，抑郁状态持续时间较长[37.1%（13）比 12.4%（19），P<0.001]，产后 SF-36 评分较低。两组之间的妊娠结局无显著差异。有抑郁症状的 NGT 组的引产率明显高于无抑郁症状的 NGT 组[31.7%（75）比 24.7%（330），调整后的比值比（aOR）1.40，95%CI（1.01-1.93），P=0.041]。有抑郁症状的 NGT 女性产后 SF-36 评分较低（P<0.001）。
产前有抑郁症状的女性更易患 GDM。有抑郁症状的 GDM 女性产后仍较易出现抑郁，生活质量较低。与无抑郁症状的 NGT 女性相比，有抑郁症状的 NGT 女性产后引产率较高，生活质量较低。
