Delanerolle Gayathri, Phiri Peter, Zeng Yutian, Marston Kathleen, Tempest Nicola, Busuulwa Paula, Shetty Ashish, Goodison William, Muniraman Hemananda, Duffy Georgia, Elliot Kathryn, Maclean Alison, Majumder Kingshuk, Hirsch Martin, Rathod Shanaya, Raymont Vanessa, Shi Jian Qing, Hapangama Dharani K
Oxford Brain Health Clinical Trials Unit, University of Oxford, United Kingdom.
Southern Health NHS Foundation Trust, United Kingdom.
EClinicalMedicine. 2021 Jul 14;38:101016. doi: 10.1016/j.eclinm.2021.101016. eCollection 2021 Aug.
Gestational diabetes mellitus (GDM) is a common complication of pregnancy and is associated with an increased risk of mental health (MH) disorders including antenatal and postnatal depression (PND), anxiety and post-traumatic-stress-disorder (PTSD). We hypothesized GDM and MH disorders will disproportionately affect individuals from Black, Asian and Minority Ethnic backgrounds.
A systematic methodology was developed, and a protocol was published in PROSPERO (CRD42020210863) and a systematic review of publications between 1st January 1990 and 30th January 2021 was conducted. Multiple electronic databases were explored using keywords and MeSH terms. The finalised dataset was analysed using statistical methods such as random-effect models, subgroup analysis and sensitivity analysis. These were used to determine odds ratio (OR) and 95% confidence intervals (CI) to establish prevalence using variables of PND, anxiety, PTSD and stress to name a few.
Sixty studies were finalised from the 20,040 data pool. Forty-six studies were included systematically with 14 used to meta-analyze GDM and MH outcomes. A second meta-analysis was conducted using 7 studies to determine GDM risk among Black, Asian and Minority Ethnic women with pre-existing MH disorders. The results indicate an increased risk with pooled adjusted OR for both reflected at 1.23, 95% CI of 1.00-1.50 and 1.29, 95% CI of 1.11-1.50 respectively.
The available studies suggest a MH sequalae with GDM as well as a sequalae of GDM with MH among Black, Asian and Minority Ethnic populations. Our findings warrant further future exploration to better manage these patients.
Not applicable.
妊娠期糖尿病（GDM）是一种常见的妊娠并发症，与心理健康（MH）障碍风险增加相关，包括产前和产后抑郁症（PND）、焦虑症和创伤后应激障碍（PTSD）。我们推测，GDM和MH障碍对黑人、亚洲人和少数族裔背景的个体影响尤为严重。
制定了一种系统方法，并在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42020210863）上发布了方案，对1990年1月1日至2021年1月30日期间的出版物进行了系统评价。使用关键词和医学主题词（MeSH）检索了多个电子数据库。使用随机效应模型、亚组分析和敏感性分析等统计方法对最终数据集进行分析。这些方法用于确定比值比（OR）和95%置信区间（CI），以使用PND、焦虑、PTSD和压力等变量确定患病率。
从20,040个数据池中最终确定了60项研究。系统纳入了46项研究，其中14项用于对GDM和MH结局进行荟萃分析。使用7项研究进行了第二项荟萃分析，以确定患有既往MH障碍的黑人、亚洲人和少数族裔女性患GDM的风险。结果表明，合并调整后的OR增加，两者分别为1.23，95%CI为1.00 - 1.50和1.29，95%CI为1.11 - 1.50。
现有研究表明，在黑人、亚洲人和少数族裔人群中，GDM会导致MH后遗症，同时MH也会导致GDM后遗症。我们的研究结果值得未来进一步探索，以更好地管理这些患者。
不适用。
