Zhao Ming-Zhe, Wei Jing, Duan Yan-Ping, Hong Xia, Jiang Jing, Ma Liang-Kun, Zhao Yue
Department of Psychological Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Department of Obstetrics and Gynecology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2022 Jun;44(3):422-427. doi: 10.3881/j.issn.1000-503X.14742.
Objective To explore the association between gestational diabetes mellitus (GDM) and postpartum depressive (PPD) episode and the influencing factors of PPD episode. Methods The clinical data of pregnant women who filed in the Department of Obstetrics,Peking Union Medical College Hospital from March 1,2020 to February 28,2021 were collected.Oral glucose tolerance test (OGTT,75 g) and determination of glycosylated hemoglobin (HbA1c) were carried out in the second trimester,and fasting blood glucose and glycosylated albumin (GA) were determined in the third trimester.Mini-International Neuropsychiatric Interview (MINI,5.0 Chinese version) was used to diagnose depressive episode and anxiety disorder within (42±7) days after delivery.We analyzed the influencing factors of PPD episode by multiple Logistic regression to explore the relationship between GDM and PPD episode.Fasting glucose and GA in the third trimester,as well as the incidence of PPD episode,between women with and without GDM were compared. Results The GDM,75 g OGTT,and HbA1c in the second trimester,as well as fasting blood glucose and GA in the third trimester,showed no significant differences between the PPD group and the non-PPD group (all >0.05).Postpartum generalized anxiety disorder (=4.656,95%=1.130-19.184, =0.033),obsessive-compulsive disorder (=11.989,95%=1.004-143.113, =0.049),and the history of mental disorder before pregnancy (=13.567,95%=2.191-83.991, =0.005) were the risk factors of PPD episode.The fasting blood glucose and GA in the third trimester,the incidence of PPD episode,and the PPD episode comorbidities of generalized anxiety disorder and obsessive-compulsive disorder had no significant differences between pregnant women with and without GDM (all >0.05).Conclusions There is no association between GDM and PPD episode under routine blood glucose management. Special attention should be paid to pregnant women with a history of mental disorder before pregnancy.
目的 探讨妊娠期糖尿病（GDM）与产后抑郁发作的关联以及产后抑郁发作的影响因素。方法 收集2020年3月1日至2021年2月28日在北京协和医院妇产科建档的孕妇的临床资料。孕中期进行口服葡萄糖耐量试验（OGTT，75g）及糖化血红蛋白（HbA1c）测定，孕晚期测定空腹血糖及糖化白蛋白（GA）。采用简易国际神经精神访谈量表（MINI，中文版5.0）在产后（42±7）天内诊断抑郁发作及焦虑障碍。通过多因素Logistic回归分析产后抑郁发作的影响因素，以探讨GDM与产后抑郁发作的关系。比较有、无GDM孕妇孕晚期的空腹血糖和GA以及产后抑郁发作的发生率。结果 产后抑郁组与非产后抑郁组在GDM、孕中期75g OGTT及HbA1c，以及孕晚期空腹血糖和GA方面比较，差异均无统计学意义（均>0.05）。产后广泛性焦虑障碍（=4.656，95%=1.13019.184，=0.033）、强迫症（=11.989，95%=1.004143.113，=0.049）及孕前精神障碍史（=13.567，95%=2.191~83.991，=0.005）是产后抑郁发作的危险因素。有、无GDM孕妇孕晚期的空腹血糖和GA、产后抑郁发作的发生率以及产后抑郁发作合并广泛性焦虑障碍和强迫症的情况比较，差异均无统计学意义（均>0.05）。结论 在常规血糖管理下，GDM与产后抑郁发作无关联。孕前有精神障碍史的孕妇应予以特别关注。
