Atuhaire Catherine, Taseera Kabanda, Atukunda Esther C, Atwine Daniel, Matthews Lynn T, Rukundo Godfrey Zari
Faculty of medicine, Mbarara University of Science and Technology, Uganda.
SOAR Research Foundation, PO BOX 1596, Mbarara, Uganda.
medRxiv. 2023 Oct 23:2023.10.23.23297392. doi: 10.1101/2023.10.23.23297392.
Postpartum Depression (PPD) is a major health challenge with potentially devastating maternal and physical health outcomes. Development of diabetes mellitus has been hypothesized as one the potential adverse effects of PPD among mothers in the postpartum period but this association has not been adequately studied. This study aimed at determining prevalence of postpartum depression and its association with diabetes mellitus among mothers in Mbarara District, southwestern Uganda.
This was a facility based cross sectional study of 309 mothers between 6 week to 6 month after childbirth. Using proportionate stratified consecutive sampling, mothers were enrolled from postnatal clinics of two health facilities, Mbarara Regional Referral Hospital and Bwizibwera Health center IV. PPD was diagnosed using the Mini-International Neuropsychiatric Interview (MINI 7.0.2) for the Diagnostic and Statistical Manual of Mental Disorders, 5 Edition (DSM-5). Diabetes mellitus was diagnosed by measuring Hemoglobin A1c (HbA1c). Logistic regression was used to determine the association of PPD and diabetes mellitus among mothers.
The study established that PPD prevalence among mothers of 6 weeks to 6 months postpartum period in Mbarara was 40.5% (95% CI: 35.1-45.1%). A statistically significant association between postpartum depression and diabetes mellitus in mothers between 6 weeks and 6 months postpartum was established. The prevalence of diabetes mellitus among mothers with PPD was 28% compared to 13.6% among mothers without PPD Mothers with PPD had 3 times higher odds of being newly diagnosed with diabetes between 6 weeks and 6 months postpartum as compared to those without PPD during the same period (aOR=3.0, 95% CI: 1.62-5.74, p=0.001).
Postpartum women within 6 weeks to 6 months have higher risks of developing diabetes mellitus. Research is needed to determine if targeted diabetes mellitus screening, prevention interventions and management will help reduce the burden.
产后抑郁症（PPD）是一项重大的健康挑战，可能对母亲的身心健康造成毁灭性后果。糖尿病的发生被认为是产后母亲患PPD的潜在不良影响之一，但这种关联尚未得到充分研究。本研究旨在确定乌干达西南部姆巴拉拉区母亲产后抑郁症的患病率及其与糖尿病的关联。
这是一项基于机构的横断面研究，对309名产后6周至6个月的母亲进行了研究。采用按比例分层连续抽样的方法，从姆巴拉拉地区转诊医院和布维齐韦拉四级健康中心这两个医疗机构的产后诊所招募母亲。使用《精神疾病诊断与统计手册》第5版（DSM-5）的迷你国际神经精神病学访谈（MINI 7.0.2）诊断PPD。通过测量糖化血红蛋白（HbA1c）诊断糖尿病。采用逻辑回归分析确定母亲中PPD与糖尿病之间的关联。
该研究确定，姆巴拉拉产后6周至6个月母亲的PPD患病率为40.5%（95%置信区间：35.1-45.1%）。产后6周和6个月之间的母亲中，产后抑郁症与糖尿病之间存在统计学上的显著关联。患有PPD的母亲中糖尿病患病率为28%，而未患PPD的母亲中这一比例为13.6%。产后6周和6个月之间，患有PPD的母亲新诊断出糖尿病的几率是未患PPD母亲的3倍（调整后比值比=3.0，95%置信区间：1.62-5.74，p=0.001）。
产后6周至6个月的妇女患糖尿病的风险更高。需要进行研究以确定有针对性的糖尿病筛查、预防干预措施和管理是否有助于减轻负担。
