Development of Perinatal Mental Illness in Women With Gestational Diabetes Mellitus: A Population-Based Cohort Study

Can J Diabetes. 2018 Aug;42(4):350-355.e1. doi: 10.1016/j.jcjd.2017.08.005. Epub 2017 Sep 22.

Abstract

Objectives: To examine the relationship between gestational diabetes mellitus (GDM) and the development of mental illness (affective and anxiety disorders) during pregnancy and 1 year postpartum.

Methods: We linked clinical and administrative databases of mothers who delivered in Alberta, Canada, between April 1, 2000, and March 31, 2009, to identify diagnoses of GDM and mental illness. Women with prepregnancy type 1 or type 2 diabetes were excluded. We used generalized estimating equation models to examine the effect of GDM on the development of new-onset mental illness in 2 separate periods: during pregnancy and during the first postpartum year. Generalized estimating equation models were adjusted for age, overweight, smoking, rural residence, ethnicity, median household income, nulliparity, preeclampsia or eclampsia, neonatal death, infant neonatal intensive care unit stay, prior chronic medical conditions and fiscal year.

Results: Of 326,723 pregnancies, 3.7% (12,140) were affected by GDM. Compared to women without GDM, women with GDM had a higher prevalence of, but did not have an increased risk for, new-onset mental illness during pregnancy (16.1% vs. 14.1%; OR 1.06, 95% CI 0.98 to 1.13) or postpartum (23.3% vs. 22.1%; OR 1.03, 95% CI 0.97, 1.10).

Conclusions: In this large population-based cohort of women in Alberta, GDM was not associated with an increased risk for developing new-onset mental illness during pregnancy or postpartum.

Keywords: anxiety; anxiété; depression; diabète sucré gestationnel; dépression; gestational diabetes mellitus; maladie mentale; maternal; maternel; mental illness; perinatal; périnatal.

MeSH terms

  • Adult
  • Anxiety / epidemiology
  • Anxiety / etiology
  • Cohort Studies
  • Depression / epidemiology
  • Depression, Postpartum / epidemiology
  • Depression, Postpartum / etiology
  • Diabetes, Gestational / epidemiology*
  • Diabetes, Gestational / psychology
  • Female
  • Humans
  • Mental Disorders / epidemiology*
  • Mental Disorders / etiology
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Complications / psychology
  • Puerperal Disorders / epidemiology*
  • Puerperal Disorders / etiology
  • Young Adult