BES2020 BES 2020 The impact of antenatal depression on pregnancy outcomes in women with gestational diabetes mellitus and normal glucose tolerant women (1 abstracts)
The impact of antenatal depression on pregnancy outcomes in women with gestational diabetes mellitus and normal glucose tolerant women
Minschart Caro 1 , De Weerdt Kyara 2 , Elegeert Astrid 2 , Van Crombrugge Paul 3 , Moyson Carolien 1 , Verhaeghe Johan 4 , Vandeginste Sofie 5 , Verlaenen Hilde 5 , Vercammen Chris 6 , Maes Toon 6 , Dufraimont Els 7 , De Block Christophe 8 , Jacquemyn Yves 9 , Mekahli Farah 10 , De Clippel Katrien 11 , Van Den Bruel Annick 12 , Loccufier Anne 13 , Laenen Annouschka 14 , Devlieger Roland 4 , Mathieu Chantal 1 & Benhalima Katrien 1
¹Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Belgium; 2Medicine, KU Leuven, Belgium; 3Department of Endocrinology, OLV ziekenhuis Aalst-Asse-Ninove, Belgium; 4Department of Obstetrics & Gynecology, UZ Gasthuisberg, KU Leuven, Belgium; 5Department of Obstetrics & Gynecology, OLV ziekenhuis Aalst-Asse-Ninove, Belgium; 6Department of Endocrinology, Imelda ziekenhuis, Belgium; 7Department of Obstetrics & Gynecology, Imelda ziekenhuis, Belgium; 8Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital, Belgium; 9Department of Obstetrics & Gynecology, Antwerp University Hospital, Belgium; 10Department of Endocrinology, Kliniek Street -Jan Brussel, Belgium; 11Department of Obstetrics & Gynecology, Kliniek Street -Jan Brussel, Belgium; 12Department of Endocrinology, AZ Street Jan Brugge, Belgium; 13Department of Obstetrics & Gynecology, AZ Street Jan Brugge, Belgium; 14Center of Biostatics and Statistical bioinformatics, Leuven, Belgium
Aims: To determine the impact of antenatal depression on pregnancy outcomes in women with gestational diabetes mellitus (GDM) and women with normal glucose tolerance (NGT).
Methods: 1843 women from a Belgian multi-centric prospective cohort study (BEDIP-N Study) received universal screening for GDM with a 75 g OGTT and the IADPSG criteria. The Center for Epidemiologic Studies – Depression (CES-D) questionnaire was completed at the time of the OGTT (before the diagnosis of GDM was communicated), and for women with GDM also in early postpartum. The SF-36 health survey was completed in early postpartum.
Results: GDM prevalence was 12.5% (231). Women with GDM were significantly more often depressed than NGT women [21.3% (48) vs. 15.1% (239), P=0.017] at the time of the OGTT. In the GDM subgroup, depressed women (n=48) had more often an ethnic minority background (EMB) [29.2% (14) vs. 15.4% (27), P=0.003], smoked more often during pregnancy [12.5% (6) vs. 4.0% (7), P=0.025], had a higher BMI in early pregnancy (27.9±5.3 versus 26.3±5.3 kg/m², P=0.048), and attended less often the postpartum OGTT [68.7% (33) vs. 87.6% (155), P=0.002] compared to non-depressed GDM women (n=177). There were no significant differences in pregnancy outcomes between both groups. Depressed GDM women remained more often depressed postpartum [37.1% (13) vs. 12.4% (19), P<0.001] and had lower SF-36 scores than non-depressed GDM women. Compared to NGT women without depression (n=1342), depressed NGT women (n=239) had more often an EMB [18.8% (45) vs. 6.1% (81), P<0.001] , a lower education degree (v0.001), less often a paid job [79.7% (189) vs. 94.0% (1258), P<0.001], smoked more often during pregnancy [5.4% (13) vs. 2.9% (39), P=0.044], had more often a first degree family history of diabetes [16.8% (39) vs. 11.2% (146), P=0.015], and had a higher BMI in early pregnancy (25.1±4.7 vs. 24.2±4.4 kg/m², P=0.003). Rates of preeclampsia and labor inductions were significantly higher in the depressed NGT group compared to the NGT group without depression [resp. 3.3% (8) vs. 1.5% (20), P=0.046 and 35.0% (75) vs. 27.4% (330), P=0.022]. After adjustment for confounders such as EMB, education, smoking, BMI and glucose levels at the time of the OGTT, only the rate of labor inductions remained significantly increased [OR 1.40 (95% CI 1.01–1.93), P=0.041]. Depressed NGT women had lower SF-36 scores (P<0.001) postpartum compared to non-depressed NGT women.
Conclusions: Women who develop GDM have more often a depression before the diagnosis. GDM women with depression have similar pregnancy outcomes as GDM women without depression but are more often depressed postpartum with lower quality of life scores. NGT women with depression have similar pregnancy outcomes than NGT women without depression except for higher rates of labor inductions.
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Endocrine Abstracts
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