Depression in Early Pregnancy Tied to Diabetes

Depression and gestational diabetes share a link that appears to run both ways, according to a new study by researchers at the National Institutes of Health (NIH).

The findings, published in the journal Diabetologia, show that women who experience depression during the first two trimesters of pregnancy are nearly twice as likely to develop gestational diabetes, and women who develop gestational diabetes are more likely to experience postpartum depression six weeks after giving birth.

Gestational diabetes is a type of diabetes occurring only in pregnancy. If left untreated, the disease may cause serious health problems for mother and baby.

“Our data suggest that depression and gestational diabetes may occur together,” said the study’s first author, Stefanie Hinkle, Ph.D., staff scientist in the Division of Intramural Population Health Research at the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

“Until we learn more, physicians may want to consider observing pregnant women with depressive symptoms for signs of gestational diabetes. They also may want to monitor women who have had gestational diabetes for signs of postpartum depression.”

Although obesity is a known risk for gestational diabetes, the odds of developing gestational diabetes were higher for non-obese women reporting depression than for obese women with depression.

For the study, the researchers looked at pregnancy records from the NICHD Fetal Growth Studies-Singleton Cohort, which tracked the progress of thousands of pregnancies, to understand the patterns of fetal growth. The study involved 2,334 non-obese and 468 obese women in weeks eight to 13 of pregnancy.

The women completed questionnaires on symptoms of depression upon enrollment in the study, again between the 16th and 22nd week of pregnancy, and then six weeks after giving birth. The researchers also reviewed the women’s records to identify who had developed gestational diabetes.

“Of particular note, persistent depression from the first to second trimester set women at even greater risk for gestational diabetes” said the study’s senior author, Cuilin Zhang, M.D., Ph.D, in the Division of Intramural Population Health Research at NICHD.

Women who had the highest scores for depression in the first and second trimesters — about 17 percent — had nearly triple the risk for gestational diabetes when compared to women with less severe forms of depression.

“Our results suggest it would be a good idea for clinicians to pay particular attention to women with high depression scores when evaluating the risk of gestational diabetes,” Dr. Zhang added.

While obesity itself increases the risk for gestational diabetes, depression did not appear to increase the risk for gestational diabetes among obese women. In fact, non-obese women with high depression scores had nearly triple the risk for gestational diabetes than the other women in the study.

Currently, the American College of Obstetricians and Gynecologists recommends that physicians screen patients at least once for depression during the perinatal period (22 weeks of pregnancy through seven days after birth.)

The findings also show a greater risk for postpartum depression among women who had gestational diabetes. Of those who had developed gestational diabetes, nearly 15 percent experienced depressive symptoms after birth, which was more than four times that of women without gestational diabetes.

Although no cause and effect relationship was proven in this study, earlier studies have shown that depression is associated with impaired glucose metabolism that may lead to higher blood sugar levels. Similarly, high blood sugar levels may lead to inflammation, hormonal, and other changes that could lead to symptoms of depression.

Source: National Institutes of Health