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Pathirana MM, Andraweera PH, Leemaqz S, Aldridge E, Arstall MA, Dekker GA, Roberts CT. Anxiety and Depression in Early Gestation and the Association with Subsequent Gestational Diabetes Mellitus in a Disadvantaged Population. Matern Child Health J 2023; 27:2185-2193. [PMID: 37823988 PMCID: PMC10618298 DOI: 10.1007/s10995-023-03778-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVES Evaluate the association between poor mental health and risk of developing gestational diabetes mellitus (GDM) in a cohort of women from a socioeconomically disadvantaged community. METHODS A total of 1363 nulliparous women with singleton pregnancies recruited to the Screening Tests to Predict Poor Outcomes of Pregnancy study in Adelaide, Australia. Women were assessed for mental health in the first trimester, including likelihood of depression, high functioning anxiety, perceived stress and risk of developing a mental health disorder. GDM was diagnosed based on the International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria. Socioeconomic status was measured using the New Zealand Socioeconomic Index (NZSEI). RESULTS Complete mental health data was available for 1281 participants. There was no statistically significant difference in SEI, depression, risk of mental health issues, high functioning anxiety and perceived stress between women who developed GDM and those who did not. There was no difference in history of depression nor risk of developing a high mental health disorder in first trimester after adjusting for SEI, BMI in first trimester, smoking status in first trimester and maternal age between women with a GDM pregnancy and those who did not. CONCLUSIONS FOR PRACTICE There was no difference in markers of poor mental health in early pregnancy between women who subsequently did or did not develop GDM. Cohort participants were socioeconomically disadvantaged, potentially contributing to the lack of apparent differences in depression observed between groups. Socioeconomically disadvantaged women should be targeted in pre-conception planning to reduce risk of GDM.
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Affiliation(s)
- Maleesa M Pathirana
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia.
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia.
| | - Prabha H Andraweera
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Shalem Leemaqz
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
| | - Emily Aldridge
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Margaret A Arstall
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Gustaaf A Dekker
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Division of Women's Health, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Claire T Roberts
- Adelaide Medical School, The University of Adelaide, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5000, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia
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Priyadarshanie MN, Waas DA, Goonewardena S, Senaratna CV, Fernando S. Association of antenatal anxiety disorders with antenatal comorbidities and adverse pregnancy outcomes among clinic attendees at a tertiary-care hospital in Sri Lanka. Heliyon 2023; 9:e13900. [PMID: 36915536 PMCID: PMC10006716 DOI: 10.1016/j.heliyon.2023.e13900] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
Purpose Evidence on the association between antenatal anxiety disorders (AADs) and adverse pregnancy outcomes with detection of AADs using the gold-standard is scarce despite being vital to make decisions on interventions. We aimed to determine this association in women attending tertiary-care antenatal clinics in Sri Lanka. Material and methods Presence/absence of AADs in a systematic random sample of 221 antenatal women attending routine antenatal clinics of a teaching hospital who participated in a questionnaire-validation study were confirmed by a psychiatrist. These women were followed up until the end of pregnancy. Information on antenatal comorbidities, adverse pregnancy outcomes was extracted from health records. The association between AADs with antenatal comorbidities and adverse pregnancy outcomes were reported using adjusted odds ratios (ORs) and 95%confidence intervals (CIs) generated from logistic regression models. Results Mean (±SD) age of the women was 30 (±5.8) years. AADs were diagnosed in 81 (37%) women. Compared to women without AADs, those who had AADs were more at risk of pregnancy-induced hypertension (OR 6.1; 95% CI 1.2-31.9), gestational diabetes mellitus (OR 12.6; 95% CI 1.5-107.2), preterm labour (OR 4.3; 95% CI 1.4-13.0), prolonged labour (OR 19.0; 95% CI 7.1-51.1), lower segment caesarean section (OR 4.7; 95% CI 2.5-8.7) and low birthweight (OR 11.2; 95% CI 4.8-26.3). All miscarriages, stillbirths and assisted labour occurred exclusively in those with AADs. Conclusions AADs are strongly associated with several adverse pregnancy outcomes. Causal pathways and effect of interventions for AADs must be explored in future research.
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Affiliation(s)
- M Nirmala Priyadarshanie
- Department of Nursing & Midwifery, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Rathmalana, Sri Lanka
| | - Dulshika A Waas
- Department of Psychiatry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Sampatha Goonewardena
- Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Chamara V Senaratna
- Non-Communicable Diseases Research Centre, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Sharaine Fernando
- Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Zhang C, Jing L, Wang J. Does depression increase the risk of gestational diabetes mellitus? A systematic review and meta-analysis. Pak J Med Sci 2023; 39:285-292. [PMID: 36694731 PMCID: PMC9843022 DOI: 10.12669/pjms.39.1.6845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/04/2022] [Accepted: 10/12/2022] [Indexed: 12/05/2022] Open
Abstract
Objective Data on the relationship between depression and gestational diabetes mellitus (GDM) is scarce and conflicting. We, hereby, aimed to review evidence if prior depression increases the risk of GDM. Methods PubMed, Embase, CENTRAL, and Google Scholar databases were searched from inception to 11th September 2021 for English language studies reporting the relationship between depression and subsequent risk of GDM. Results Ten studies were included. Meta-analysis of data from nine studies including 127,195 patients indicated that prior depression was associated with a significantly increased risk of GDM (OR: 1.29 95% CI: 1.10, 1.52). There was no change in the significance of the results on sensitivity analysis. On subgroup analysis based on study location, we noted that the association between depression and GDM was seen only in USA-based studies with the pooled analysis of non-USA studies indicating no such relationship. Similar conflicting results were noted on subgroup analysis based on diagnostic criteria for GDM and depression. Conclusion Our study indicates that prior depression can lead to a 29% increased risk of GDM in pregnant females. Current evidence is derived from a limited number of studies with significant heterogeneity in the timing and diagnostic criteria for depression.
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Affiliation(s)
- Chuanjiang Zhang
- Chuanjiang Zhang, Department of Anxiety and Depression Treatment Center, The Third Hospital of Inner Mongolia Autonomous Region, Inner Mongolia, 010010 P.R. China
| | - Lan Jing
- Lan Jing, Department of Children’s Psychological Health Center, The Third Hospital of Inner Mongolia Autonomous Region, Inner Mongolia, 010010 P.R. China
| | - Juan Wang
- Juan Wang, Department of Endocrine, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, 010050 P.R. China
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Maternal income and preconception mental disorders: a Finnish cohort study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Thiele GA, Ryan DM, Oberlander TF, Hanley GE. Preconception mental health and the relationship between antenatal depression or anxiety and gestational diabetes mellitus: a population-based cohort study. BMC Pregnancy Childbirth 2022; 22:670. [PMID: 36045319 PMCID: PMC9429302 DOI: 10.1186/s12884-022-05002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/23/2022] [Indexed: 11/11/2022] Open
Abstract
Background Antenatal depression and anxiety are highly prevalent conditions that have been associated with increased risk for myriad adverse outcomes. Current literature exploring the connection between antenatal mental health and gestational diabetes mellitus (GDM) is limited, presenting conflicting evidence. We sought to evaluate the association between antenatal depression/anxiety (DEP-ANX) and GDM using population-based, administrative data, accounting for aspects of preconception mental health. Methods In this population-based retrospective cohort study, we included all singleton births in British Columbia, Canada from April 1, 2000, to December 31, 2014. We identified instances of DEP-ANX from outpatient and inpatient records that included relevant diagnostic codes and stratified our cohort by preconception DEP-ANX persistence. Logistic regression models were run to estimate odds of GDM given antenatal DEP-ANX. Models were adjusted for the birthing person’s socio-demographics and pregnancy characteristics. Using an expanded cohort, we ran conditional logistic regression models that matched birthing people to themselves (in a subsequent pregnancy) based on discordance of exposure and outcome. Results Out of the 228,144 births included in this study, 43,664 (19.1%) were to birthing people with antenatal health service use for DEP-ANX. There were 4,180 (9.6%) cases of GDM among those antenatal exposure to DEP-ANX compared to 15,102 (8.2%) among those without exposure (SMD 0.049). We observed an unadjusted odds ratio (OR) of 1.19 (95% CI: 1.15 – 1.23) and fully adjusted OR of 1.15 (95% CI: 1.11 – 1.19) overall. Apparent risk for GDM given antenatal DEP-ANX was highest among the no DEP-ANX history stratum, with a fully adjusted OR of 1.24 (95% CI: 1.15 – 1.34). Associations estimated by matched sibling analysis were non-significant (fully adjusted OR 1.19 [95% CI: 0.86 – 1.63]). Conclusions Results from this population-based study suggest an association between antenatal DEP-ANX and GDM that varied based on mental health history. Our analysis could suggest that incident cases of DEP-ANX within pregnancy are more closely associated with GDM compared to recurring or chronic cases. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05002-5.
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Björkstedt SM, Koponen H, Kautiainen H, Gissler M, Pennanen P, Eriksson JG, Laine MK. Preconception Mental Health, Socioeconomic Status, and Pregnancy Outcomes in Primiparous Women. Front Public Health 2022; 10:880339. [PMID: 35910895 PMCID: PMC9326245 DOI: 10.3389/fpubh.2022.880339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background: One in four women of childbearing age has some degree of mental disorders and are, therefore, prone to both pregnancy complications and adverse health outcomes in their offspring. We aimed to evaluate the impact of preconception severe mental disorders on pregnancy outcomes in primiparous women. Methods The study cohort was composed of 6,189 Finnish primiparous women without previously diagnosed diabetes, who delivered between 2009 and 2015, living in the city of Vantaa, Finland. Women were classified to have a preconception severe mental disorder if they had one or more outpatient visits to a psychiatrist or hospitalization with a psychiatric diagnosis 1 year before conception. Data on pregnancies, diagnoses, and pregnancy outcomes were obtained from national registers at an individual level. Results Primiparous women with preconception severe psychiatric diagnosis were younger, more often living alone, smokers, and had lower educational attainment and lower taxable income than women without psychiatric diagnosis (for all p < 0.001). Of all women, 3.4% had at least one psychiatric diagnosis. The most common psychiatric diagnoses were depression and anxiety disorders. The most common comorbidity was the combination of depression and anxiety disorders. There were no differences in the need for respiratory treatments, admissions to the neonatal intensive care unit, or antibiotic treatments between the offspring's groups. Conclusion Although primiparous women had severe mental disorders, the well-being of newborns was good. The most common severe mental health disorders were depression and anxiety disorders, and psychiatric comorbidity was common. Women with severe mental disorders more often belonged to lower socioeconomic groups.
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Affiliation(s)
- Satu-Maarit Björkstedt
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Social Services and Health Care Division, Helsinki, Finland
- *Correspondence: Satu-Maarit Björkstedt
| | - Hannu Koponen
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Karolinska Institute and Region Stockholm, Stockholm, Sweden
| | | | - Johan G. Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Obstetrics and Gynecology and Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Agency for Science, Technology and Research (ASTAR), Singapore Institute for Clinical Sciences (SICS), Singapore, Singapore
| | - Merja K. Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
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Wilson CA, Newham J, Rankin J, Ismail K, Simonoff E, Reynolds RM, Stoll N, Howard LM. Systematic review and meta-analysis of risk of gestational diabetes in women with preconception mental disorders. J Psychiatr Res 2022; 149:293-306. [PMID: 35320739 DOI: 10.1016/j.jpsychires.2022.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 11/27/2022]
Abstract
There is a well-established bidirectional association between Type 2 diabetes and mental disorder and emerging evidence for an increased risk of perinatal mental disorder in women with gestational diabetes (GDM). However, the relation between mental disorder prior to pregnancy and subsequent risk of GDM remains relatively unexplored. This is a systematic review and meta-analysis of the risk of GDM in women with a range of preconception mental disorders. Peer-reviewed literature measuring odds of GDM and preconception mood, anxiety, psychotic and eating disorders was systematically reviewed. Risk of bias was assessed using a checklist. Two independent reviewers were involved. 22 observational studies met inclusion criteria; most were retrospective cohorts from English speaking, high income countries. 14 studies were at high risk of bias. There was evidence for an increased risk of GDM in women with schizophrenia (pooled OR 2.44; 95% CI 1.17,5.1; 5 studies) and a reduced risk of GDM in women with anorexia nervosa (pooled OR 0.63; 95% CI 0.49,0.80; 5 studies). There was some limited evidence of an increased risk in women with bipolar disorder. There was no evidence for an association with preconception depression or bulimia nervosa on meta-analysis. There were insufficient studies on anxiety disorders for meta-analysis. This review indicates that there is not a significant risk of GDM associated with many preconception mental disorders but women with psychotic disorders represent a group uniquely vulnerable to GDM. Early detection and management of GDM could improve physical and mental health outcomes for these women and their children.
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Affiliation(s)
- Claire A Wilson
- Section of Women's Mental Health, PO31 King's College London, De Crespigny Park, London, SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, BR3 3BX, UK.
| | - James Newham
- Faculty of Health and Life Sciences, Sutherland Building, Northumbria University, Newcastle-upon-Tyne, NE1 8ST, UK
| | - Judith Rankin
- Institute of Health and Society, Baddiley-Clark Building, Newcastle University, Newcastle-upon-Tyne, NE2 4AX, UK
| | - Khalida Ismail
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, BR3 3BX, UK; Department of Psychological Medicine, Weston Education Centre, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - Emily Simonoff
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, BR3 3BX, UK; Department of Child and Adolescent Psychiatry, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Nkasi Stoll
- Department of Psychological Medicine, Weston Education Centre, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - Louise M Howard
- Section of Women's Mental Health, PO31 King's College London, De Crespigny Park, London, SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, BR3 3BX, UK
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Li H, Yu X, Qiang W, Lu M, Jiang M, Hou Y, Gu Y, Tao F, Zhu B. A longitudinal cohort study of gestational diabetes mellitus and perinatal depression. BMC Pregnancy Childbirth 2022; 22:337. [PMID: 35440070 PMCID: PMC9017412 DOI: 10.1186/s12884-022-04667-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 04/08/2022] [Indexed: 11/26/2022] Open
Abstract
Background The association between gestational diabetes mellitus (GDM) and perinatal depression (PND) remains controversial. Our study aimed to comprehensively assess this association in a longitudinal cohort study with repeated measurements of depression. Methods Our cohort study was nested in a pilot study of an implementation study aiming to screen and manage perinatal depression within the primary health system in China. Women were recruited in the first trimester from May–September 2019 and followed four times up to 1 year postpartum. Data on sociodemographic characteristics and depression were collected using self-developed questionnaires incorporating the Edinburgh Postnatal Depression Scale (EPDS). Oral glucose tolerance test at 24 ~ 28 weeks and fasting plasma glucose (FPG) data were extracted from medical records. Depression throughout the whole period was divided into different trajectories. Associations of GDM with PND at different time periods and PND of different trajectories were determined by logistic regression. The path of association between blood glucose and depression over time was estimated with an autoregressive cross-lagged model. Results In total, 1043 women were included in this analysis and 313 (30.0%) were diagnosed with GDM. The prevalence of depression in the first, second, and third trimesters and postpartum period were 17.2, 6.9, 6.8 and 9.0%, respectively. GDM was neither significantly associated with PND at any time point nor with any specific trajectory of depression. Except for autoregressive paths, no cross-lagged path of FPG and scores of EPDS was significant. Conclusions Our study indicates no association between GDM/blood glucose and PND. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04667-2.
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Affiliation(s)
- Haiyan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xiayan Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wenjing Qiang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Mengjuan Lu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Minmin Jiang
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yanyan Hou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yue Gu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Beibei Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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Wilson CA, Santorelli G, Reynolds RM, Simonoff E, Howard LM, Ismail K. Development of type 2 diabetes in women with comorbid gestational diabetes and common mental disorders in the Born in Bradford cohort. BMJ Open 2022; 12:e051498. [PMID: 35288380 PMCID: PMC8921865 DOI: 10.1136/bmjopen-2021-051498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To compare, in a population of women with gestational diabetes mellitus (GDM), the time to diagnosis of Type 2 diabetes in those with and without common mental disorder (CMD) (depression and/or anxiety) during pregnancy. DESIGN AND SETTING prospective study of the Born in Bradford cohort in Bradford, UK. PARTICIPANTS 909 women diagnosed with GDM between 2007 and 2010, with linkage to their primary care records until 2017. The exposed population were women with an indicator of CMD during pregnancy in primary care records. The unexposed were those without an indicator. OUTCOME MEASURES Time to diagnosis of type 2 diabetes as indicated by a diagnosis in primary care records. ANALYSIS time to event analysis using Cox regression was employed. Multiple imputation by chained equations was implemented to handle missing data. Models were adjusted for maternal age, ethnicity, education, preconception CMD and tobacco smoking during pregnancy. RESULTS 165 women (18%) were diagnosed with type 2 diabetes over a follow-up period of around 10 years. There was no evidence of an effect of antenatal CMD on the development of type 2 diabetes following GDM (adjusted HR 0.95; 95% CI 0.57 to 1.57). CONCLUSIONS Women with CMD were not at an increased risk of type 2 diabetes following GDM. This is reassuring for women with these co-morbidities but requires replication in other study populations.
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Affiliation(s)
- Claire A Wilson
- Section of Women's Mental Health, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Gillian Santorelli
- Born in Bradford, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Emily Simonoff
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Louise M Howard
- Section of Women's Mental Health, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Khalida Ismail
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Kings College London, London, UK
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Mohd Sa’id II, Papachristou Nadal I, Forbes A, Goldsmith K, Ismail IZ, Hassan F, Ching SM, Guess N, Murphy H, Prina M, Mohd Yusoff BN, Basri NI, Binti Salim MSF, Mahamad Sobri NH, Har Yap PP, Ismail K, Chew BH. A Protocol of Process Evaluations of Interventions for the Prevention of Type 2 Diabetes in Women With Gestational Diabetes Mellitus: A Systematic Review. INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2021. [DOI: 10.1177/16094069211034010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Process evaluations of randomised controlled trials (RCTs) can provide insight and inform us on the intervention implementation, the causal mechanisms and the contextual factors. This will inform about interventions’ success or failure due to their implementation or the interventions themselves. We aim to consolidate the methodology from previous process evaluations of complex interventions upon their findings on facilitators and barriers to address the prevention of type 2 diabetes mellitus among women with gestational diabetes mellitus (GDM). Methods Comprehensive search will be conducted on electronic databases and reference lists of recent reviews for RCTs of complex interventions which address process evaluations of diabetes prevention intervention (DPI) for women with GDM in healthcare settings. There is no restriction on the language of the papers and year of publication until December 2020. Data from each study will be extracted by two reviewers independently using standardised forms. Data extracted include descriptive items on the study design and the outcomes of process evaluations from the three dimensions: (1) implementation; (2) mechanism of impact and (3) context. The quality of the studies will be assessed using mixed methods appraisal tool which is designed for the appraisal of mixed studies in systematic reviews. A narrative and framework analysis of the findings will be presented to inform the contents of a new DPI for women with GDM. Discussion The findings from this process evaluation findings are valuable in determining whether a complex intervention should be scaled up or modified for other contexts in future plan. It will give deeper understanding of potential challenges and solutions to aid in the implementation of effective DPIs for GDM in Malaysia.
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Affiliation(s)
- Iklil Iman Mohd Sa’id
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Angus Forbes
- Care of Long-term Conditions Division, King’s College London, London, UK
| | - Kimberley Goldsmith
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Irmi Zarina Ismail
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Faezah Hassan
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nicola Guess
- Research Centre for Optimal Health, University of Westminster, London, UK
| | - Helen Murphy
- Norwich Medical School, Bob Champion Research and Education Building, University of East Anglia, Norwich
- UK/Division of Women’s Health, St Thomas’ Campus, Kings College London, London, UK
- UK/Honorary Consultant Physician, Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital, UK
| | - Matthew Prina
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Barakatun Nisak Mohd Yusoff
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nurul Iftida Basri
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mazatulfazura SF Binti Salim
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nur Hafizah Mahamad Sobri
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Pamela Phui Har Yap
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Khalida Ismail
- Department of Psychological Medicine, King’s College London, London, UK
| | - Boon How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Clinical Research Unit, Hospital Pengajar Universiti Putra Malaysia (HPUPM Teaching Hospital), Serdang, Malaysia
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Delanerolle G, Phiri P, Zeng Y, Marston K, Tempest N, Busuulwa P, Shetty A, Goodison W, Muniraman H, Duffy G, Elliot K, Maclean A, Majumder K, Hirsch M, Rathod S, Raymont V, Shi JQ, Hapangama DK. A systematic review and meta-analysis of gestational diabetes mellitus and mental health among BAME populations. EClinicalMedicine 2021; 38:101016. [PMID: 34308317 PMCID: PMC8283332 DOI: 10.1016/j.eclinm.2021.101016] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/02/2021] [Accepted: 06/21/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a common complication of pregnancy and is associated with an increased risk of mental health (MH) disorders including antenatal and postnatal depression (PND), anxiety and post-traumatic-stress-disorder (PTSD). We hypothesized GDM and MH disorders will disproportionately affect individuals from Black, Asian and Minority Ethnic backgrounds. METHODS A systematic methodology was developed, and a protocol was published in PROSPERO (CRD42020210863) and a systematic review of publications between 1st January 1990 and 30th January 2021 was conducted. Multiple electronic databases were explored using keywords and MeSH terms. The finalised dataset was analysed using statistical methods such as random-effect models, subgroup analysis and sensitivity analysis. These were used to determine odds ratio (OR) and 95% confidence intervals (CI) to establish prevalence using variables of PND, anxiety, PTSD and stress to name a few. FINDINGS Sixty studies were finalised from the 20,040 data pool. Forty-six studies were included systematically with 14 used to meta-analyze GDM and MH outcomes. A second meta-analysis was conducted using 7 studies to determine GDM risk among Black, Asian and Minority Ethnic women with pre-existing MH disorders. The results indicate an increased risk with pooled adjusted OR for both reflected at 1.23, 95% CI of 1.00-1.50 and 1.29, 95% CI of 1.11-1.50 respectively. INTERPRETATION The available studies suggest a MH sequalae with GDM as well as a sequalae of GDM with MH among Black, Asian and Minority Ethnic populations. Our findings warrant further future exploration to better manage these patients. FUNDING Not applicable.
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Affiliation(s)
| | - Peter Phiri
- Southern Health NHS Foundation Trust, United Kingdom
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, United Kingdom
| | - Yutian Zeng
- Southern University of Science and Technology, United Kingdom
| | | | - Nicola Tempest
- University of Liverpool, United Kingdom
- Liverpool Women's Hospital NHS Foundation Trust, United Kingdom
| | - Paula Busuulwa
- University of Liverpool, United Kingdom
- Liverpool Women's Hospital NHS Foundation Trust, United Kingdom
| | - Ashish Shetty
- University College London Hospitals NHS Foundation Trust, United Kingdom
- University College London, United Kingdom
| | - William Goodison
- University College London Hospitals NHS Foundation Trust, United Kingdom
| | - Hemananda Muniraman
- Department of Pediatrics, Creighton University Medical School, United Kingdom
| | | | | | - Alison Maclean
- University of Liverpool, United Kingdom
- Liverpool Women's Hospital NHS Foundation Trust, United Kingdom
| | | | - Martin Hirsch
- University College London Hospitals NHS Foundation Trust, United Kingdom
| | | | - Vanessa Raymont
- Department of Psychiatry, University of Oxford, United Kingdom
| | - Jian Qing Shi
- Southern University of Science and Technology, United Kingdom
- Alan Turing Institute, United Kingdom
| | - Dharani K. Hapangama
- University of Liverpool, United Kingdom
- Liverpool Women's Hospital NHS Foundation Trust, United Kingdom
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12
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Minschart C, De Weerdt K, Elegeert A, Van Crombrugge P, Moyson C, Verhaeghe J, Vandeginste S, Verlaenen H, Vercammen C, Maes T, Dufraimont E, De Block C, Jacquemyn Y, Mekahli F, De Clippel K, Van Den Bruel A, Loccufier A, Laenen A, Devlieger R, Mathieu C, Benhalima K. Antenatal Depression and Risk of Gestational Diabetes, Adverse Pregnancy Outcomes, and Postpartum Quality of Life. J Clin Endocrinol Metab 2021; 106:e3110-e3124. [PMID: 33693709 DOI: 10.1210/clinem/dgab156] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Indexed: 12/12/2022]
Abstract
AIMS To determine the impact of depressive symptoms on pregnancy outcomes and postpartum quality of life in women with gestational diabetes mellitus (GDM) and normal glucose tolerance (NGT). METHODS 1843 women from a prospective cohort study received universal GDM screening with an oral glucose tolerance test (OGTT). The Center for Epidemiologic Studies-Depression questionnaire was completed before GDM diagnosis was communicated and in GDM women in early postpartum. All participants completed the 36-Item Short Form Health Survey (SF-36) health survey postpartum. RESULTS Women who developed GDM (231; 12.5%) had significantly more often depressive symptoms than NGT (1612; 87.5%) women [21.3% (48) vs 15.1% (239), odds ratio (OR) 1.52, 95% confidence interval (CI) (1.08-2.16), P = 0.017]. Compared to GDM women without depressive symptoms, depressed GDM women attended less often the postpartum OGTT [68.7% (33) vs 87.6% (155), P = 0.002], remained more often depressed [37.1% (13) vs 12.4% (19), P < 0.001], and had lower SF-36 scores postpartum. There were no significant differences in pregnancy outcomes between both groups. Rates of labor inductions were significantly higher in the NGT group with depressive symptoms compared to the nondepressed NGT group [31.7% (75) vs 24.7% (330), adjusted OR (aOR) 1.40, 95% CI (1.01-1.93), P = 0.041]. NGT women with depressive symptoms had lower SF-36 scores (P < 0.001) postpartum compared to nondepressed NGT women. CONCLUSIONS Women with antenatal symptoms of depression develop more often GDM. GDM women with depressive symptoms remain more often depressed postpartum with lower quality of life. NGT women with depressive symptoms have higher rates of labor inductions and lower quality of life postpartum compared to nondepressed NGT women.
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Affiliation(s)
- Caro Minschart
- Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | | | | | - Paul Van Crombrugge
- Department of Endocrinology, OLV ziekenhuis Aalst-Asse-Ninove, Aalst, Belgium
| | - Carolien Moyson
- Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Johan Verhaeghe
- Department of Obstetrics and Gynecology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Sofie Vandeginste
- Department of Obstetrics and Gynecology, OLV ziekenhuis Aalst-Asse-Ninove, Aalst, Belgium
| | - Hilde Verlaenen
- Department of Obstetrics and Gynecology, OLV ziekenhuis Aalst-Asse-Ninove, Aalst, Belgium
| | - Chris Vercammen
- Department of Endocrinology, Imelda ziekenhuis, Bonheiden, Belgium
| | - Toon Maes
- Department of Endocrinology, Imelda ziekenhuis, Bonheiden, Belgium
| | - Els Dufraimont
- Department of Obstetrics and Gynecology, Imelda ziekenhuis, Bonheiden, Belgium
| | - Christophe De Block
- Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital, Edegem, Belgium
| | - Yves Jacquemyn
- Department of Obstetrics and Gynecology, Antwerp University Hospital, Edegem, Belgium
| | - Farah Mekahli
- Department of Endocrinology, Kliniek St-Jan Brussel, Brussel, Belgium
| | - Katrien De Clippel
- Department of Obstetrics and Gynecology, Kliniek St-Jan Brussel, Brussel, Belgium
| | | | - Anne Loccufier
- Department of Obstetrics and Gynecology, AZ St Jan Brugge, Brugge, Belgium
| | - Annouschka Laenen
- Center of Biostatics and Statistical bioinformatics, KU Leuven, 3000 Leuven, Belgium
| | - Roland Devlieger
- Department of Obstetrics and Gynecology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Chantal Mathieu
- Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Katrien Benhalima
- Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
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Sinaci S, Ozden Tokalioglu E, Ocal D, Atalay A, Yilmaz G, Keskin HL, Erdinc SO, Sahin D, Moraloglu Tekin O. Does having a high-risk pregnancy influence anxiety level during the COVID-19 pandemic? Eur J Obstet Gynecol Reprod Biol 2020; 255:190-196. [PMID: 33147531 PMCID: PMC7585497 DOI: 10.1016/j.ejogrb.2020.10.055] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 01/18/2023]
Abstract
Objective We aimed to analyze the changing level of anxiety during COVID-19 pandemic in pregnant women, with and without high-risk indicators separately, in a tertiary care center serving also for COVID-19 patients, in the capital of Turkey. Study design We designed a case-control and cross-sectional study using surveys. The Spielberger State-Trait Anxiety Scale questionnaire (STAI-T) and Beck Anxiety Inventory (BAI) which were validated in Turkish were given to outpatient women with high-risk pregnancies as study group and normal pregnancies as control group. A total of 446 women were recruited. Results There was a statistically significant difference between those with and without high-risk pregnancy in terms of Trait-State Anxiety scores with COVID-19 pandemic (p < 0.05). We found an increased prevalence of anxiety during COVID-19 pandemic in high-risk pregnant women comparing to pregnancies with no risk factors (p < 0.05). There was a statistically significant difference between the education level in high-risk pregnant women in terms of anxiety scores (p < 0.05), Beck Anxiety score was highest in high school graduates (42.75). While the level of Trait Anxiety was the highest with pandemic in those with high-risk pregnancy with threatened preterm labor and preterm ruptures of membranes (58.0), those with thrombophilia were the lowest (50.88). The State Anxiety level and Beck Anxiety Score of those with maternal systemic disease were the highest (53.32 and 45.53), while those with thrombophilia were the lowest (46.96 and 40.08). The scores of Trait Anxiety (56.38), State Anxiety (52.14), Beck Anxiety (43.94) were statistically higher during the pandemic in those hospitalized at least once (p < 0.05). Conclusion High-risk pregnant women require routine anxiety and depression screening and psychosocial support during the COVID-19 pandemic. High-risk pregnancy patients have comorbid conditions most of the time, hence they not only at more risk for getting infected, but also have higher anxiety scores because of the stress caused by COVID-19 pandemic.
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Affiliation(s)
- Selcan Sinaci
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Doga Ocal
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Aysegul Atalay
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Gamze Yilmaz
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Huseyin Levent Keskin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Seval Ozgu Erdinc
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey; Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey; Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
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