The Effect of Gestational Diabetes on Depression and Breastfeeding Self-Efficacy in Pregnancy and Postpartum Period

Objective: The purpose of this study was to explore the effect of gestational diabetes mellitus (GDM) on depression and breastfeeding self-efficacy during pregnancy and the postpartum period. Methods: This descriptive study was conducted in Obstetrics and Perinatology clinics of two university hospitals in Turkey between July 2016 and June 2017. Women were followed up two times. The first follow-up was performed face-to-face in the gestational week 34th to 38th and the second one was performed by telephone in the 8th week of the postpartum period. In the first follow-up, 104 pregnant women with GDM and 133 pregnant with non-GDM women were interviewed. In the second follow up, 30 women could not be reached in both groups. Data were collected by the Individual Description Form, Edinburgh Postpartum Depression Scale, and Breastfeeding Self-Efficacy Scale-Short Form. Descriptive statistics, repeated measures analysis of variance and correlation analysis were used in the data analysis. Results: The depression risk of mothers with GDM was found higher compared to non- GDM mothers. No significant difference was found between the depression and breastfeeding self-efficacy mean scores in the antenatal and postpartum period of women by the presence of GDM. There was no significant difference between the depression and breastfeeding self-efficacy mean scores in the antenatal and postpartum period by the presence of GDM and some confounding variables. As the breastfeeding self-efficacy level of mothers with GDM both in the antenatal and postpartum period increased, the depression risk decreased. Conclusion: In the study, it has been concluded that GDM does not have an impact on depression and breastfeeding self-efficacy during pregnancy and in the postpartum period.

Association Between Gestational Diabetes and Mental Illness

The rates of both gestational diabetes mellitus (GDM) and mental illness in pregnancy are rising. There is an association between type 2 diabetes and major depressive disorder, anxiety and schizophrenia, thus there is a need for greater understanding of the relationship between GDM and mental illness. This review suggests that there is a bidirectional and complex relationship between antenatal depression, gestational diabetes and postpartum depression. The combined effect of both a history of depression and gestational diabetes significantly increases the risk of postpartum depression. There is an association between severe mental illness and GDM; however, it is strongly mediated by antipsychotic medications and psychosocial factors, in addition to the disease itself. Medication has a major role in treating mental illness during pregnancy and is not directly linked with GDM in either depression or psychosis. Health-care providers should be mindful of the association between GDM and mental illness to appropriately screen and treat both disorders.

The association between gestational diabetes and postpartum depression: A systematic review and meta-analysis

AIMS

Postpartum period is a critical period for mothers, which is often accompanied by increased risk of depression. Many studies have evaluated the relationship between gestational diabetes (GDM) and postpartum depression (PPD), but contradictory results have been reported. Therefore, the present study was conducted to investigate the relationship between GDM and PPD.

METHODS

This systematic review and meta-analysis was conducted based on PRISMA Guideline. We searched all the relevant epidemiological studies in international databases of Scopus, PubMed, Science Direct, Embase, Web of Science, CINAHL, Cochrane Library, EBSCO, and Google scholar search engine using the MeSH Keywords in English without time limit until 2018. The heterogeneity of the studies was calculated using the I² index and Cochran's Q test. Relative risk (RR) and 95% confidence interval (CI) were extracted from each study. The results of the study were analyzed using the random effects model and Comprehensive Meta-Analysis Software Version 2.

RESULTS

A total of 18 studies with a sample size of 2,370,958 were reviewed. Meta-analysis results showed that GDM significantly increased the risk of PPD, and RR was 1.59 (95% CI: 1.22-2.07, p = 0.001). The RR for 15 cohort studies, 2 cross-sectional studies and 1 case-control study was 1.67 (95% CI: 1.22-2.28), 1.37 (95% CI: 0.91-2.05), and 1.29 (95% CI: 0.98-1.68), respectively.

CONCLUSIONS

GDM can be a risk factor for PPD. Therefore, PPD examination in pregnant women with GDM seems to be necessary.