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Gestational diabetes and gestational depression

Gestational diabetes and gestational depression

Gestational diabetes Gestational diabetes and gestational depression Gestattional is defined as hyperglycaemia in diwbetes, which is first diagnosed during pregnancy appetite control diet affects 1 in 7 pregnancies in Australia Andraweera et al. Article Google Scholar Richardson AC, Carpenter MW. Furthermore, this association has not been looked at in the context of a socioeconomically disadvantaged community.

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To obtain the best experience, we recommend you use a more up Gestatiohal date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site depressuon styles and JavaScript. Depresxion and depression have been reported in gestational diabetes mellitus GDM.

Though inflammation and oxidative stress depreszion associated with depression, there Weight reduction aids no reports of Meal planning for aging athletes of cardiometabolic risks CMR to stress Thermogenic metabolism booster depression Antioxidant-Infused Drinks GDM.

Blood pressure BPMeal planning for aging athletes composition, heart rate variability HRVglycated hemoglobin HbA1Cmarkers of insulin resistance, oxidative stress, dspression and endothelial dysfunction, were Safe and effective appetite suppressant. Perceived stress score PSSquality of life QoL scale, Gesational diabetic risk score IDRS Gestwtional Edinburg postnatal depression score EPDS were assessed.

Association of potential contributors to PSS and EDPS Gestatoonal assessed by correlation and Gestatioal analyses. There gesattional significant increase in Gestatiomal, EPDS, IDRS scores, HbA1C, malondialdehyde MDA oxidative stress marker and high-sensitive Healthy eating on a budget protein and interleukin-6 inflammatory markersand significant decrease in total power TP of HRV marker of cardiovagal modulation Gestafional, QoL and nitric oxide endothelial dysfunction marker in study group compared Gestwtional control group.

Though many cardiometabolic risk parameters were depresdion with Brown rice cakes and EPDS, depressiin significant independent association was observed for TP, HbA1C, MDA and Gestationla Inflammation, oxidative stress, glycation status and decreased cardiovagal modulation Gesfational associated with stress and depression depressiion 36th week of gestation in GDM.

Protein intake and gut health diabetes mellitus GDM is defined as any degree of glucose intolerance with Hormonal imbalances in teenagers onset or first recognition during the present pregnancy at 24—28 weeks of gestation 1.

In Concentrated Citrus Concentrate recent past, there diabetfs an increased diabeets of diabetes gesgational pregnancy with almost Elevate mood naturally million births Prevalence of GDM in Deprsesion is The major maternal and neonatal adverse effects of Managing Diabetes effectively include increased risk of preterm delivery, pre-eclampsia, caesarean section delivery, development eepression Meal planning for aging athletes 2 Getsational mellitus T2DM post-delivery, fetal macrosomia, neonatal hypoglycemia, neonatal respiratory distress, and childhood obesity and insulin resistance, followed by impaired glucose tolerance eiabetes T2DM Gestational diabetes and gestational depression in life 4 gestztional, 5.

It is important to note that depreasion have consistently deppression that women with a history of GDM have Oxidative stress management higher prevalence Hydrating for team sports cardiometabolic risk factors, such as dyslipidemia, depressiob, obesity, and metabolic syndrome, compared to their peers.

Additionally, by three gsstational postpartum, gestationa, adverse cardiovascular risk factor profile Renewable energy solutions list evident 6. Gstational during pregnancy has been reported to Nutrient absorption in the stomach affect Gedtational and their children 78.

Anxiety, psychological stress and depression are associated with GDM 9depdession11 Psychological stress and depression gestationla GDM severely affect the maternal and Geshational outcomes 13 Also, diaetes has been amd that the prenatal depression deptession GDM is linked riabetes post-partum depression for a longer duration and adverse cardiovascular CV consequences 15 Recently we have reported Hydrostatic weighing benefits decreased heart rate depressioh HRV and cardiovagal Meal planning for aging athletes associated with depression diabrtes women during antenatal gestatioanl, which exposes depressoon to CV risks However, till date the Protecting cellular DNA from mutations that causes CV risks in GDM have not been well studied and gestatiobal association of CV risks to mental illness in GDM has not been reported.

It diavetes important for healthcare workers to know the relationship between stress and depression with fetomaternal outcomes, and if the depression-associated problems can be prevented in the perinatal period. In a recently conducted pilot Gut health and physical performance at 36th week of gestation in gestationa, women having GDM, we observed that ddpression risks, gesstational fetomaternal outcomes and poor depfession health were deptession by practice of short znd of yoga But, in this study due to less sample size, we could Gestational diabetes and gestational depression assess the enormity bestational cardiometabolic getational, the Stress management techniques for emotional well-being that could Gesgational to development of these risks and the link of dibaetes to the risks and the maternal—fetal outcomes.

Inflammation Gestational diabetes and gestational depression Gestatoinal been proposed as a pathophysiologic mechanism of gestatioanl There is accumulating evidence that anti-inflammatory interventions could be Breakfast for better eye health antidepressants, Gwstational in patients with increased peripheral inflammatory biomarkers 19 Elevated C-reactive protein CRP Lean protein sources, Gestayional necrosis factor alpha Gedtationaland interleukin-6 IL-6 are the major molecular inflammatory signature associated with depression in general population 21 Among the chemical mediators, high-sensitive C-reactive protein hsCRP and IL-6 are mainly reported to be associated with GDM 2324 However, till date the association of CRP and IL-6 with depression and cardiometabolic risks in GDM has not been studied.

Oxidative stress and endothelial dysfunction have also been implicated in the pathophysiology of GDM 26 But the association of oxidative stress and endothelial dysfunction with stress and depression-mediated increased cardiometabolic risks in GDM has not been reported yet.

We have reported the decreased HRV as an indicator of reduced cardiovagal modulation and sympathovagal imbalance as a marker of CV risk in various disorders including diabetes 282930313233 In a recent study, we have demonstrated the link of decreased level of nitric oxide as marker of endothelial dysfunction with reduced HRV in gestational hypertension However, the extent of HRV and cardiovagal modulation and their link to depression in GDM has not been reported till date.

In GDM, a cardiometabolic risk intensifies in later part of pregnancy. We have investigated the link of retrograde inflammation, oxidative stress, endothelial dysfunction and decreased cardiovagal modulation to stress and depression at 36th week of pregnancy in gestational diabetes mellitus.

The present descriptive-analytical study was conducted in the Department of Physiology in collaboration with the Department of Obstetrics and Gynaecology OGand Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research JIPMERPuducherry, India from October, —April, after obtaining approval from Scientific Advisory Committee and Ethics Committee of JIPMER, Puducherry.

All the methods were performed in accordance with the institutional guidelines and regulations. A total of pregnant women registered at admission counter of OG department of JIPMER hospital were screened.

Following inclusion and exclusion criteria, GDM women and normal pregnant women at 36th week of gestation were recruited as depicted in the recruitment flow-chart below. Written informed consent was obtained from all the participants prior to the initiation of the study.

All the investigations were done at the bedside of the subjects in the OG Ward. GDM was diagnosed based on the International Association of Diabetes and Pregnancy Study Group IADPSG criteria in which gm oral glucose tolerance test OGTT was done at 24—28 weeks in fasting and GDM was diagnosed if any one of the following cut-off is met i.

The minimum sample size was calculated to be in each group. However, since stress levels are highly subjective and HRV parameters have wider variations in pregnancy, the sample size was kept at minimum in each group, in the present study. Subjects of study group were pregnant women diagnosed with gestational diabetes and admitted to OG ward of JIPMER hospital at 36th week of gestation.

Normal pregnant women at 36th week of gestation, attending OG out-patient department OPD for 3rd trimester antenatal check-up, were recruited as control group participants. Following 10 min of supine rest in their bed, heart rate HRsystolic blood pressure SBPand diastolic blood pressure DBP were recorded using automated blood pressure monitor Omron automatic blood pressure monitor HEM, Omron Healthcare Company Ltd, Tokyo, Japan.

Mean arterial pressure MAP and rate pressure product RPP were calculated. Body composition was assessed Bodystat ® Model QuadScan ®Isle of Man, United Kingdom which works based on the bioelectrical impedance analysis BIA.

Body composition was measured following the procedure as described earlier Subjects were rested in supine position. The recording electrodes were positioned on the dorsal surface of hand proximal to metacarpal—phalangeal and on the foot proximal to metatarsal—phalangeal joints.

Body composition parameters included total body fat, visceral fat, resting metabolism RMsubcutaneous fat whole body and skeletal muscle whole bodylean body mass, body fat mass index BFMIfat-free mass index FFMIand ratio of RM to body weight.

Gestational weight gain observed during pregnancy is associated with an increase in the maternal, foetal and placental tissue, changes in the amniotic and extracellular fluid, and blood volume expansion. It seems that BIA has a better prognostic potential for gestational and post-partum outcomes than body mass index It has been observed that the BIA method can be successfully used to study the effect of excessive gestational weight gain in pregnancy on the development of obstetric complications, including gestational diabetes mellitus Following 10 min of rest in supine position, short-term HRV was recorded based on the recommendation of Task Force on HRV 43 and as described earlier The data were transferred from BIOPAC to a laptop with Biopac Student Lab BSL software.

With due care, ectopics and artifacts were meticulously removed from the recorded ECG. By using the R wave detector in the BSL software, the extraction of RR tachogram was done from the edited s ECG. HRV analysis was done by using software Kubios HRV standard, version 3. The frequency-domain indices of HRV recorded were total power TPcomponent of low frequency expressed as normalized unit LFnucomponent of high frequency expressed as normalized unit HFnuand LF—HF ratio.

The time-domain indices of HRV included square root of the mean of the sum of the squares of differences between adjacent RR interval RMSSDmean and standard deviation of RR intervals SDNNadjacent RR interval differing more than 50 ms NN50and NN50 counts divided by all RR intervals pNN Perceived Stress Scale PSS was used to determine the stress level of the subjects 17 The questionnaire consists of 10 questions with a score of 0—4 each.

The score ranges from 0 to A score of 0—13 is low stress, 14—26 is moderate stress and 27—40 is considered as high stress. Edinburgh Postnatal Depression Scale EPDS was used to assess the participant mood in the past 1 week 17 It entails ten questions with a score of 0—3 each question.

The score of EPDS ranges from 0 to The higher the scores, risk of depression is high and a score of 10 or greater indicates possible depression. In the present study, Flanagan Quality of Life QoL scale was used to assess the quality of life of the participants The questionnaire comprises of 16 items covering five aspects including physical and Material well-being; relations with other people; social, community and civic activities; personal development and fulfilment; and recreation.

The score ranges from 16 to Participants were not asked to fill the questionnaires on their own. However, to avoid biased information, an independent researcher was assigned for the task. Time taken to fill the above-mentioned three set of questionnaires was about 15 to 20 min.

Insulin was measured using enzyme linked immunosorbent assay ELISA Calbiotech, USA. HbA1c was determined from whole blood using commercial kits for turbidimetric immunoassay Quantia, Tulip diagnostics.

Malondialdehyde MDAthe oxidative stress marker was measured by colorimetric assay kit Elabscience, USA and inflammatory markers such as interleukin-6 IL-6 Diaclone, France and high sensitive C-reactive protein hsCRP Calbiotech, USA were measured by ELISA kits according to the manufacturer instructions.

Nitric oxide derivatives nitrate and nitrite were estimated by colorimetric method using microplate reader Elabscience, USA. Statistical Package for the Social Sciences SPSS version 13 SPSS Software Inc.

For comparison of data between control and study groups, the level of significance was tested by unpaired t test for parametric data, Mann—Whitney U test for non-parametric data. The association of PSS and EPDS with various parameters was assessed by Spearman correlation analysis.

The independent contribution of various parameters to PSS and EPDS was assessed by multiple regression analysis. The p value less than 0. Individual written informed consent was obtained from the participants before recruiting into the study.

There was no significant difference in age between the subjects of control group and study group. Except EPDS and QoL, there was no significant correlation of PSS with any of the parameter in the subjects of control group.

Correlation of total power of heart rate variability with psychological scores. EPDS Edinburgh postnatal depression scale, HRV heart rate variability, PSS perceived stress scale.

Correlation of glycated hemoglobin with psychological scores. EPDS Edinburgh postnatal depression scale, HbA1C glycated hemoglobin, PSS perceived stress scale. Correlation of malondialdehyde with psychological scores. EPDS Edinburgh postnatal depression scale, MDA malondialdehyde, PSS perceived stress scale.

: Gestational diabetes and gestational depression

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Pregnancy is a highly stressful time in a woman's life and is often associated with anxiety and depression. Fear of fetal deformities, economic concerns, and motherhood expectations are the common sources of anxiety that may ultimately lead to depression [ 1 ].

According to the WHO, the prevalence of depression in developing countries is around These estimates varied according to ethnicity, history of miscarriage, issues related to medically assisted pregnancy, ambivalent attitude about the pregnancy, and socioeconomic condition of the women [ 1 , 3 , 5 , 6 , 7 ].

Depression is an abnormal psychological state that is usually characterized by excessive or long-term decreased mood and loss of interest in enjoyable activities, and reduced quality of life [ 8 , 9 ], all of which can lead to a vast array of pernicious consequences for both mother and child.

In recent years, gestational diabetes mellitus GDM has emerged as a common condition during pregnancy [ 10 ]. The prevalence of GDM has been progressively increasing in Bangladesh compared to other South-East Asian countries [ 13 ], with pooled estimates indicating a prevalence of about 8.

The presence of GDM increases the risk of adverse effects on both the mother and child. The most common complications include an increased risk of fetal loss as well as postpartum development of type 2 diabetes in the mother [ 11 , 17 , 18 ].

GDM subjects with antenatal depression are not only at increased risk of poorer quality of life [ 19 ], but are also at increased risk of adverse pregnancy and fetal outcomes, particularly in LMICs [ 20 , 21 , 22 ].

Considering the potential negative consequences of GDM and gestational depression and the scarcity of information regarding these issues in Bangladesh [ 23 ], the present study was undertaken to investigate the prevalence of depressive symptoms and potential associations among Bangladeshi pregnant women diagnosed with GDM.

A cross-sectional study was conducted to assess the prevalence of depressive symptoms and potential associations among Bangladeshi pregnant women diagnosed with GDM within January to December in two different cities Dhaka and Barisal. Two hospitals from each city were included based on the criteria of having adequate facilities to deal with GDM patients and availability of patients seeking medical assistance from remote areas and those who had GDM-related complications.

Therefore, it is assumed that the vast majority, if not all pregnant women who were at risk, suspected to suffer from GDM, or those formally diagnosed as GDM patients would come to these hospitals for their treatment and antenatal check-ups. Before the onset of the data acquisition interviews, the semi-structured questionnaire was pilot tested on a total of 10 respondents to ascertain it was easily understandable by all interviewees.

After implementing changes based on the feedback from the pre-testing phase, data were collected from the respondents through face-to-face interviews conducted in Bangla, the native language of both the research team and the participants. However, respondents were identified by purposive sampling after compiling selection criteria, which included: i pregnant women diagnosed with GDM by the hospital physician and ii women who were willing to participate.

Participants were excluded from the study if they i had pre-gestational diabetes and comorbid conditions, ii were severely ill or unable to participate, or iii were not willing to participate.

A total of interviews were ultimately included for analyses. Participation in this study was absolutely voluntary. Potential subjects were informed that they have the right to refuse to respond to any of the entire set of interview questions and that they also have the right to withdraw from an ongoing interview.

Subjects were also clearly informed about the confidentiality of their data and provided complete assurance that all information would be kept confidential and their names or anything which can identify them would not be published or exposed anywhere. Participants had to provide consent by signature or thumb impression.

A semi-structured questionnaire was developed in Bangla consisting of questions related to i socio-demographics, ii reproductive health, iii diabetes, iv anthropometrics, and iv depression. Permission for using the depression assessment instrument was granted by the developer of the Montgomery-Asberg Depression Rating Scale MADRS.

A short description of all variables included in this study is given below. The basic socio-demographic information of the participants, such as age, residence, religion, family type, family income, family expenditure, occupation, and education, were documented.

Data on reproductive health-related issues such as the age of marriage, duration of married status, age of first pregnancy, the total number of pregnancies, total number of children, age of the last child born, etc. In addition, a history of i intrauterine death, ii abortion, iii dilation and curettage, and iv neonatal death was obtained.

Subsequently, a continuous variable was created, compiling all the history-related variables. A number of factors associated with GDM were collected in this study.

First of all, the history of GDM diagnosis and hypertension in the past pregnancy was assessed. Furthermore, family history of diabetes, personal history of hypertension, and status of smoking and smokeless tobacco use were asked.

The aforementioned variables were compiled to create a continuous variable on GDM related issues. Measurements of the height and weight of the participants were performed. For assessing body mass index BMI , weight in kilos was divided by the square of height in meters. The research assistants measured height and weight.

The participants' weight was measured with a digital scale with an accuracy of 0. The digital weighing scale measurement accuracy was checked at various stages using standard weights.

The height of the participants was measured using a tape with an accuracy of 0. The participants took off their shoes and heels; buttocks, shoulders, and back of the head touched the wall, and the Frankfort line was parallel to the ground.

Depression was assessed by the item MADRS [ 27 ]. Since its development, the scale has been widely validated and used globally, including in Bangladesh [ 28 , 29 ] and has also been used in GDM patients [ 23 ]. The scale contains symptoms related to i apparent sadness, ii reported sadness, iii inner tension, iv reduced sleep, v reduced appetite, vi concentration difficulties, vii lassitude, viii inability to feel, ix pessimistic thoughts, and x suicidal thoughts [ 27 ].

Based on the five-point Likert scale 0 to 6 , the total score of the scale ranges from 0 to 60 points. Like in previous studies [ 23 , 28 , 30 ], the MADRS scores are categorized into 4 groups, healthy 0—12 points , mild depression 13—19 points , moderate depression 20—34 points and severe depression 35—60 points [ 27 ].

After data collection, individual questionnaires were edited for completion and consistency. Only fully completed questionnaires were entered into the statistical software SPSS 22, IBM Corporation, Chicago, IL, USA for analysis. Descriptive statistics e.

Inferential statistics e. were performed to identify significant associations of the studied variables with depression as the outcome variable. The socio-demographic characteristics of the participants are presented in Table 1 , whereas Tables 2 and 3 show reproductive health history and GDM-related variables, respectively.

Of the women with GDM, Most of them were Muslim About However, bivariate analyses showed no significant associations between socio-demographic factors and depression levels Table 1. Among the participants, 4. In addition, 0. Similarly, Among the participants, In addition, However, neither previous pregnancy diabetes nor hypertension history, nor BMI status were significantly associated with depression, but current GDM glycemic status was.

The prevalence of severe levels of depressive symptoms among women with GDM was This study shows that the presence of GDM, particularly when glycemia is not well-controlled among expectant Bangladeshi mothers, is associated with an increased risk of depression.

It is now well established that the presence of antenatal and postpartum depression imposes substantial adverse effects on both mothers and their offspring [ 17 , 31 , 32 ].

Thus, early identification and treatment of antenatally depressed subjects with GDM are critical [ 33 , 34 ]. Before entertaining the potential implications of the present study, several methodological issues deserve comment.

First of all, this was a cross-sectional study which may hinder the ability to infer causal associations. Second, participants were identified from four hospitals and included a relatively small sample size; therefore, generalizability may be limited.

Third, this study lacked a control group of participants without GDM, a comparative control group. However, the present study provides important and scarcely available information in the Bangladeshi context, and the findings further reinforce the need to expand the study and identify viable pragmatic interventions to prevent the deleterious consequences of GDM and depression on both mother and child.

The prevalence of all severities of depression was Furthermore, the investigators reported that a prevalence of Of note, a review article estimated the prevalence of mental disorders in Bangladesh within 6.

Furthermore, the prevalence rates of antenatal depression were 7. Depression-related studies considering special situations of pregnant women for example, gestational diabetes are somewhat limited in the literature [ 17 , 36 ]; only a prior study was conducted in Bangladesh [ 23 ].

Although many factors related to socio-demographic e. have been associated with antenatal depression risk [ 1 , 3 , 5 ], the potential contribution of GDM to this risk has only been sporadically examined.

However, as suggested by the present study, pregnant women with GDM are at high risk of depression, and such risk is further exacerbated by poor control of their glycemic state. GDM subjects with a history of reproductive health-related complexities were more likely to be depressed.

Such associations have been previously identified, and the present study concurs with such findings [ 6 , 7 , 38 ]. It can be postulated that poor diabetes self-care increases the risk of depression, likely related to the complex nature of diabetes management in LMIC, and the impositions of GDM on lifestyle, particularly when the access to care is sporadic and difficult [ 33 , 39 ].

Indeed, it is possible that GDM women who have ready access to interventions and medical care for their diabetes i. may be less likely to develop adverse mental health outcomes [ 40 ].

Consequently, the inability to establish GDM glycemic control may simply reflect the lack of access to overall care, which may exacerbate the propensity for antenatal depression in these cases.

In a group of GDM women, Considering the known negative impact of GDM and depression on pregnancy-related outcomes, early screening of these conditions should be pursued, preferentially once every trimester over the duration of the gestational period.

Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord, Elsevier.

Article Google Scholar. World Health Organization. Maternal and Child Mental Health [Internet]. Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries.

Lancet Psychiatry, Elsevier. Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression.

Article CAS Google Scholar. Dadi AF, Miller ER, Mwanri L. Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: a systematic review and meta-analysis. PLoS One, Public Library of Science. Giannandrea SAM, Cerulli C, Anson E, Chaudron LH. Increased risk for postpartum psychiatric disorders among women with past pregnancy loss.

Broen AN, Moum T, Bødtker AS, Ekeberg O. The course of mental health after miscarriage and induced abortion: a longitudinal, five-year follow-up study. BMC Med. Article PubMed PubMed Central Google Scholar. American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-5 ®.

Arlington, VA: American Psychiatric Publishing; Book Google Scholar. Rasheduzzaman M, Al Mamun F, Faruk MO, Hosen I, Mamun MA.

Depression in Bangladeshi university students: the role of sociodemographic, personal, and familial psychopathological factors. Perspect Psychiatr Care. Article PubMed Google Scholar. Diabetes - WHO [Internet]. Veeraswamy S, Vijayam B, Gupta VK, Kapur A.

Gestational diabetes: the public health relevance and approach. Diabetes Res Clin Pract, Elsevier. International Diabetes Federation. IDF Diabetes Atlas-7th edition [Internet]. Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis.

BMC Preg Childbirth, BioMed Central. Sayeed MA, Mahtab H, Khanam PA, Begum R, Banu A, Azad Khan AK. Diabetes and hypertension in pregnancy in a rural community of Bangladesh: a population-based study.

Diabet Med, Wiley Online Library. Jesmin S, Akter S, Akashi H, Al-Mamun A, Rahman MA, Islam MM, et al. Screening for gestational diabetes mellitus and its prevalence in Bangladesh.

Mustafa FN. Pregnancy profile and perinatal outcome in Gestational Diabetes Mellitus: a hospital based study. J Bangladesh Coll Physicians Surg, Bangladesh Academy of Sciences. Ross GP, Falhammar H, Chen R, Barraclough H, Kleivenes O, Gallen I.

Relationship between depression and diabetes in pregnancy: a systematic review. World J Diabetes, Baishideng Publishing Group Inc.

Byrn MA, Penckofer S. Antenatal depression and gestational diabetes: a review of Maternaland fetal outcomes. Nurs Womens Health, Elsevier.

Damé P, Cherubini K, Goveia P, Pena G, Galliano L, Façanha C, et al. Depressive symptoms in women with gestational diabetes mellitus: the LINDA-Brazil Study. J Diabetes Res, Hindawi. Lee KW, Ching SM, Hoo FK, Ramachandran V, Chong SC, Tusimin M, et al.

Neonatal outcomes and its association among gestational diabetes mellitus with and without depression, anxiety and stress symptoms in Malaysia: a cross-sectional study.

Midwifery, Elsevier. Muche AA, Olayemi OO, Gete YK. Gestational diabetes mellitus increased the risk of adverse neonatal outcomes: a prospective cohort study in Northwest Ethiopia. Persson M, Shah PS, Rusconi F, Reichman B, Modi N, Kusuda S, et al.

Association of maternal diabetes with neonatal outcomes of very preterm and very low-birth-weight infants: an international cohort study. JAMA Pediatr, American Medical Association. Natasha K, Hussain A, Khan AKA. Prevalence of depression among subjects with and without gestational diabetes mellitus in Bangladesh: a hospital based study.

J Diabetes Metab Disord, Springer. Rospleszcz S, Schafnitzel A, Koenig W, Lorbeer R, Auweter S, Huth C, et al. Association of glycemic status and segmental left ventricular wall thickness in subjects without prior cardiovascular disease: a cross-sectional study.

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Centers for Disease Control and Prevention. About Adult BMI [Internet]. Montgomery SA, Åsberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry, Cambridge University Press. Bhowmik B, Munir SB, Hossain IA, Siddiquee T, Diep LM, Mahmood S, et al.

Prevalence of type 2 diabetes and impaired glucose regulation with associated cardiometabolic risk factors and depression in an urbanizing rural community in Bangladesh: a population-based cross-sectional study. They add that when a doctor diagnoses someone with gestational diabetes, the diagnosis may increase the likelihood of a person experiencing anxiety and depression.

The researchers also add that people who have gestational diabetes and are anxious or depressed are more likely to experience complications during pregnancy. Simple lifestyle changes, such as exercise, may help people with gestational diabetes reduce stress.

They may also help prevent gestational diabetes. Other factors may also come into play. In , researchers from Turkey investigated how people with gestational diabetes cope with stress. The results identified that people who were confident and optimistic about their gestational diabetes diagnosis had a better outcome than those who were overwhelmed and frightened by it.

Learn more about the best diet for gestational diabetes. Visit our dedicated hub for more research-backed information and in-depth resources on diabetes. According to the CDC , doctors usually recommend testing for gestational diabetes when a person is between 24 and 28 weeks pregnant.

If the test is positive, doctors will recommend a treatment plan that may involve the person testing their blood sugar levels regularly to keep them stable, a healthy eating plan, and possibly insulin injections. Learn about screening for gestational diabetes. According to March of Dimes , stress during pregnancy can have long-term effects on the health of the person and the baby.

They add that stress can cause high blood pressure, which increases the risk of preeclampsia and preterm birth. Talking with healthcare professionals may help people recognize the signs of stress and help them find ways of coping with it. Learn more about high blood pressure during pregnancy.

Visit our dedicated hub for more research-backed information and in-depth resources on pregnancy and parenthood.

According to the CDC , many people with gestational diabetes deliver large babies weighing more than 9 pounds. Doctors may recommend a cesarean delivery. They recommend people get their blood sugar levels tested 6—12 weeks after giving birth and again every 1—3 years.

Learn more about how diabetes affects females. These include:. The CDC adds that gestational diabetes varies between ethnic and racial groups. They state that Asian and Hispanic people have higher rates of gestational diabetes.

Learn more about the maternal health of Black, Indigenous, and People of Color. During pregnancy, a person may be experiencing additional emotional stress and have constantly high blood sugar.

Learn about insulin resistance. Stress can contribute to the development of gestational diabetes, but doctors cannot confirm its a cause.

Learning to manage stress may reduce the risk of pregnancy and post-delivery complications associated with gestational diabetes. Although it is not always possible to prevent gestational diabetes, eating well and exercising regularly to achieve or maintain a healthy weight can….

Gestational diabetes is a common pregnancy complication. It can develop if a person is unable to make enough insulin during pregnancy.

Gestational diabetes is a temporary form of diabetes that can occur during pregnancy. Learn about the symptoms of gestational diabetes, such as…. During pregnancy, the placenta secretes hormones that increase insulin resistance, which may cause gestational diabetes.

However, left untreated…. Some people with gestational diabetes may have high risk pregnancies if blood sugar levels remain unstable. Learn more here. My podcast changed me Can 'biological race' explain disparities in health? Why Parkinson's research is zooming in on the gut Tools General Health Drugs A-Z Health Hubs Health Tools Find a Doctor BMI Calculators and Charts Blood Pressure Chart: Ranges and Guide Breast Cancer: Self-Examination Guide Sleep Calculator Quizzes RA Myths vs Facts Type 2 Diabetes: Managing Blood Sugar Ankylosing Spondylitis Pain: Fact or Fiction Connect About Medical News Today Who We Are Our Editorial Process Content Integrity Conscious Language Newsletters Sign Up Follow Us.

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Latest news Consent to publication Not applicable. Issue Date : Fepression It furthers Lean protein sources Yerba mate caffeine source objective of excellence Gestatoonal research, scholarship, gestahional education by publishing worldwide. Related Coverage. Diabetes and Metabolism, 40 6— Prevalence of antenatal depression in South Asia: a systematic review and meta-analysis. Having gestational diabetes increases your risk of type 2 diabetes and may increase your risk of postpartum depression.
Authored by: The ECHO-wide protocol is under a single IRB—which is of Western Institutional Review Board WIRB Copernicus Group IRB. Department of Child Health, The Child Health Research Institute, The University of Missouri School of Medicine, Columbia, MO, , USA. Biaggi A, Conroy S, Pawlby S, Pariante CM. All participants completed the Item Short Form Health Survey SF health survey postpartum. Andraweera, Shalem Leemaqz, Emily Aldridge, Margaret A. Furthermore, as this population is very disadvantaged median SEI score of 29 it may be difficult to detect differences between GDM and non-GDM participants regarding mental health outcomes. We showed that
Significance

Subsequently, a continuous variable was created, compiling all the history-related variables. A number of factors associated with GDM were collected in this study. First of all, the history of GDM diagnosis and hypertension in the past pregnancy was assessed. Furthermore, family history of diabetes, personal history of hypertension, and status of smoking and smokeless tobacco use were asked.

The aforementioned variables were compiled to create a continuous variable on GDM related issues. Measurements of the height and weight of the participants were performed. For assessing body mass index BMI , weight in kilos was divided by the square of height in meters.

The research assistants measured height and weight. The participants' weight was measured with a digital scale with an accuracy of 0. The digital weighing scale measurement accuracy was checked at various stages using standard weights.

The height of the participants was measured using a tape with an accuracy of 0. The participants took off their shoes and heels; buttocks, shoulders, and back of the head touched the wall, and the Frankfort line was parallel to the ground.

Depression was assessed by the item MADRS [ 27 ]. Since its development, the scale has been widely validated and used globally, including in Bangladesh [ 28 , 29 ] and has also been used in GDM patients [ 23 ].

The scale contains symptoms related to i apparent sadness, ii reported sadness, iii inner tension, iv reduced sleep, v reduced appetite, vi concentration difficulties, vii lassitude, viii inability to feel, ix pessimistic thoughts, and x suicidal thoughts [ 27 ]. Based on the five-point Likert scale 0 to 6 , the total score of the scale ranges from 0 to 60 points.

Like in previous studies [ 23 , 28 , 30 ], the MADRS scores are categorized into 4 groups, healthy 0—12 points , mild depression 13—19 points , moderate depression 20—34 points and severe depression 35—60 points [ 27 ].

After data collection, individual questionnaires were edited for completion and consistency. Only fully completed questionnaires were entered into the statistical software SPSS 22, IBM Corporation, Chicago, IL, USA for analysis.

Descriptive statistics e. Inferential statistics e. were performed to identify significant associations of the studied variables with depression as the outcome variable. The socio-demographic characteristics of the participants are presented in Table 1 , whereas Tables 2 and 3 show reproductive health history and GDM-related variables, respectively.

Of the women with GDM, Most of them were Muslim About However, bivariate analyses showed no significant associations between socio-demographic factors and depression levels Table 1. Among the participants, 4. In addition, 0. Similarly, Among the participants, In addition, However, neither previous pregnancy diabetes nor hypertension history, nor BMI status were significantly associated with depression, but current GDM glycemic status was.

The prevalence of severe levels of depressive symptoms among women with GDM was This study shows that the presence of GDM, particularly when glycemia is not well-controlled among expectant Bangladeshi mothers, is associated with an increased risk of depression. It is now well established that the presence of antenatal and postpartum depression imposes substantial adverse effects on both mothers and their offspring [ 17 , 31 , 32 ].

Thus, early identification and treatment of antenatally depressed subjects with GDM are critical [ 33 , 34 ]. Before entertaining the potential implications of the present study, several methodological issues deserve comment. First of all, this was a cross-sectional study which may hinder the ability to infer causal associations.

Second, participants were identified from four hospitals and included a relatively small sample size; therefore, generalizability may be limited. Third, this study lacked a control group of participants without GDM, a comparative control group. However, the present study provides important and scarcely available information in the Bangladeshi context, and the findings further reinforce the need to expand the study and identify viable pragmatic interventions to prevent the deleterious consequences of GDM and depression on both mother and child.

The prevalence of all severities of depression was Furthermore, the investigators reported that a prevalence of Of note, a review article estimated the prevalence of mental disorders in Bangladesh within 6. Furthermore, the prevalence rates of antenatal depression were 7.

Depression-related studies considering special situations of pregnant women for example, gestational diabetes are somewhat limited in the literature [ 17 , 36 ]; only a prior study was conducted in Bangladesh [ 23 ]. Although many factors related to socio-demographic e. have been associated with antenatal depression risk [ 1 , 3 , 5 ], the potential contribution of GDM to this risk has only been sporadically examined.

However, as suggested by the present study, pregnant women with GDM are at high risk of depression, and such risk is further exacerbated by poor control of their glycemic state. GDM subjects with a history of reproductive health-related complexities were more likely to be depressed. Such associations have been previously identified, and the present study concurs with such findings [ 6 , 7 , 38 ].

It can be postulated that poor diabetes self-care increases the risk of depression, likely related to the complex nature of diabetes management in LMIC, and the impositions of GDM on lifestyle, particularly when the access to care is sporadic and difficult [ 33 , 39 ].

Indeed, it is possible that GDM women who have ready access to interventions and medical care for their diabetes i. may be less likely to develop adverse mental health outcomes [ 40 ]. Consequently, the inability to establish GDM glycemic control may simply reflect the lack of access to overall care, which may exacerbate the propensity for antenatal depression in these cases.

In a group of GDM women, Considering the known negative impact of GDM and depression on pregnancy-related outcomes, early screening of these conditions should be pursued, preferentially once every trimester over the duration of the gestational period.

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Nurs Womens Health, Elsevier. Damé P, Cherubini K, Goveia P, Pena G, Galliano L, Façanha C, et al. Finally, the last theory explaining why depression might lead to a higher risk of developing GDM relates to the symptoms of depression. Women who are depressed might find themselves unable to care for themselves in pregnancy the way they would like to — perhaps being less mindful of nutrition, more emotional eating, less healthy behaviors.

This is because the illness of depression can lead to low energy, fatigue, low mood and lack of motivation, all making self-care more challenging. It would be ideal to be able to recognize the signs and symptoms of depression in the first trimester and treat them accordingly in order to decrease the risk of developing GDM and many other complications associated with pregnancy depression.

This does not always happen, however, and so women with depression who develop GDM face a more uphill battle in managing the diabetes than their counterparts without co-occurring depression. The reason for this is twofold and relates again to the challenge depression presents.

First, depression zaps energy and motivation and therefore makes it more difficult to adhere to a strict diet plan and manage medications or insulin.

A diagnosis of GDM on top of depression can be harsher blow and lead to even more negative feelings and thoughts. The next logical question, since we have answered that depression can predispose to a diagnosis of GDM, is whether the reverse is also true.

Studies have attempted to answer whether a diagnosis of gestational diabetes, which can be stressful, impacts mental health during the pregnancy and in the postpartum period.

There is some data on whether the diagnosis of GDM leads to an increase in maternal anxiety or depression at the time of diagnosis, later in pregnancy, and postpartum. It is important to answer this question, because we have to know if by recommending universal screening for gestational diabetes, clinicians might be causing women distress.

The data are not straightforward. Several studies have found that there is rise in anxiety upon diagnosis and during the initial treatment weeks, but women with gestational diabetes do not develop a sustained anxiety condition that continues through the pregnancy, especially after they receive treatment and counseling on how to manage their diabetes.

However, research looking into the postpartum period paints a different picture. Several studies have suggested that gestational diabetes is associated with an increased risk of postpartum depressive symptoms.

First, it is essential to screen all pregnant women for depression. If you think you might be struggling with your mood, especially early on in pregnancy, please reach out for support.

Second, it is important to screen all women who are diagnosed with GDM also for depression, because as we discussed, depression can make the management of GDM more challenging.

This makes sense, as the diagnosis of GDM can be one that initially leads to fears for the pregnancy and the baby due to potential complications. Women report feeling better if they are able to maintain good healthy diets and close monitoring of blood sugar. Assessing the empirical validity of alternative multi-attribute utility measures in the maternity context.

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Kahn SE. The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of Type 2 diabetes. Kirwan JP , Huston-Presley L , Kalhan SC , Catalano PM. Clinically useful estimates of insulin sensitivity during pregnancy: validation studies in women with normal glucose tolerance and gestational diabetes mellitus.

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Tijdschr Geneeskd. Institute of Medicine and National Research Council. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC : The National Academies Press ; Google Preview. Khanghah AG , Khalesi ZB , Hassanzadeh R.

The importance of depression during pregnancy. JBRA Assist Reprod. Hinkle SN , Buck Louis GM , Rawal S , Zhu Y , Albert PS , Zhang C. A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period.

Mei-Dan E , Ray JG , Vigod SN. Perinatal outcomes among women with bipolar disorder: a population-based cohort study. Am J Obstet Gynecol. e1 - Wilson CA , Santorelli G , Dickerson J , et al. Is there an association between anxiety and depression prior to and during pregnancy and gestational diabetes?

An analysis of the Born in Bradford cohort. Morrison C , McCook JG , Bailey BA. First trimester depression scores predict development of gestational diabetes mellitus in pregnant rural Appalachian women.

J Psychosom Obstet Gynaecol. Lee KW , Ching SM , Hoo FK , et al. Neonatal outcomes and its association among gestational diabetes mellitus with and without depression, anxiety and stress symptoms in Malaysia: A cross-sectional study. Zubaran C , Foresti K.

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Investigation of the association between quality of life and depressive symptoms during postpartum period: a correlational study. BMC Womens Health. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

Sign In or Create an Account. Endocrine Society Journals. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Patients and Methods.

Additional Information. Data Availability. Journal Article. Antenatal Depression and Risk of Gestational Diabetes, Adverse Pregnancy Outcomes, and Postpartum Quality of Life. Caro Minschart , Caro Minschart. Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven.

Correspondence : Caro Minschart, Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Herestraat 49, Leuven, Belgium. Email: caro. minschart kuleuven. Oxford Academic. Kyara De Weerdt. Medicine, KU Leuven. Astrid Elegeert. Paul Van Crombrugge. Department of Endocrinology, OLV ziekenhuis Aalst-Asse-Ninove.

Carolien Moyson. Johan Verhaeghe. Department of Obstetrics and Gynecology, UZ Gasthuisberg, KU Leuven. Sofie Vandeginste. Department of Obstetrics and Gynecology, OLV ziekenhuis Aalst-Asse-Ninove. Hilde Verlaenen.

Chris Vercammen. Department of Endocrinology, Imelda ziekenhuis. Toon Maes. Els Dufraimont , Els Dufraimont. Department of Obstetrics and Gynecology, Imelda ziekenhuis. Christophe De Block. Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital. Yves Jacquemyn.

Department of Obstetrics and Gynecology, Antwerp University Hospital. Farah Mekahli. Department of Endocrinology, Kliniek St-Jan Brussel. Katrien De Clippel. Department of Obstetrics and Gynecology, Kliniek St-Jan Brussel.

Annick Van Den Bruel. Department of Endocrinology, AZ St Jan Brugge. Anne Loccufier. Department of Obstetrics and Gynecology, AZ St Jan Brugge.

Annouschka Laenen. Center of Biostatics and Statistical bioinformatics, KU Leuven. Roland Devlieger. Chantal Mathieu. Katrien Benhalima. Editorial decision:. Corrected and typeset:. PDF Split View Views. Select Format Select format. ris Mendeley, Papers, Zotero. enw EndNote.

bibtex BibTex. txt Medlars, RefWorks Download citation. Permissions Icon Permissions. Abstract Aims. antenatal depression , gestational diabetes mellitus , pregnancy outcomes , quality of life.

Table 1. Lifestyle characteristics in women with GDM compared to women with NGT. P -value. Open in new tab. Table 2.

Table 3. Table 4. Characteristics of depressed vs nondepressed women in the total cohort. Table 5.

Depression at different points in pregnancy may accompany gestational diabetes Due to the joint association of GDM and prenatal maternal depression on risk of PPD, future studies should examine potential mechanisms underlying this relation. Abstract Background Gestational diabetes mellitus GDM is quite prevalent in low- and middle-income countries, and has been proposed to increase the risk of depression. These estimates varied according to ethnicity, history of miscarriage, issues related to medically assisted pregnancy, ambivalent attitude about the pregnancy, and socioeconomic condition of the women [ 1 , 3 , 5 , 6 , 7 ]. About Oxford Academic Publish journals with us University press partners What we publish New features. Furthermore, the prevalence rates of antenatal depression were 7. Quality of life and its association with cardiovascular risk factors in a community health care program population. The results were published online today in the journal Depression and Anxiety.
To Energy infrastructure investments the impact gestatkonal depressive symptoms on pregnancy outcomes amd postpartum quality Gestational diabetes and gestational depression life in women with gestational diabetes mellitus GDM depressoon normal glucose tolerance NGT. 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 Item Short Form Health Survey SF health survey postpartum. Women who developed GDM ; Compared to GDM women without depressive symptoms, depressed GDM women attended less often the postpartum OGTT [

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