NIH Study: Depression in Early Pregnancy Linked to Gestational Diabetes

While obesity is a known risk factor in gestational diabetes, women who were obese and also were depressed when they became pregnant were at greater risk of gestational diabetes than those who did not have depression.

A study by researchers from the National Institutes of Health (NIH) finds that gestational diabetes and depression go hand-in-hand: a woman who suffers either one early in pregnancy is likely to develop the other.

Findings were published online in the Diabetologia.

In gestational diabetes, blood sugar levels are elevated in women who previously were not diagnosed with diabetes. The condition is caused by improper insulin responses and can be harmful to both the mother and the baby.

“Our data suggest that depression and gestational diabetes may occur together. Until we learn more, physicians may want to consider observing pregnant women with depressive symptoms for signs of gestational diabetes," Iead author Stefanie Hinkle, PhD, staff scientist at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), said in a statement. "They might also want to monitor women who have had gestational diabetes for signs of postpartum depression.”

Researchers studied data from the NICHD Fetal Growth Studies-Singleton Cohort, which tracked the progress from 2334 pregnant women who were not obese and 468 pregnant women who were obese between weeks 8 and 13, and again between weeks 16 and 22. The women had a final follow-up 6 weeks after giving birth. Researchers also had access to records, so they knew which women had gestational diabetes.

While obesity is known to raise the risk of gestational diabetes, curiously the risk of gestational diabetes was higher for women who were not obese but did have depression compared with those who did not have depression. Of note, “persistent depression from the first to second trimester set women at even greater risk for gestational diabetes,” said senior author Cuilin Zhang, MD, PhD, also of NICHD. Women with the highest scores for depression in the first and second trimesters (about 17% of the women) had nearly triple the risk for gestational diabetes.

Postpartum depression was more likely among women who had experienced gestational diabetes; of this group, nearly 15% had postpartum depression, a rate 4 times greater than those without gestational diabetes.

Hinkle said while the study showed a strong association between the 2 conditions, it does not show a cause and effect. Other research has shown the connections between impaired glucose metabolism and higher blood sugar levels, which cause inflammation and hormonal changes that can lead to depression.

Reference

Hinkle SN, Buck Louis GM, Rawal S, et al. A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period [published online September 19, 2016]. Diabetologia. DOI: 10.1007/s00125-016-4086-1