The Association between a Medical History of Depression and Gestational Diabetes in a Large Multi-ethnic Cohort in the United States

Authors

  • Katherine Bowers,

    Corresponding author
    1. Cincinnati Children's Hospital Medical Center, Division of Biostatistics and Epidemiology, Cincinnati, OH
    • Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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  • S. Katherine Laughon,

    1. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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  • Sungduk Kim,

    1. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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  • Sunni L. Mumford,

    1. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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  • Jennifer Brite,

    1. School of Public Health, City University of New York, New York, NY
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  • Michele Kiely,

    1. Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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  • Cuilin Zhang

    Corresponding author
    • Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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Correspondence:

Katherine Bowers, Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5041, Cincinnati, OH 45229, USA.

E-mail: katherine.bowers@cchmc.org

Cuilin Zhang, Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD 20852, USA.

E-mail: zhangcu@mail.nih.gov

Abstract

Background

Both major depression and gestational diabetes mellitus (GDM) are prevalent among women of reproductive age. Our objective was to determine whether a medical history of depression is related to subsequent development of GDM.

Methods

The Consortium on Safe Labor was a US retrospective cohort study of 228 562 births between 2002 and 2008. Exclusion criteria for the present analysis included multiple gestation pregnancies (n = 5059), pre-existing diabetes (n = 12 771), deliveries <24 weeks (n = 395), site GDM prevalence (<1%) (n = 20 721) and missing data on pre-pregnancy body mass index (BMI) (n = 61 321). Using generalised estimating equations, we estimated the association between a history of depression and a pregnancy complicated by GDM.

Results

The final analytic population included 121 260 women contributing 128 295 pregnancies, of which 5606 were affected by GDM. A history of depression was significantly associated with an increased risk of developing GDM (multivariate odds ratio [aOR] = 1.42 [95% confidence interval (CI) 1.26, 1.60]). Adjusting for pre-pregnancy BMI and weight gain during pregnancy attenuated the association, although it remained statistically significant (aOR = 1.17 [95% CI 1.03, 1.33]).

Conclusions

A history of depression was significantly associated with an increased GDM risk among a large multi-ethnic US cohort of women. If the association is confirmed, depression presents a potentially modifiable risk factor of GDM and provides additional clues to the underlying pathophysiology of GDM.

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