Objective: To investigate the relationship between antenatal depression symptoms and gestational diabetes mellitus (GMD) and whether antenatal depression symptoms is a risk factor for the incidence of GMD.
Methods: We enrolled 1 554 pregnant women taking their first prenatal examination (before 20-week of the gestation) at Guangdong Provincial Women and Children Hospital between January and September 2016. For all the participants, depressive symptoms during early pregnancy were assessed with the 10-item Edinburgh Postnatal Depression Scale (EPDS) and a 75-g oral glucose tolerance test (OGTT) was conducted to diagnose GDM in a follow-up survey between 24- and 28-week of gestation. We compared the difference in the incidence of GMD between the participants with and without depressive symptoms and explored the associations of antenatal depression symptoms with GDM and influence factors of GDM using logistic regression analysis.
Results: The incidence of GDM was 17.7% among all the participants and the incidence was unsignificantly higher among the participants with antenatal depression symptoms than among those without the symptoms (18.5% vs. 17.3%; χ 2 = 0.3, P = 0.57). The results of logistic regression analysis revealed that prenatal depression was not associated with GDM (odds ratio [ OR] = 1.1, 95% confidence interval [95% CI]: 0.82 – 1.43); while, age ( OR = 1.7, 95% CI: 1.2 – 2.3), high pre-pregnancy body mass index (BMI) of ≥ 24.0 kg/m 2 ( OR = 1.7, 95% CI: 1.2 – 2.3), history of preterm delivery ( OR = 2.8, 95% CI: 1.3 – 6.0), GDM history ( OR = 7.6, 95% CI: 3.9 – 14.9), and family history of diabetes ( OR = 2.1, 95% CI: 1.1 – 4.0) were significant risk factors of GDM.
Conclusion: Gestational diabetes mellitus incidence is not correlated with prenatal depression symptoms but significantly influenced by age, pre-pregnancy BMI, histories of preterm delivery and GDM, and family history of diabetes.
［摘 要］ 目的 探讨产前抑郁症状与妊娠期糖尿病 (GDM) 的关系, 研究抑郁症状能否作为 GDM 预防的风险因素。 方法 将 2016 年 1 — 9 月在广东省妇幼保健院产科首次产检并接受抑郁症状评估的 1 554 名孕妇 (孕 20 周前) 纳入调查, 追踪随访到 24～28 周行糖耐量试验 (OGTT), 根据其结果及医生诊断为 GDM, 比较有、无抑郁症状组孕妇 GDM 的发病率, logistic 回归分析产前抑郁症状与 GDM 发病的相关性, 并分析影响 GDM 发病的风险因素。 结果 GDM 发病率为 17.7 %, 抑郁症状组孕妇 GDM 发病率 (18.5 %) 高于非抑郁组 (17.3 %), 但 2 组发病率差异无统计学意义 ( χ 2 = 0.3, P = 0.57) 。logistic 回归分析发现产前抑郁与 GDM 发病无关 ( OR = 1.1, 95 % CI = 0.82～1.43), 高龄 ( OR =1.7, 95 % CI = 1.2～2.3) 、孕前体质指数 (BMI) ( OR = 1.7, 95 % CI = 1.2～2.3) 、早产史 ( OR = 2.8, 95 % CI = 1.3～6.0) 、 GDM 史 ( OR = 7.6, 95 % CI = 3.9～14.9) 、糖尿病家族史 ( OR = 2.1, 95 % CI = 1.1～4.0) 是 GDM 发病的风险因素。 结论 产前抑郁症状与中晚期妊娠期糖尿病发病无相关性, 高龄、孕前 BMI、早产史、GDM 史、糖尿病家族史是 GDM 发病的风险因素。