Objective

Despite the prevalence of depression in women with gestational diabetes mellitus (GDM) and the relationship between mental health (depression and well-being) and metabolic health, little is known about mental health or its metabolic impact in GDM pregnancy. This prospective clinical cohort study aimed to investigate associations between 1) well-being and depression, and 2) mental health and weight/weight gain in women with GDM.

Methods

We included 334 pregnant women with GDM treated at a Swiss University Hospital between January 2016 and December 2018. They completed two self-report questionnaires: The World Health Organization well-being index (WHO-5) at the first (29 weeks of gestation) and last (36 weeks of gestation) GDM visits during pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) at the first GDM visit. A cut-off of ≥11 was selected for this questionnaire to indicate the presence of elevated depression scores.

Results

There was an inverse association between the well-being and depression total scores at the first GDM visit during pregnancy (r = −0.55; p < 0.0001). Elevated depression scores at the first GDM visit were associated with subsequent weight gain in GDM pregnancy (β = 1.249; p = 0.019).

Conclusion

In women with GDM, elevated depression scores during pregnancy are prospectively associated with weight gain. Depression symptoms should therefore be screened for and treated in women with GDM to reduce the risks associated with excessive weight gain during pregnancy.

中文翻译：

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妊娠期糖尿病女性的心理健康及其与体重的关系。一项前瞻性临床队列研究

客观的

尽管患有妊娠期糖尿病 (GDM) 的女性普遍存在抑郁症以及心理健康（抑郁和幸福感）与代谢健康之间的关系，但人们对心理健康或其对 GDM 妊娠的代谢影响知之甚少。这项前瞻性临床队列研究旨在调查 1) 幸福感和抑郁症，以及 2) GDM 女性的心理健康和体重/体重增加之间的关联。

方法

我们纳入了 2016 年 1 月至 2018 年 12 月期间在瑞士大学医院接受治疗的 334 名 GDM 孕妇。她们完成了两份自我报告问卷：第一次（妊娠 29 周）的世界卫生组织幸福指数 (WHO-5)妊娠期间最后一次（妊娠 36 周）GDM 访视和第一次 GDM 访视时的爱丁堡产后抑郁量表 (EPDS)。该问卷选择了 ≥ 11 的临界值来表明抑郁评分升高。

结果

在怀孕期间第一次 GDM 就诊时，幸福感和抑郁总分呈负相关（r  = -0.55；p  < 0.0001）。第一次 GDM 就诊时抑郁评分升高与随后 GDM 妊娠体重增加相关（β  = 1.249；p  = 0.019）。

结论

在患有 GDM 的女性中，妊娠期间抑郁评分升高与体重增加有前瞻性相关。因此，应对 GDM 女性的抑郁症状进行筛查和治疗，以降低与怀孕期间体重过度增加相关的风险。