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Gestational diabetes mellitus and peripartum depression: a longitudinal study of a bidirectional relationship

Žutić, Maja; Matijaš, Marijana; Štefulj, Jasminka; Brekalo, Maja; Nakić Radoš, Sandra (2024) Gestational diabetes mellitus and peripartum depression: a longitudinal study of a bidirectional relationship. BMC Pregnancy and Childbirth, 24 (1). ISSN 1471-2393

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Abstract

Background Gestational diabetes mellitus (GDM) and peripartum depression (PPD) are increasing global health issues with potentially long-lasting adverse outcomes. While limited studies suggest a bidirectional relationship between GDM and PPD, most research has been cross-sectional and focused on one direction of the relationship, primarily if GDM predicts postpartum depression. The interplay between antenatal depression and GDM is less explored, with a critical lack of prospective bidirectional studies. This longitudinal study aimed to investigate the bidirectional relationship between GDM and PPD in a total sample and according to different pre-pregnancy body mass index (BMI) categories. Specifically, we examined whether antenatal depression symptoms predict a subsequent GDM diagnosis and whether GDM predicts subsequent postpartum depression symptoms. Methods A three-wave online longitudinal study included 360 women who were followed from the second trimester (20–28 weeks, T1) through the third trimester (32–42 weeks, T2), and into the postpartum period (6–20 weeks after birth, T3). Participants completed the General Data Questionnaire, one item about the diagnosis of GDM, and the Edinburgh Postnatal Depression Scale (EPDS). The sample was stratified according to pre-pregnancy BMI into normal-weight (N=247) and overweight/obese (N=113) subgroups. Women with type I and II diabetes, GDM at T1, and underweight BMI were excluded. Results In the total sample, antenatal depression symptoms predicted GDM, whereas GDM did not predict postpartum depression symptoms. A bidirectional relationship was observed in normal-weight women, where antenatal depression symptoms predicted subsequent GDM diagnosis, and GDM diagnosis predicted postpartum depression symptoms. In contrast, no associations were found in either direction in the overweight/obese subgroup. Conclusions This study provides evidence of a bidirectional relationship between GDM and PPD only in women with normal body weight before pregnancy. The results highlight the complexity of the relationship between peripartum mental and metabolic health, that is dependent on pre-pregnancy BMI. Clinicians should be aware that normalweight women may have a unique sensitivity to the bidirectional interplay between GDM and PPD. Pregnant women should be closely monitored for both mental and metabolic health issues and targeted for prevention programs to reduce the risks and burdens associated with both conditions.

Item Type: Article
Uncontrolled Keywords: Gestational diabetes mellitus, Peripartum depression, Pregnancy, Antenatal, Postpartum, Depression, Body mass index, Obesity, Metabolic health
Subjects: BIOMEDICINE AND HEALTHCARE
Divisions: Division of Molecular Biology
Projects:
Project titleProject leaderProject codeProject type
Utjecaj majčinog metaboličkog stanja na serotoninski sustav posteljice i neonatusa: od metilacije DNA do funkcije proteinaSandra Nakić RadošDOK-2020-01-4127HRZZ
Program mobilnosti - Odlazna mobilnost viših asistenata MOBODL-2023-12-6514Marijana MatijašMOBODL-2023-12-6514HRZZ
Depositing User: Ivana Vuglec
Date Deposited: 28 Nov 2025 07:13
URI: http://fulir.irb.hr/id/eprint/10092
DOI: 10.1186/s12884-024-07046-1

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