Abstract
Many women develop postpartum mental health symptoms, ranging from the maternity blues to clinically diagnosed postpartum depression (PPD). Substantial literature supports an association between depression and type 2 diabetes, but there is limited literature regarding to what extent this relationship pertains to gestational diabetes (GDM) and postpartum depression. Review of the literature regarding GDM and PPD with a particular focus on describing the prevalence of PPD among women who may be at increased risk for GDM, including low-income and ethnic minority groups, was performed. Literature searches were conducted across four databases for studies reporting postpartum mental health outcomes (including postpartum depression, behavioral symptoms, mental disorders, mood, anxiety, quality of life) following a diagnosis of GDM. Studies including subgroups of women with GDM were included if postpartum mental health outcomes were reported. Of the 245 abstracts identified, ten studies were included in the final review. Findings suggest that PPD was high among low-income, ethnic minority women. Additional research is required to understand the complex relationship between GDM and PPD among low-income women, with the ultimate goal of implementing tailored interventions to address their medical and psychiatric needs.
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Notes
Recently, the American College of Obstetrics and Gynecology (ACOG) and the US Preventive Services Task Force issued statements supporting screening asymptomatic pregnant women at 24 weeks for GDM with a “B” recommendation, suggesting adequate evidence that benefits associated with earlier screening outweigh potential risks. According to ACOG, early pregnancy screening for undiagnosed DMT2 is also suggested in women with risk factors, including those with a prior history of GDM. If the result of early testing is negative, repeat screening for high-risk women is recommended at 24–28 weeks of gestation. The two-step approach to testing, commonly used in the USA, is based on the first screening with the administration of 50 g of an oral glucose solution followed by a 1-h venous glucose determination. Those individuals meeting or exceeding the screening threshold undergo a 100-g, 3-h diagnostic oral glucose tolerance test (OGTT).
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Acknowledgments
This project was supported by National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health under Award Number P60MD006902.
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Barakat, S., Martinez, D., Thomas, M. et al. What do we know about gestational diabetes mellitus and risk for postpartum depression among ethnically diverse low-income women in the USA?. Arch Womens Ment Health 17, 587–592 (2014). https://doi.org/10.1007/s00737-014-0460-5
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DOI: https://doi.org/10.1007/s00737-014-0460-5