Summary: A new study reveals a link between gestational diabetes and an increased risk of developing postpartum depression in first time mothers.
Source: Mount Sinai Hospital.
Researchers from the Icahn School of Medicine at Mount Sinai and the Karolinska Institutet have found that gestational diabetes raises the risk of postpartum depression (PPD) in first-time mothers. This is the largest study of its kind to date, including more than 700,000 women. The results were published online today in the journal Depression and Anxiety.
The researchers also established that women with a history of depression are more than 20 times more likely to experience PPD than mothers without a previous clinical diagnosis of depression. And while gestational diabetes alone increased risk for PPD, a history of maternal depression in conjunction with gestational diabetes further increased the likelihood of PPD.
“Most practitioners think of these as two isolated and very different conditions, but we now understand gestational diabetes and postpartum depression should be considered together,” says Michael E. Silverman, PhD, an Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, and lead author of the study. “While having diabetes increases PPD risk for all women, for those women who have had a past depressive episode, having diabetes during pregnancy makes it 70 percent more likely that they will develop PPD.”
In addition to gestational diabetes, the researchers studied more than a dozen other risk factors, including pre-gestational diabetes, for association with PPD in women with and without a history of depression. Among women with a history of depression, pre-gestational diabetes and mild preterm delivery increased risk. Young age, instrument-assisted or cesarean delivery, and moderate preterm delivery increased risk in women who had no history of depression.
Studying the modifying effect of maternal depression on pre- and perinatal PPD risk factors sheds new light on the relationship between diabetes and depression. Showing that a history of depression modifies some of the risks associated with obstetric and perinatal factors suggests that there may be different causal pathways of PPD in women with and without a history of depression.
PPD can result in negative personal and child developmental outcomes, and identifying previous depressive episodes as a risk factor for PPD allows doctors to pursue earlier interventions. “The reason a doctor asks if you smoke is because they know you are 20 times more likely to get cancer if you do. We believe OB/GYNs should now do the same for depression history,” Dr. Silverman said. “With this information, we can now intervene early, before the mother gives birth.”
This is the largest population-based study to date to characterize PPD in relation to depression history. Researchers used the nationwide Swedish Medical Birth Register, which includes information on all births in Sweden. Unlike in past studies, researchers relied on clinical diagnoses of PPD since symptom-based PPD inventories have a tendency to overestimate the prevalence of the condition.
Funding: The study was funded by the U.S. National Institute of Child Health and Development. The team included researchers from the Department of Psychiatry and The Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai; the Karolinska Institutet in Stockholm, Sweden; and Brown University.
Source: Laura Werle – Mount Sinai Hospital
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Abstract for “The risk factors for postpartum depression: A population-based study” by Michael E. Silverman, Abraham Reichenberg, David A. Savitz, Sven Cnattingius, Paul Lichtenstein, Christina M. Hultman, Henrik Larsson and Sven Sandin in Depression and Anxiety. Published online January 18 2017 doi:10.1002/da.22597
[cbtabs][cbtab title=”MLA”]Mount Sinai Hospital “Gestational Diabetes Increases Postpartum Depression Risk.” NeuroscienceNews. NeuroscienceNews, 21 January 2017.
<https://neurosciencenews.com/gestational-diabetes-postpartum-depression-5986/>.[/cbtab][cbtab title=”APA”]Mount Sinai Hospital (2017, January 21). Gestational Diabetes Increases Postpartum Depression Risk. NeuroscienceNew. Retrieved January 21, 2017 from https://neurosciencenews.com/gestational-diabetes-postpartum-depression-5986/[/cbtab][cbtab title=”Chicago”]Mount Sinai Hospital “Gestational Diabetes Increases Postpartum Depression Risk.” https://neurosciencenews.com/gestational-diabetes-postpartum-depression-5986/ (accessed January 21, 2017).[/cbtab][/cbtabs]
Abstract
The risk factors for postpartum depression: A population-based study
Background
Postpartum depression (PPD) can result in negative personal and child developmental outcomes. Only a few large population-based studies of PPD have used clinical diagnoses of depression and no study has examined how a maternal depression history interacts with known risk factors. The objective of this study was to examine the impact of a depression history on PPD and pre- and perinatal risk factors.
Methods
A nationwide prospective cohort study of all women with live singleton births in Sweden from 1997 through 2008 was conducted. Relative risk (RR) of clinical depression within the first year postpartum and two-sided 95% confidence intervals were estimated.
Results
The RR of PPD in women with a history of depression was estimated at 21.03 (confidence interval: 19.72–22.42), compared to those without. Among all women, PPD risk increased with advanced age (1.25 (1.13–1.37)) and gestational diabetes (1.70 (1.36–2.13)). Among women with a history of depression, pregestational diabetes (1.49 (1.01–2.21)) and mild preterm delivery also increased risk (1.20 (1.06–1.36)). Among women with no depression history, young age (2.14 (1.79–2.57)), undergoing instrument-assisted (1.23 (1.09–1.38)) or cesarean (1.64(1.07–2.50)) delivery, and moderate preterm delivery increased risk (1.36 (1.05–1.75)). Rates of PPD decreased considerably after the first postpartum month (RR = 0.27).
Conclusion
In the largest population-based study to date, the risk of PPD was more than 20 times higher for women with a depression history, compared to women without. Gestational diabetes was independently associated with a modestly increased PPD risk. Maternal depression history also had a modifying effect on pre- and perinatal PPD risk factors.
“The risk factors for postpartum depression: A population-based study” by Michael E. Silverman, Abraham Reichenberg, David A. Savitz, Sven Cnattingius, Paul Lichtenstein, Christina M. Hultman, Henrik Larsson and Sven Sandin in Depression and Anxiety. Published online January 18 2017 doi:10.1002/da.22597
