title: The association between a medical history of depression and gestational diabetes in a large multi-ethnic cohort in the United States.
abstract: BACKGROUND
  Both major depression and gestational diabetes mellitus (GDM) are prevalent among women of reproductive age. Our objective was to determine whether a medical history of depression is related to subsequent development of GDM.
  
  
  METHODS
  The Consortium on Safe Labor was a US retrospective cohort study of 228,562 births between 2002 and 2008. Exclusion criteria for the present analysis included multiple gestation pregnancies (n = 5059), pre-existing diabetes (n = 12,771), deliveries <24 weeks (n = 395), site GDM prevalence (<1%) (n = 20, 721) and missing data on pre-pregnancy body mass index (BMI) (n = 61,321). Using generalised estimating equations, we estimated the association between a history of depression and a pregnancy complicated by GDM.
  
  
  RESULTS
  The final analytic population included 121, 260 women contributing 128 295 pregnancies, of which 5606 were affected by GDM. A history of depression was significantly associated with an increased risk of developing GDM (multivariate odds ratio [aOR] = 1.42 [95% confidence interval (CI) 1.26, 1.60]). Adjusting for pre-pregnancy BMI and weight gain during pregnancy attenuated the association, although it remained statistically significant (aOR = 1.17 [95% CI 1.03, 1.33]).
  
  
  CONCLUSIONS
  A history of depression was significantly associated with an increased GDM risk among a large multi-ethnic US cohort of women. If the association is confirmed, depression presents a potentially modifiable risk factor of GDM and provides additional clues to the underlying pathophysiology of GDM.
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20852, USA. katherine.bowers@cchmc.org
authors.forename: Katherine
authors.initials: K
authors.lastname: Bowers
authors.forename: S Katherine
authors.initials: SK
authors.lastname: Laughon
authors.forename: Sungduk
authors.initials: S
authors.lastname: Kim
authors.forename: Sunni L
authors.initials: SL
authors.lastname: Mumford
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brite
authors.forename: Michele
authors.initials: M
authors.lastname: Kiely
authors.forename: Cuilin
authors.initials: C
authors.lastname: Zhang
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003866:Depressive Disorder / Q000208:ethnology*; D016640:Diabetes, Gestational / Q000208:ethnology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D044469:Racial Groups; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult