title: Mental health in early pregnancy is associated with pregnancy outcome in women with pregestational diabetes.
abstract: OBJECTIVE
  To explore the role of early pregnancy health-related quality of life, anxiety, depression and locus of control for pregnancy outcome in women with pregestational diabetes.
  
  
  METHODS
  This was a cohort study of 148 pregnant women with pregestational diabetes (118 with Type 1 diabetes and 30 with Type 2 diabetes), who completed three internationally validated questionnaires: the 36-item Short-Form Health Survey, the Hospital Anxiety and Depression Scale and the Multidimensional Health Locus of Control survey at 8 weeks. Selected pregnancy outcomes were preterm delivery (< 37 weeks) and large for gestational age infants (birth weight > 90(th) percentile). Differences between groups in the questionnaires were analysed using an unpaired t-test.
  
  
  RESULTS
  Women with preterm deliveries (n = 28) had lower (i.e. worse) mean (sd) quality-of-life scores for the two 36-item Short-Form Health Survey scales, Role-Emotional [58.3 (38.1) vs. 82.9 (31.3); P = 0.0005] and Mental Health [67.7 (20.4) vs. 75.2 (15.8), P = 0.04], and a lower score for the 36-item Short-Form Health Survey scale Mental Component Summary (42.8 (13.1) vs. 48.8 (9.7), P = 0.03) in early pregnancy, compared with women with term deliveries. Depression symptoms (Hospital Anxiety and Depression Scale depression score ≥ 8) were more frequent in women with preterm vs. term deliveries (seven (25%) vs. six women (5%); P = 0.003), while levels of anxiety and locus of control were similar in these two groups. No difference in early pregnancy scores for health-related quality of life, anxiety, depression and locus of control were seen in women delivering large or appropriate for gestational age infants.
  
  
  CONCLUSIONS
  Poor mental quality of life and the presence of depressive symptoms in early pregnancy were associated with preterm delivery in women with pregestational diabetes.
authors: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.|Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
authors: N F
authors: NF
authors: Callesen
authors: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.|Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
authors: A L
authors: AL
authors: Secher
authors: Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
authors: P
authors: P
authors: Cramon
authors: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.|Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
authors: L
authors: L
authors: Ringholm
authors: Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
authors: T
authors: T
authors: Watt
authors: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.|Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
authors: P
authors: P
authors: Damm
authors: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.|Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: E R
authors: ER
authors: Mathiesen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D003863:Depression / Q000150:complications*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000523:psychology*; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007389:Internal-External Control; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000523:psychology*; D047928:Premature Birth / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012306:Risk; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human