title: Pregnancy Hyperglycaemia and Risk of Prenatal and Postpartum Depressive Symptoms.
abstract: BACKGROUND
  Glucose dysregulation in pregnancy may affect maternal depressive symptoms during the prenatal and postpartum periods via both physiologic and psychological pathways.
  
  
  METHODS
  During mid-pregnancy, a combination of 50-g 1-h non-fasting glucose challenge test (GCT) and 100-g 3-h fasting oral glucose tolerance test was used to determine pregnancy glycaemic status among women participating in Project Viva: normal glucose tolerance (NGT), isolated hyperglycaemia (IHG), impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM). Using the Edinburgh Postnatal Depression Scale (EPDS), we assessed depressive symptoms at mid-pregnancy and again at 6 months postpartum. We used logistic regression, adjusted for sociodemographic, anthropometric and lifestyle factors, to estimate the odds of elevated prenatal and postpartum depressive symptoms (EPDS ≥ 13 on 0-30 scale) in relation to GCT glucose levels and GDM status in separate models.
  
  
  RESULTS
  A total of 9.6% of women showed prenatal and 8.4% postpartum depressive symptoms. Women with higher GCT glucose levels were at greater odds of elevated prenatal depressive symptoms [multivariable-adjusted odds ratio (OR) per standard deviation (SD) increase in glucose levels (27 mg/dL): 1.25; 95%: 1.07, 1.48]. Compared with NGT women, the association appeared stronger among women with IHG [OR: 1.80; 95% confidence interval (CI): 1.08, 3.00] than among those with GDM (OR: 1.45; 95% CI: 0.72, 2.91) or IGT (OR: 1.43; 95% CI: 0.59, 3.46). Neither glucose levels assessed from the GCT nor pregnancy glycaemic status were significantly associated with elevated postpartum depressive symptoms.
  
  
  CONCLUSIONS
  Pregnancy hyperglycaemia was cross-sectionally associated with higher risk of prenatal depressive symptoms, but not with postpartum depressive symptoms.
authors.affiliation: Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: Tianyi
authors.initials: T
authors.lastname: Huang
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Rifas-Shiman
authors.affiliation: Division of Biostatistics and Epidemiology, Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Ertel
authors.affiliation: Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
authors.forename: Janet
authors.initials: J
authors.lastname: Rich-Edwards
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
authors.forename: Ken
authors.initials: K
authors.lastname: Kleinman
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.|Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gillman
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.|Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
authors.affiliation: Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Tamarra
authors.initials: T
authors.lastname: James-Todd
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003863:Depression / Q000097:blood / Q000209:etiology* / Q000523:psychology; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology / Q000523:psychology*; D016015:Logistic Models; D062407:Meals; D016017:Odds Ratio; D049590:Postpartum Period / Q000097:blood / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000523:psychology*; D012307:Risk Factors; D013997:Time Factors
chemical_list: D001786:Blood Glucose
keywords: gestational diabetes; hyperglycaemia; impaired glucose tolerance; postpartum depression; prenatal depression