title: MENTAL HEALTH DISORDERS SUBSEQUENT TO GESTATIONAL DIABETES MELLITUS DIFFER BY RACE/ETHNICITY.
abstract: BACKGROUND
  The relationship between gestational diabetes mellitus (GDM) and postpregnancy mental health disorders has been inconsistently reported. Additionally, race/ethnicity data are limited. We sought to elucidate the intersection of these relationships.
  
  
  METHODS
  We analyzed 18,109 women aged 18-40 with self-reported race/ethnicity. Women with (n = 659) and without (n = 14,461) GDM were followed for a median of 4.4 (interquartile range 1.4-6.8) and 4.0 (1.5-6.4) years, respectively, for incident mental health disorders. Multivariable repeated measures analyses were conducted to examine associations between GDM and postpregnancy mental health disorders, race/ethnicity, and the interaction of these factors.
  
  
  RESULTS
  Women with compared to women without GDM were older (mean ± standard deviation, 32 ± 5 vs. 30 ± 5 years; P < .001) and had higher body mass index (29.0 ± 7.2 vs. 25.3 ± 5.2 kg/m(2) ; P < .001). GDM was associated with increased risk for depression and anxiety after adjusting for age and pregnancy complications; however, loss of significance in the fully adjusted model for depression (odds ratio [95% CI]: 1.29 [0.98, 1.70]; P = .064) and anxiety (1.14 [0.83, 1.57], P = .421) suggested that clinical and socioeconomic factors influence this relationship. Hispanic compared to white women had a greater risk for depression (1.40 [1.15, 1.72]; P = .001), even after multivariable adjustment. The interaction between GDM and race was evident in complication-adjusted but not fully adjusted models.
  
  
  CONCLUSIONS
  The incidence of mental health disorders subsequent to GDM was attenuated after adjustment for clinical and socioeconomic factors. Moreover, race/ethnicity influenced this relationship. Further investigation is warranted to clarify potential underlying mechanisms.
authors.affiliation: Medicine/Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Walmer
authors.affiliation: Medicine/Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Huynh
authors.affiliation: Medicine/Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Julia
authors.initials: J
authors.lastname: Wenger
authors.affiliation: Medicine/Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ankers
authors.affiliation: Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Allison Bryant
authors.initials: AB
authors.lastname: Mantha
authors.affiliation: Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Ecker
authors.affiliation: Medicine/Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Ravi
authors.initials: R
authors.lastname: Thadhani
authors.affiliation: Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Elyse
authors.initials: E
authors.lastname: Park
authors.affiliation: Medicine/Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Bentley-Lewis
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000523:psychology*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D001523:Mental Disorders / Q000208:ethnology*; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D012306:Risk; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: anxiety/anxiety disorders; depression; epidemiology; ethnicity/race; pregnancy and postpartum