title: Quality of life, anxiety and depression symptoms in early and late pregnancy in women with pregestational diabetes.
abstract: BACKGROUND
  The aim of this study was to explore changes in health-related quality of life, anxiety and depression symptoms during pregnancy in women with pregestational diabetes.
  
  
  METHODS
  An observational cohort study including 137 pregnant women with pregestational diabetes (110 with type 1 and 27 with type 2). To evaluate changes from early to late pregnancy, the internationally validated questionnaires 36-Item Short-Form Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS) were completed at 8 and 33 gestational weeks.
  
  
  RESULTS
  From early to late pregnancy, the SF-36 scales Physical Function, Role Physical, Bodily Pain and Physical Component Summary worsened (p < 0.0001 for all scales). Physical Component Summary score deteriorated from mean 52.3 (SD 6.5) to 40.0 (9.7) (p < 0.0001) and the deterioration was negatively associated with gestational weight gain in multiple linear regression (β = -0.34/kg, p = 0.03). The SF-36 scale Mental Health improved (p = 0.0009) and the Mental Component Summary score increased moderately from 47.6 (10.6) to 53.5 (8.6) (p < 0.0001). Greater improvement in Mental Component Summary score was seen with lower HbA1c in late pregnancy. The HADS anxiety score improved slightly from 5.0 (3.3) to 4.5 (3.4) (p = 0.04) whereas the HADS depression score remained unchanged. The prevalence of women with HADS anxiety or depression score ≥8 did not change.
  
  
  CONCLUSIONS
  Physical quality of life deteriorated whereas mental quality of life improved slightly during pregnancy in women with pregestational diabetes. A minor reduction in anxiety and stable depression symptoms was observed. The results on mental health are reassuring, considering the great demands that pregnancy places on women with pregestational diabetes.
authors: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.|Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
authors: Nicoline C
authors: http://orcid.org/0000-0003-0868-5537
authors: NC
authors: Do
authors: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.|Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
authors: Anna L
authors: AL
authors: Secher
authors: Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
authors: Per
authors: http://orcid.org/0000-0003-1065-6225
authors: P
authors: Cramon
authors: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.|Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.|Steno Diabetes Center, Gentofte, Denmark.
authors: Lene
authors: L
authors: Ringholm
authors: Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
authors: Torquil
authors: http://orcid.org/0000-0002-6001-7440
authors: T
authors: Watt
authors: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.|The Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.|Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
authors: Peter
authors: http://orcid.org/0000-0002-2067-5246
authors: P
authors: Damm
authors: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark.|Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.|The Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Elisabeth R
authors: http://orcid.org/0000-0003-3279-0863
authors: ER
authors: Mathiesen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D015992:Body Mass Index; D015331:Cohort Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D009325:Nausea / Q000150:complications; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000523:psychology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000150:complications; D015430:Weight Gain; D055815:Young Adult
keywords: 36-Item Short-Form health survey; anxiety; depression; hospital anxiety and depression scale; pregestational diabetes; pregnancy; quality of life