title: Relationship between depression and diabetes in pregnancy: A systematic review.
abstract: OBJECTIVE
  To systematically review the literature on women with both diabetes in pregnancy (DIP) and depression during or after pregnancy.
  
  
  METHODS
  In this systematic literature review, PubMed/MEDLINE and EMBASE were searched (13 November 2015) using terms for diabetes (type 1, type 2, or gestational), depression, and pregnancy (no language or date restrictions). Publications that reported on women who had both DIP (any type) and depression or depressive symptoms before, during, or within one year after pregnancy were considered for inclusion. All study types were eligible for inclusion; conference abstracts, narrative reviews, nonclinical letters, editorials, and commentaries were excluded, unless they provided treatment guidance.
  
  
  RESULTS
  Of 1189 articles identified, 48 articles describing women with both DIP and depression were included (sample sizes 36 to > 32 million). Overall study quality was poor; most studies were observational, and only 12 studies (mostly retrospective database studies) required clinical depression diagnosis. The prevalence of concurrent DIP (any type) and depression in general populations of pregnant women ranged from 0% to 1.6% (median 0.61%; 12 studies). The prevalence of depression among women with gestational diabetes ranged from 4.1% to 80% (median 14.7%; 16 studies). Many studies examined whether DIP was a risk factor for depression or depression was a risk factor for DIP. However, there was no clear consensus for either relationship. Importantly, we found limited guidance on the management of women with both DIP and depression.
  
  
  CONCLUSIONS
  Given the increasing prevalence of diabetes and depression, high-quality research and specific guidance for management of pregnant women with both conditions are warranted.
authors.affiliation: Glynis P Ross, Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales 2050, Australia.
authors.forename: Glynis P
authors.initials: GP
authors.lastname: Ross
authors.affiliation: Glynis P Ross, Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales 2050, Australia.
authors.forename: Henrik
authors.initials: H
authors.lastname: Falhammar
authors.affiliation: Glynis P Ross, Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales 2050, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Chen
authors.affiliation: Glynis P Ross, Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales 2050, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Barraclough
authors.affiliation: Glynis P Ross, Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales 2050, Australia.
authors.forename: Ole
authors.initials: O
authors.lastname: Kleivenes
authors.affiliation: Glynis P Ross, Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales 2050, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Gallen
keywords: Depression; Depressive disorder; Diabetes; Diabetes mellitus; Gestational; Perinatal care; Postnatal care; Postpartum depression; Pregnancy