The Association between a Medical History of Depression and Gestational Diabetes in a Large Multi-ethnic Cohort in the United States

Background Both major depression and gestational diabetes mellitus (GDM) are prevalent among women of reproductive age. Our objective was to determine whether a medical history of depression is related to subsequent development of GDM. Methods The Consortium on Safe Labor was a US retrospective cohort study of 228562 births between 2002 and 2008. Exclusion criteria for the present analysis included multiple gestation pregnancies (n=5059), pre-existing diabetes (n=12771), deliveries <24 weeks (n=395), site GDM prevalence (<1%) (n=20721) and missing data on pre-pregnancy body mass index (BMI) (n=61321). Using generalised estimating equations, we estimated the association between a history of depression and a pregnancy complicated by GDM. Results The final analytic population included 121260 women contributing 128295 pregnancies, of which 5606 were affected by GDM. A history of depression was significantly associated with an increased risk of developing GDM (multivariate odds ratio [aOR]=1.42 [95% confidence interval (CI) 1.26, 1.60]). Adjusting for pre-pregnancy BMI and weight gain during pregnancy attenuated the association, although it remained statistically significant (aOR=1.17 [95% CI 1.03, 1.33]). Conclusions A history of depression was significantly associated with an increased GDM risk among a large multi-ethnic US cohort of women. If the association is confirmed, depression presents a potentially modifiable risk factor of GDM and provides additional clues to the underlying pathophysiology of GDM.