Mental health and its associations with glucose-lowering medication in women with gestational diabetes mellitus. A prospective clinical cohort study

Aims: Mental health symptoms are frequent in women with gestational diabetes mellitus (GDM) and may influence glycemic control. We therefore investigated if mental health symptoms (high depression and low wellbeing scores) predicted a need for glucose-lowering medication and if this use of medication influenced the trajectory of mental health during pregnancy and in the postpartum period. Methods: We included 341 pregnant women from a cohort of GDM women in a Swiss University Hospital. The World Health Organization Well-being Index-Five was collected at the first and last GDM and at the postpartum clinical visits and the Edinburgh Postnatal Depression Scale at the first GDM and the postpartum clinical visits. Medication intake was extracted from participants' medical records. We conducted linear and logistic regressions with depression as an interaction factor. Results: Mental health symptoms did not predict a need for medication (all p >= 0.29). Mental health improved over time (both p <= 0.001) and use of medication did not predict this change (all p >= 0.40). In women with symptoms of depression, medication was associated with less improvement in well-being at the postpartum clinical visit (p for interaction=0.013). Conclusions: Mental health and glucose-lowering medication did not influence each other in an unfavourable way in this cohort of women with GDM.

Automated summary

In this cohort of women with gestational diabetes mellitus, mental health symptoms did not predict the need for medication and did not influence the improvement of mental health over time. However, in women with symptoms of depression, medication use was associated with less improvement in well-being during the postpartum period.