Gestational Diabetes Increases Risk for Postpartum Depression
Researchers from the Icahn School of Medicine at Mount Sinai and the Karolinska Institutet have found that gestational diabetes raises the risk of postpartum depression (PPD) in first-time mothers. This is the largest study of its kind to date, including more than 700,000 women. The results were published online today in the journal Depression and Anxiety.
The researchers also established that women with a history of depression are more than 20 times more likely to experience PPD than mothers without a previous clinical diagnosis of depression. And while gestational diabetes alone increased risk for PPD, a history of maternal depression in conjunction with gestational diabetes further increased the likelihood of PPD.
“Most practitioners think of these as two isolated and very different conditions, but we now understand gestational diabetes and postpartum depression should be considered together,” says Michael E. Silverman, PhD, an Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, and lead author of the study. “While having diabetes increases PPD risk for all women, for those women who have had a past depressive episode, having diabetes during pregnancy makes it 70 percent more likely that they will develop PPD.”
In addition to gestational diabetes, the researchers studied more than a dozen other risk factors, including pre-gestational diabetes, for association with PPD in women with and without a history of depression. Among women with a history of depression, pre-gestational diabetes and mild preterm delivery increased risk. Young age, instrument-assisted or cesarean delivery, and moderate preterm delivery increased risk in women who had no history of depression.
Studying the modifying effect of maternal depression on pre- and perinatal PPD risk factors sheds new light on the relationship between diabetes and depression. Showing that a history of depression modifies some of the risks associated with obstetric and perinatal factors suggests that there may be different causal pathways of PPD in women with and without a history of depression.
PPD can result in negative personal and child developmental outcomes, and identifying previous depressive episodes as a risk factor for PPD allows doctors to pursue earlier interventions. “The reason a doctor asks if you smoke is because they know you are 20 times more likely to get cancer if you do. We believe OB/GYNs should now do the same for depression history,” Dr. Silverman said. “With this information, we can now intervene early, before the mother gives birth.”
This is the largest population-based study to date to characterize PPD in relation to depression history. Researchers used the nationwide Swedish Medical Birth Register, which includes information on all births in Sweden. Unlike in past studies, researchers relied on clinical diagnoses of PPD since symptom-based PPD inventories have a tendency to overestimate the prevalence of the condition.
The study was funded by the U.S. National Institute of Child Health and Development. The team included researchers from the Department of Psychiatry and The Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai; the Karolinska Institutet in Stockholm, Sweden; and Brown University.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai is a national and international source of unrivaled education, translational research and discovery, and collaborative clinical leadership ensuring that we deliver the highest quality care—from prevention to treatment of the most serious and complex human diseases. The Health System includes more than 7,200 physicians and features a robust and continually expanding network of multispecialty services, including more than 400 ambulatory practice locations throughout the five boroughs of New York City, Westchester, and Long Island. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of the Top 20 Best Hospitals in the country and the Icahn School of Medicine as one of the Top 20 Best Medical Schools in country. Mount Sinai Health System hospitals are consistently ranked regionally by specialty and our physicians in the top 1% of all physicians nationally by U.S. News & World Report.