Is there an association between anxiety and depression prior to and during pregnancy and gestational diabetes? An analysis of the Born in Bradford cohort
Is there an association between anxiety and depression prior to and during pregnancy and gestational diabetes? An analysis of the Born in Bradford cohort
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DOI：
10.1016/j.jad.2020.07.019
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发表时间：
2020-11-01
影响因子：
6.6
通讯作者：
Howard, Louise M.
中科院分区：
文献类型：
--
作者：
Wilson, Claire A.;Santorelli, Gillian;Howard, Louise M.
背景：焦虑和抑郁在妊娠期糖尿病妇女中很常见，但尚不清楚它们更有可能先于妊娠期糖尿病的发病还是与妊娠期糖尿病同时发生。我们的目的是比较患有和不患有妊娠期糖尿病的女性在怀孕前和怀孕期间(I)常见的焦虑和抑郁精神障碍之间的关联强度。方法：样本来自英国出生在布拉德福德的队列中的12,239名孕妇，13,539名孕妇。以口服葡萄糖耐量试验(OGTT)诊断妊娠期糖尿病。常见精神障碍的指标从相关的初级保健记录中获得。采用多变量稳健泊松回归和Logistic回归。利用链式方程进行多重填补，处理缺失数据。模型根据产妇的年龄、种族、教育程度和产科并发症进行了调整。结果：没有证据表明孕前常见精神障碍与妊娠期糖尿病有关(调整后的RR为0.96；95%CI为0.80，1.15)，或妊娠期糖尿病与妊娠期常见精神障碍之间的关联(调整后的OR为0.91；限制：队列中高水平的剥夺和多种族构成可能限制这些结果对其他人群的推广。结论：常规初级保健记录没有发现孕前有常见精神障碍的妇女患妊娠期糖尿病的风险增加，或在妊娠期有常见精神障碍的妇女患妊娠期糖尿病的风险增加。
Background: anxiety and depression are common in women with gestational diabetes but it is not clear whether they are more likely to precede the onset of gestational diabetes or to co-occur with it. Our aims were to compare the strength of association between common mental disorders of anxiety and depression (i) before pregnancy and (ii) during pregnancy in women with and without gestational diabetes.Methods: the sample comprised 12,239 women with 13,539 pregnancies from the UK's Born in Bradford cohort. Gestational diabetes was diagnosed by oral glucose tolerance test (OGTT). Indicators of common mental disorders were obtained from linked primary care records. Multivariable robust Poisson and logistic regression were employed. Multiple imputation by chained equations was implemented to handle missing data. Models were adjusted for maternal age, ethnicity, education and obstetric complications. Analyses of common mental disorders during pregnancy were additionally adjusted for maternal smoking, pre-pregnancy BMI, multiple pregnancy and common mental disorders prior to pregnancy.Results: there was no evidence for an association between common mental disorders prior to pregnancy and gestational diabetes (adjusted RR 0.96; 95% CI 0.80,1.15) or between gestational diabetes and common mental disorders during pregnancy (adjusted OR 0.91; 95% CI 0.73,1.12).Limitations: high levels of deprivation and multi-ethnic composition of the cohort may limit generalisability of these findings to other populations.Conclusions: routine primary care records did not identify an increased risk of gestational diabetes in women with common mental disorders prior to pregnancy or of gestational diabetes in women with common mental disorders during pregnancy.