Is gestational diabetes associated with adverse maternal and child mental health outcomes?

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Gestational diabetes mellitus (GDM) is diabetes (i.e. sugar levels being too high in the blood) arising during pregnancy. Around one in 20 pregnant women are affected in the UK. Mental illness during pregnancy is even more prevalent and is the most common illness to affect women during the perinatal period (during pregnancy or one year following delivery), with around one in five affected in the UK. While it is known that depression is twice as common in the general population amongst those who have diabetes, as those who do not, less is known about the link between mental illness and GDM, including how common mental illness is in those with GDM. Even less is known about potential reasons for a relationship between GDM and mental illness in the perinatal period. Both GDM and perinatal mental illness have been linked to possible emotional problems and learning delays in the child. However the effect of having both mental illness and GDM on the child has never been studied. Yet both GDM and mental illnesses are preventable conditions. During the proposed fellowship I will:1) Investigate the extent to which GDM increases the risk of perinatal mental illness.2) Investigate whether or not mothers with GDM who also have mental illness during pregnancy are more likely to go on to develop diabetes in the future.3) Compare the development of children whose mothers had GDM and mental illness during pregnancy to those whose mothers had GDM but no mental illness. If links are found, reasons for these will be explored.In my first study, I will systematically review the existing relevant research literature, assessing its quality, to inform my own research methods. During this review, I will aim to calculate how common mental illnesses are during pregnancy and in the year following delivery for women with GDM in order to ascertain the extent of the risk for mental illness in women have GDM. I will also explore potential reasons why this might be.In my second study, I will use information collected from a group of mothers and their children in Bradford (called the Born in Bradford: BiB study) to answer each of my research questions. All mothers in the study were offered a test for GDM. This will provide information on which mothers had GDM (681 cases of GDM from 9779 women in total) then I can examine to what extent these women are more likely to have mental illnesses than women without GDM. Diagnoses of diabetes up to the present day in mothers following their diagnosis of GDM will also be available from primary care records. This will mean I can examine whether women with GDM and mental illness are more likely to develop diabetes after birth compared with women with GDM and no illness. I will then use two assessments completed by the child's teacher to examine the effects of GDM and mental illness in the mother on the child. One is of their emotional development (from a standard questionnaire) at the age of four years and the other is of their performance at school from national assessments at the age of seven years. In exploring potential reasons for significant links that I find, I will use information from the study about the mother's lifestyle such as diet and physical activity levels and blood tests from the newborn and mother.This research will provide knowledge and a better understanding of the link between GDM and mental illness. If it appears that mental illness in those with GDM influences the development of diabetes in the future and the development of the child then this research should help scientists to develop strategies for improving the long-term health of not only the mother but also her child.