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

妊娠期糖尿病(GDM)是指怀孕期间发生的糖尿病(即血液中的血糖水平过高)。在英国，大约每20名孕妇中就有一人受到影响。怀孕期间的精神疾病更加普遍，是围产期(怀孕期间或分娩后一年)影响妇女的最常见疾病，在英国，大约五分之一的人受到影响。虽然众所周知，抑郁症在糖尿病患者中的普遍程度是非糖尿病患者的两倍，但对精神疾病和GDM之间的联系，包括精神疾病在GDM患者中的普遍程度，人们知之甚少。关于妊娠期糖尿病与围产期精神疾病之间关系的潜在原因更是知之甚少。妊娠期糖尿病和围产期精神疾病都与儿童可能出现的情绪问题和学习延迟有关。然而，同时患有精神疾病和妊娠期糖尿病对儿童的影响从未被研究过。然而，妊娠期糖尿病和精神疾病都是可以预防的疾病。在拟议的奖学金期间，我将：1)调查妊娠期糖尿病增加围产期精神疾病风险的程度。2)调查妊娠期患有妊娠期糖尿病的母亲是否更有可能在未来发展为糖尿病。3)比较母亲在怀孕期间患有妊娠期糖尿病和精神疾病的儿童与母亲患有妊娠期糖尿病但没有精神疾病的儿童的发育情况。在我的第一次研究中，我将系统地回顾现有的相关研究文献，评估其质量，以告知我自己的研究方法。在这次审查中，我的目标是计算妊娠期和产后一年内精神疾病的普遍程度，以确定患有妊娠期糖尿病的妇女精神疾病的风险程度。在我的第二项研究中，我将使用从布拉德福德的一群母亲和她们的孩子那里收集的信息(称为出生在布拉德福德：BIB研究)来回答我的每个研究问题。研究中的所有母亲都接受了妊娠期糖尿病的测试。这将提供关于哪些母亲患有妊娠期糖尿病的信息(总共9779名妇女中有681例患有妊娠期糖尿病)，然后我可以检查这些妇女比没有妊娠期糖尿病的妇女更有可能在多大程度上患有精神疾病。母亲诊断出妊娠期糖尿病后，到目前为止的糖尿病诊断也将从初级保健记录中获得。这将意味着我可以检查患有妊娠期糖尿病和精神疾病的妇女是否比患有妊娠期糖尿病和没有疾病的妇女更有可能在出生后患糖尿病。然后，我将使用孩子的老师完成的两项评估来检查母亲的妊娠期糖尿病和精神疾病对孩子的影响。一项是他们四岁时的情绪发展(通过标准问卷)，另一项是七岁时国家评估的他们在学校的表现。在探索我发现的显著联系的潜在原因时，我将使用研究中关于母亲生活方式的信息，如饮食和体力活动水平，以及新生儿和母亲的血液测试。这项研究将提供知识，更好地理解妊娠期糖尿病和精神疾病之间的联系。如果妊娠期糖尿病患者的精神疾病似乎会影响未来糖尿病的发展和孩子的发育，那么这项研究应该有助于科学家制定策略，不仅改善母亲的长期健康，也改善她的孩子的长期健康。

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.