Diabetes Linked to Depression During and After Pregnancy

During pregnancy one thing that is usually not on the expectant mother’s mind is her income. However, it has been shown that low-income women that have diabetes and are pregnant or have recently given birth face almost twice the risk of depression compared to the women who do not have a blood sugar disorder. It also did not matter whether the women developed diabetes before or during their pregnancy, or if they were taking oral medications or insulin; the risk of them developing depression was still much stronger for the women with diabetes.

The study’s lead author Katy Backes Kozhimannil, who is a research fellow in the department of ambulatory care and prevention at Harvard Medical School in Boston, stated that women who had never been depressed before appeared to be at risk also. She said, ”One in ten women who had no indication of prior depression received a diagnosis of depression within a year following delivery.” The results of this study will be published in the February 25th issue of the Journal of the American Medical Association.

Although this study did not look at potential reasons for this association, Kozhimannil stated that there are biological changes that occur with diabetes that could increase the risk for depression. She also said that the stress of managing a chronic illness such as diabetes might contribute to the risk for depression.

Postpartum depression affects approximately 10 percent of new mothers, usually between two and six months after having given birth, according to the background information for the study. If it is left untreated, postpartum depression can affect the relationship between the mother and her child, as well as the child’s development.

The risk factors for postpartum depression include a history of depression, trouble in relationships, domestic violence, stressful events, financial problems, lack of emotional or social support, a difficult pregnancy or delivery, and health problems with the infant. According to the authors, previous studies conducted have linked diabetes to an increased risk of developing depression in general.

To assess whether or not diabetes is a fact in pre- and postpartum depression, Kozhimannil and her team reviewed data on approximately more than 11,000 women who gave birth between the years 2004 and 2006. All of these women were continuously enrolled in Medicaid during the period of the study. From this low-income population, the researchers found that 15.2 percent of the women who had diabetes developed depression during or after their pregnancy. In the women that did not have diabetes, the number was 8.5 percent. In the women who had never depressed before, 9.6 percent of the women with diabetes developed depression in comparison with 5.9 percent of those that did not have the blood sugar condition.

Kozhimannil said, “Health-care facilities need to pay particular attention for depression in women with diabetes during the post-partum period. Both diabetes and depression in the post-partum period are treatable.”

Dr. Robert Welch, who is the chairman of obstetrics and gynecology at Providence Hospital in Southfield, Michigan, said that the new research is an interesting study, but he said that it left some important questions unanswered. For example, Dr. Welch wondered how many of the pregnancies were actually planned, and exactly how many of the women that had diabetes were newly diagnosed? He said that a new diagnosis of diabetes could be overwhelming for a lot of women. Also, in the population on Medicaid, it can be much more difficult to get their diabetes well monitored, which could also add to the stress that these women are already feeling. Diabetes can be quite an expensive disease, and this study is calling out the need for additional mid-level providers who have more time to assist in making a diagnosis of depression.

Both Kozhimannil and Welch said that while this particular study was done studying low-income women, the findings could be similar for women with higher income, though the stressors may be different. Welch recommended that no matter what your income is, if you are an expectant mother, you should try and set up a support system before the baby is born. Try and set up some extra help so that you are not alone with the infant day after day.