Diabetes in pregnancy: worse medical outcomes in type 1 diabetes but worse psychological outcomes in gestational diabetes

• Published in: QJM : An International Journal of Medicine Vol. 110; no. 11; pp. 721 - 727
• Main Authors: Egan, A M, Dunne, F P, Lydon, K, Conneely, S, Sarma, K, McGuire, B E
• Format: Journal Article
• Language: English
• Published: England 01.11.2017
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcx106

Women with diabetes experience an increased risk of adverse pregnancy outcomes. We aim to describe and quantify the psychological impact of the diagnosis of diabetes in pregnant women with type 1 diabetes and gestational diabetes mellitus (GDM) compared to each other and to their counterparts without diabetes. This is a survey-based study with prospective collection of pregnancy outcome data. A total of 218 pregnant women (50% with diabetes) were administered questionnaires relating to psychological health. Maternal and neonatal characteristics and pregnancy outcomes were collected. Associations between key psychometric and health outcome variables were examined. At least 25% of women in all three pregnancy groups had scores indicating affective distress in at least one domain. Compared to those with type 1 diabetes, women with GDM evidenced a greater number of uplifts in pregnancy (U = 94, P = 0.041), but also higher levels of overall anxiety (U = 92, P = 0.03) and stress (U = 82, P < 0.01). Women with GDM also had significantly elevated overall depression scores, compared with the control group (U = 34, P = 0.02). Both groups of women with diabetes had clinically elevated levels of diabetes-related distress. There were no associations between maternal psychological variables and pregnancy outcomes. This work highlights a potential role for targeted psychological interventions to address and relieve symptoms of anxiety and depression among pregnant women with diabetes.