New research by Western Sydney University, has found if a mother receives a higher score for depression during early pregnancy she is more likely to develop Gestational Diabetes Mellitus.
Lead researcher, Professor Hannah Dahlen, from the School of Nursing and Midwifery, says this is the first time an association has been found between a high Edinburgh Postnatal Depression Scale (EPDS) score done by midwives in early pregnancy and the subsequent development of diabetes during the pregnancy (known as GDM).
A possible explanation for this is that depression and anxiety increase levels of cortisol and catecholamine production impacting on the glucose transport and insulin resistance. Also, the resulting reduction in physical activity commonly seen with depression and weight gain may increase the chances of developing diabetes.
Further to these findings women with higher scores for depression were less likely to breastfeed and were more likely to bleed during pregnancy.
An association was also found between a higher depression score and other risks such as domestic violence, childhood abuse, thoughts of self-harm and more.
“During maternity care we are very focused on the pregnant belly and the baby – it’s now time more focus is put towards looking at the brain. Supporting women in relationship based models of care such as continuity of midwifery care are the ideal way to do this,” says Professor Dahlen.
“Support and care around mental health should not be considered a ‘fancy extra’ but an urgent priority which is equally, if not more important, than all the clinical care we provide women.
“While screening for depression and other psychosocial vulnerabilities has been done routinely with pregnant women in NSW public hospitals for the past five to ten years, nearly one third of the population of women under private obstetric care are still not routinely screened.”
While Australian born women in the study published were shown to be at higher risk for mental health problems compared to those born overseas it is quite possible that differences in cultural understandings around depression may not translate well when they are screened and this needs to be explored further.
There is no doubt significant lifestyle influences are associated with the development of diabetes, such as obesity and inactivity, however this study suggests mental health may also play a role in increasing this risk as well.
The research, conducted in collaboration with Blacktown Hospital and St John of God Raphael Centre, was recently published in the journal BMC Pregnancy and Childbirth.
(Source: Western Sydney University, BMC Pregnancy and Childbirth)