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Mental Health During Late Pregnancy and Postpartum in Mothers With and Without Type 1 Diabetes: The ENDIA Study

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posted on 02.02.2022, 16:34 by Madeleine Hall, Helena Oakey, Megan AS Penno, Kelly McGorm, Amanda J Anderson, Pat Ashwood, Peter G Colman, Maria E Craig, Elizabeth A Davis, Mark Harris, Leonard C Harrison, Aveni Haynes, Claire Morbey, Richard O Sinnott, Georgia Soldatos, Peter J Vuillermin, John M Wentworth, Rebecca L Thomson, Jennifer J Couper, the ENDIA Study Group
OBJECTIVE

Pregnancy and type 1 diabetes are each associated with increased anxiety and depression, but the combined impact on wellbeing is unresolved. We compared the mental health of women with and without type 1 diabetes during pregnancy and postpartum, and examined the relationship between mental health and glycaemic control.

RESEARCH DESIGN AND METHODS

Participants were women enrolled from 2016 to 2020 in the Environmental Determinants of Islet Autoimmunity (ENDIA) study, a pregnancy-birth prospective cohort following children with a first-degree relative with type 1 diabetes. Edinburgh Postnatal Depression Scale (EPDS) and Perceived Stress Scale (PSS) were completed during the third trimester (T3) (median [IQR] 34 [32, 36] weeks) and postpartum (14 [13, 16] weeks) by 737 women (800 pregnancies) with (n=518) and without (n=282) type 1 diabetes.

RESULTS

EPDS and PSS scores did not differ between women with and without type 1 diabetes during T3 and postpartum. EPDS scores were marginally higher in T3: predicted mean (95% CI) 5.7 (5.4, 6.1) than postpartum: 5.3 (5.0, 5.6), independent of type 1 diabetes status (p=0.01). HbA1c levels in type 1 diabetes were 6.3 [5.8, 6.9] % in T3 and did not correlate with EPDS or PSS scores. Reported use of psychotropic medications was similar in women with (n=44/518 [8%]) and without type 1 diabetes (n=17/282 [6%]), as was their amount of physical activity.

CONCLUSIONS

Overall, mental health in late pregnancy and postpartum did not differ between women with and without type 1 diabetes and mental health scores were not correlated with glycaemic control.

Funding

Prepared on behalf of the ENDIA Study Team. ANZCTR registration number: ACTRN12613000794707. This research was supported by JDRF Australia, the recipient of the Commonwealth of Australia grant for Accelerated Research under the Medical Research Future Fund, and with funding from the Leona M. and Harry B. Helmsley Charitable Trust (grant key 3-SRA-2020-966-M-N) and The National Health and Medical Research Council of Australia.

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