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Diabetes associated with increased risk of perinatal depression in low-income mothers, Medicaid data show

Wednesday, March 11 2009 | Comments
Evidence Grade 11 What's This?
Among low-income mothers, prepregnancy and gestational diabetes are associated with an increased risk of depression during the perinatal period, according to an analysis of New Jersey Medicaid data.

As part of a retrospective cohort study, researchers reviewed Medicaid data for 11,024 women who gave birth between July 1, 2004, and Sept. 30, 2006; all of the women included in the study were enrolled in Medicaid for >=6 months prior to and 1 year following the birth.

The participants were characterized as having diabetes or depression if they had received a diagnosis of the condition or if they filed a prescription drug claim for a diabetes drug or an antidepressant drug, respectively. Women characterized as having depression based on antidepressant use were excluded if they had a diagnosis other than depression for which an antidepressant drug might be prescribed.

In the study sample, 15.2% of the women with prepregnancy or gestational diabetes had perinatal depression, compared with 8.5% of the women without diabetes. In an analysis adjusted for age, race, year of delivery, and gestational age at birth, the odds ratio (OR) for perinatal depression was 1.85 (95% CI, 1.45-2.36) among the women with diabetes relative to the women without diabetes.

This association did not vary significantly by diabetes classification (gestational vs nongestational; insulin use vs no insulin use) nor did it change when the analysis was further adjusted for type of delivery.

The data also suggested that diabetes might be associated with an increased risk of new-onset depression during the postpartum period among women without prenatal depression. Specifically, among the women who had no prenatal indication of depression, 9.6% of those with diabetes had postpartum depression, compared with 5.9% of those without diabetes (OR, 1.69; 95% CI, 1.27-2.23).

The authors noted that the association between diabetes and depression observed in this population is consistent with results of research evaluating the relationship between diabetes and major depression in general adult populations. (Kozhimannil KB, et al. JAMA 2009;301:842-847.)

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