Abstract / Summary
Abstract Purpose Diabetes mellitus and depression are both major diagnoses obstetrician-gynecologists must contend with when treating pregnant patients. While previous studies have shown an association between gestational (GDM) or pregestational diabetes mellitus (PGDM) and risk of subsequent mood and substance use disorders, few studies have compared them directly, which this study addressed. Methods TriNetX was used to conduct this retrospective study of patients aged 18–65. Cohort 1 included patients with GDM, while cohort 2 included patients with PGDM. Each cohort was propensity-score matched to be comparable in demographics and prior diagnoses. The outcomes measured were risks of depressive episode, recurrent major depression (MDD), postpartum depression (PPD), anxiety, adjustment disorder, and substance use within 270 days of initial GDM or PGDM diagnosis. Results After matching, each cohort consisted of 139,725 patients. Compared to PGDM patients, GDM patients had significantly lower risks of depressive episode (RR: 0.689; 95% CI: 0.662, 0.716), recurrent MDD (RR: 0.745; 95% CI: 0.688, 0.808), anxiety (RR: 0.798; 95% CI: 0.769, 0.827), adjustment disorder (RR: 0.632; 95% CI: 0.584, 0.684), and substance use (RR: 0.667; 95% CI: 0.631, 0.705), but slightly higher risk of PPD (RR: 1.076; 95% CI: 1.024, 1.131). Conclusion These findings suggest that patients with PGDM are at significantly higher risk than those with GDM for subsequent mood and substance use complications. Adding to current clinical guidelines recommending mental health screening in pregnant patients, heightened awareness and support are warranted for the particular psychological burden faced by patients with PGDM.