This Article  • Full text  • PDF  • JAMA Report Video  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Psychiatry  • Depression  • Women's Health  • Pregnancy and Breast Feeding  • Endocrine Diseases  • Diabetes Mellitus  • Alert me on articles by topic  Social Bookmarking   What's this?

Katy Backes Kozhimannil, MPA; Mark A. Pereira, PhD; Bernard L. Harlow, PhD

JAMA. 2009;301(8):842-847.

Context  Perinatal depression affects at least 10% to 12% of new mothers, and diabetes complicates up to 9% of pregnancies. Prior research shows a higher rate of major depression among individuals with diabetes.

Objective  To examine the association between diabetes and depression during pregnancy and the postpartum period among a sample of low-income women.

Design, Setting, and Patients  Retrospective cohort study using data from New Jersey's Medicaid administrative claims database of 11 024 women who gave birth between July 1, 2004, and September 30, 2006, and who were continuously enrolled in Medicaid for 6 months prior to delivery and 1 year after giving birth.

Main Outcome Measures  Multivariate logistic regression was used to assess the association between prepregnancy diabetes or gestational diabetes and perinatal depression. Depression was defined as an International Classification of Diseases, Ninth Revision, diagnosis for depression or a prescription drug claim for an antidepressant medication, and diabetes was defined as having a diabetes diagnosis or filling a prescription for a diabetes medication. Both measures were assessed during the 6 months prior to and up to 1 year following delivery.

Results  In the sample of women who gave birth, 15.2% (n = 100) with prepregnancy or gestational diabetes and 8.5% (n = 886) without diabetes were depressed during pregnancy or postpartum. After adjusting for age, race, year of delivery, and gestational age at birth, women with diabetes compared with those without diabetes had nearly double the odds of experiencing depression during the perinatal period (odds ratio, 1.85; 95% confidence interval, 1.45-2.36). Women with diabetes and no prenatal indication of depression (n = 62, 9.6%) had higher odds than their counterparts without diabetes (n = 604, 5.9%) of receiving a postpartum depression diagnosis or taking an antidepressant medication in the year following delivery (odds ratio, 1.69; 95% confidence interval, 1.27-2.23).

Conclusion  Prepregnancy or gestational diabetes was independently associated with perinatal depression, including new onset of postpartum depression, in our sample of low-income new mothers.

Author Affiliations: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts (Ms Kozhimannil); and Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis (Drs Pereira and Harlow).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Diabetes and Risk for Antenatal and Postpartum Depression
JWatch Women's Health 2009;2009:4-4.
FULL TEXT  

All you need to read in the other general journals
BMJ 2009;338:b863-b863.
FULL TEXT  

Diabetes, Depression, and Pregnancy
JWatch General 2009;2009:1-1.
FULL TEXT