Table 2.
Summary of data provided by each study and effect estimates for high levels of antenatal depressive symptoms at the time of GDM diagnosis
| Author and year | Sample size | Mental disorder measure and time | GDM measure | Ethnicity | Pre‐pregnancy BMI (kg/m2) | Risk of bias | Prevalence of depression in GDM group (%) | Unadjusted OR (95% CI) |
|---|---|---|---|---|---|---|---|---|
| Bisson et al., 2014 | 52 |
EPDS ≥10 Time of enrolment, mean 30 weeks gestation |
75 g OGTT 24–28 weeks' gestation 2008 Canadian Diabetes Association criteria On 75 g OGTT, two or more of: Fasting ≥ 5.3 mmol/l 1‐h ≥ 10.6 mmol/l 2‐h ≥ 8.9 mmol/l |
Canadian (ethnicity unspecified) |
Mean (sd) GDM: 26.3 (4.5) No GDM: 26.4 (4.5) |
High | 23.1† | 16.8* (0.89–315.89) |
| Byrn and Penckofer, 2015 | 135 |
EPDS ≥ 12 24–40 weeks gestation |
‘Medical data to verify GDM status’ |
White: 32.6% Black: 23% Hispanic: 32.6% Other: 11.9% |
Mean (sd) 32.6 (6.42) NB not clear when measured |
Low to moderate | 20† | 1.69* (0.67–4.28) |
| Dame et al., 2017 | 820 |
EPDS ≥ 12 Third trimester |
Self‐report and confirmed by medical records. Criteria based on two‐step approach. ‘Initially, diagnoses were often made using a single elevated 2‐h plasma glucose test. However, more recently, the criteria developed by the IADPSG have become more commonly used.' | Brazil (ethnicity unspecified) |
< 25: 22.8% Overweight: 30.4% Obese class one: 27.6% Obese class two or three: 19.3% |
High | 31† | Unavailable |
| Daniells et al., 2003 | 100 |
MHI‐5 ≥ 16 30 weeks gestation |
ADIPS criteria One or more of: Fasting plasma glucose ≥ 5.1 mmol/l 1‐h post 75 g OGTT ≥ 10.0 mmol/l 2‐h post 75 g OGTT ≥ 8.5 mmol/l |
Australian born GDM: 66% No GDM: 86% |
Mean (sd) GDM: 27.4 (7.2) No GDM: 24.6 (3.8) |
High | 30† | Not used for meta‐analysis as unclear if pre‐GDM excluded |
| Ghaffar et al., 2016 | 108 |
EPDS ≥ 11 13–40 weeks' gestation |
OGTT >7 mmol/l | Pakistan (ethnicity unspecified) | Unavailable | High | 56.5† | Unavailable |
| Hassan et al., 2017 | 100 |
BDI ≥ 20 (unknown version) 24–36 weeks' gestation |
75 g OGTT using ADA criteria | Iraq (ethnicity unspecified) |
Mean (sd) GDM: 27.4 (7.2) No GDM: 24.6 (3.8) NB not clear when measured |
High | 86† | Not used for meta‐analysis as unclear if pre‐GDM excluded |
| Huang et al., 2015 | 2112 |
EPDS ≥ 13 Time of diagnosis |
1‐h 50 g non‐fasting glucose challenge test (GCT) and if > 140 mg/dl (7.8 mmol/l), then 3‐h fasting 100 g OGTT according to ADA criteria |
(Percentages across categories of depression) White: 50–72% Black: 13–24% Hispanic: 6–14% Asian: 4–7% Other: 4–7% |
(Percentages across categories of depression) Underweight (< 18.5): 3–6% Normal (18.5 to < 25): 50–61% Overweight(25 to < 30): 20–26% Obese (≥ 30): 14–25% |
High | 12.7† | 1.69† (0.88–3.23) (age adjusted) |
| Larrabure‐Torrealva et al., 2018 | 1300 |
PHQ‐9 ≥ 10 24–28 weeks gestation |
IADPSG criteria Any one of: Fasting plasma glucose ≥ 5.1 1‐h post 75 g OGTT ≥ 10.0 mmol/l 2‐h post 75 g OGTT ≥ 8.5 mmol/l |
Mestizo 98.1% Other 1.9% |
< 25: 53.6% 25–29.99: 34.9% ≥ 30: 11.5% |
High | 15.6† | 1.52† (1.09–2.12) |
| Mautner et al., 2009 | 40 |
EPDS ≥ 10 24–37 weeks gestation |
Medical records | Austria (ethnicity unspecified) | Unavailable | High | 45.5‡ | 3.19‡ (0.72–14.15) |
| Natasha et al., 2018 | 748 |
MADRS ≥13 24–28 weeks' gestation |
Plasma glucose ≥7.0 (WHO criteria) or ≥ 5.3 mmol/l at fasting and ≥ 8.6 mmol/l at 2‐h post 75g OGTT (ACOG criteria) | Bangladesh (ethnicity unspecified) | Unavailable | Low to moderate | 25.9† | 3.02† (2.01–4.53) |
| Median prevalence 28% (IQR 20–45.5%) | ||||||||
| Pooled OR 2.08 (95% CI 1.42–3.05) | ||||||||
*Derived from data in paper. †Estimate given in paper. ‡Data provided by study author.
ADIPS, Australasian Diabetes in Pregnancy Society; BDI, Beck Depression Inventory; EPDS, Edinburgh Postnatal Depression Scale; IADPSG, International Association of Diabetes and Pregnancy Study Groups; MADRS, Montgomery–Åsberg Depression Rating Scale; MHI‐5, Mental Health Inventory‐5; OGTT, oral glucose tolerance test; PHQ‐9, Patient Health Questionnaire‐9.