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Mood, anxiety disorders before pregnancy may influence gestational diabetes risk

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November 13, 2017

Women with a history of anxiety or mood disorder in the 2 years before pregnancy had a moderately increased risk for developing gestational diabetes vs. women who did not have an anxiety or mood disorder, according to an analysis of population-level data in Canada.

Qendresa Beka, MSc, of the University of Alberta School of Public Health in Edmonton, Canada, and colleagues assessed administrative data from six databases from the Alberta Ministry of Health — the discharge abstract database, ambulatory care database, physician claims database, Alberta Health Care Insurance Plan registry, the vital statistics database and the 2006 census dataset — as well as all delivery data from the Alberta Perinatal Health Program between April 2000 and March 2010 (n = 253,911 with 373,674 pregnancies). Researchers then linked perinatal data to the administrative data from Alberta Health to identify any diagnoses of mood or anxiety disorders in the 2 years before pregnancy and a subsequent diagnosis of gestational diabetes. An anxiety or mood disorder was defined as having at least one hospitalization, outpatient visit or physician claim for a mood or anxiety disorder in any diagnosis field in the 2 years before pregnancy. Researchers used generalized estimating equations to determine the adjusted OR of gestational diabetes, comparing women with and without anxiety or mood disorders.

Within the cohort, 95,867 (25.7%) had at least one diagnosis of a mood or anxiety disorder in the 2 years before pregnancy, according to researchers. These women were more likely to be smokers, weigh more, be of Aboriginal ethnicity, deliver babies large for gestational age and have a diagnosis of gestational diabetes.

In logistic regression analyses, women with a history of a mood or anxiety disorder were more likely to develop gestational diabetes vs. women without a mood or anxiety disorder (OR = 1.15; 95% CI, 1.1-1.19); however, the OR was reduced in generalized estimating equation regression (OR = 1.12; 95% CI, 1.08-1.17).

In stratifying women by type of disorder, those with a history of mood disorder had an OR of 1.09 (95% CI, 1.04-1.15) and women with a history of anxiety disorders had an OR of 1.11 (95% CI, 1.06-1.16) vs. women without a history of mood or anxiety disorders.

The researchers acknowledged that the study definition of mood or anxiety disorder may have led to an overestimation of the disorders in the population, and used a more specific algorithm in which a woman was classified with a mood or anxiety disorder if she had two physician claims or one hospitalization for a mood or anxiety disorder within 1 year. Using that algorithm, the OR was attenuated to 1.08 (95% CI, 1.02-1.13), according to researchers.

“Our administrative datasets also had limited information on some potentially important confounding variables, such as weight/BMI, physical activity level, diet and family or social support,” the researchers wrote, adding that further research on the link between mood and anxiety disorders and the development of gestational diabetes are still needed. – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.