Perceived Stress and Early Postpartum Depressive Symptoms in Women with Recent GDM: Implications for Postpartum Lifestyle Programs.

IF 1.7 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Maternal and Child Health Journal Pub Date : 2025-04-01 Epub Date: 2025-02-07 DOI:10.1007/s10995-025-04045-2

Jennifer M Dias, Estelle C Kelty, Jacinda M Nicklas, John T Doucette, Sue E Levkoff, Ellen W Seely

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引用次数: 0

Abstract

Objectives: To inform the development and adaptation of lifestyle programs to prevent type 2 diabetes, we sought to identify factors associated with depressive symptoms in the early postpartum period among women with recent gestational diabetes (GDM).

Methods: Participants are from the Balance after Baby Intervention (BABI) study, a two-year randomized clinical trial of a lifestyle program for women with recent GDM conducted in Boston, MA, and Denver, CO between 2016 and 2019. The Edinburgh Postpartum Depression Scale (EPDS) and Perceived Stress Scale (PSS-10) were administered at an average of 8-weeks postpartum. We defined an EPDS score of ≥ 9 as depressive symptoms and reviewed medical records for medical history. We conducted bivariate analyses to identify predictors of postpartum depressive symptoms, then modeled the odds of postpartum depressive symptoms using multivariable logistic regression and selected the best fit model.

Results: Our analysis included 181 women. Thirty-five (19%) scored ≥ 9 on the EPDS. While both perceived stress and whether this was the first pregnancy complicated by GDM were significant in the bivariate analysis, only perceived stress remained a significant predictor of postpartum depressive symptoms in the multivariate regression model (OR 4.34, 95% CI [2.58-7.31]). The effect of first GDM pregnancy was no longer significant in the multivariate model (OR 2.00, 95% CI [0.63-6.33]). Additionally, a mediation model determined that perceived stress fully mediated the effect of first GDM pregnancy on depressive symptoms (Effect ratio, 0.5507/1.5377 = 0.358, p = 0.036).

Conclusions for practice: Perceived stress was predictive of postpartum depressive symptoms in women with recent GDM and was found to mediate the relationship between first pregnancy complicated by GDM and postpartum depressive symptoms. Addressing perceived stress in the early postpartum period may be an important target for future lifestyle programs to maximize diabetes prevention efforts.

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近期GDM妇女的感知压力和产后早期抑郁症状：产后生活方式计划的意义

目的：为预防2型糖尿病生活方式的制定和适应提供信息，我们试图确定近期妊娠期糖尿病（GDM）妇女产后早期抑郁症状的相关因素。方法：参与者来自婴儿干预后平衡（BABI）研究，这是一项为期两年的随机临床试验，针对2016年至2019年在马萨诸塞州波士顿和科罗拉多州丹佛市进行的近期GDM妇女的生活方式计划。平均于产后8周进行爱丁堡产后抑郁量表（EPDS）和感知压力量表（PSS-10）。我们将EPDS评分≥9定义为抑郁症状，并查阅病史记录。我们通过双变量分析来确定产后抑郁症状的预测因素，然后使用多变量logistic回归对产后抑郁症状的几率进行建模，并选择最佳拟合模型。结果：我们的分析包括181名女性。35例（19%）患者EPDS评分≥9分。虽然在双变量分析中，感知压力和是否首次妊娠合并GDM都是显著的，但在多变量回归模型中，只有感知压力仍然是产后抑郁症状的显著预测因子（OR 4.34, 95% CI[2.58-7.31]）。在多变量模型中，首次妊娠GDM的影响不再显著（OR 2.00, 95% CI[0.63-6.33]）。此外，一个中介模型确定感知压力完全介导了GDM首次妊娠对抑郁症状的影响（效应比，0.5507/1.5377 = 0.358,p = 0.036）。实践结论：感知压力可预测近期GDM妇女的产后抑郁症状，并介导首次妊娠合并GDM与产后抑郁症状的关系。解决产后早期感受到的压力可能是未来生活方式规划的一个重要目标，以最大限度地预防糖尿病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Maternal and Child Health Journal PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

3.20

自引率

4.30%

发文量

271

期刊介绍： Maternal and Child Health Journal is the first exclusive forum to advance the scientific and professional knowledge base of the maternal and child health (MCH) field. This bimonthly provides peer-reviewed papers addressing the following areas of MCH practice, policy, and research: MCH epidemiology, demography, and health status assessment Innovative MCH service initiatives Implementation of MCH programs MCH policy analysis and advocacy MCH professional development. Exploring the full spectrum of the MCH field, Maternal and Child Health Journal is an important tool for practitioners as well as academics in public health, obstetrics, gynecology, prenatal medicine, pediatrics, and neonatology. Sponsors include the Association of Maternal and Child Health Programs (AMCHP), the Association of Teachers of Maternal and Child Health (ATMCH), and CityMatCH.