Effects of depression and relative fat mass on gestational diabetes mellitus history: evidence from NHANES 2007-2020.

Abstract

Background: The growing prevalence of gestational diabetes mellitus (GDM) presents a significant clinical concern. In parallel, obesity has escalated to epidemic levels, and the mental health-GDM connection has been increasingly documented. Against this backdrop, the present study primarily investigates the independent and joint contributions of relative fat mass (RFM) and depression to GDM risk.

Methods: Data were collected from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007-2020. The separate associations of RFM and depression with GDM history were analyzed using a weighted logistic regression model, while interaction analysis was conducted to explore their combined effect. Subgroup analyses were conducted for further validation.

Results: Among 8622 eligible participants, 775 (9.00%) had a history of GDM. The median age at first live birth was 22.00 years (19.00, 26.00). After adjusting for confounding variables, both increased RFM (OR = 1.07; 95% CI: 1.05-1.09) and depression scores (OR = 1.04; 95% CI: 1.02-1.06) were linked to an elevated risk of GDM. The coexistence of obesity (RFM ≥ 40%) and depression yielded a synergistic effect greater than their individual impacts (RERI = 0.87; ROR = 1.33). These findings were consistent across subgroup and sensitivity analyses.

Conclusions: Concurrent elevation in RFM and depressive symptoms significantly heightens the likelihood of GDM history. These results support the integration of metabolic and psychological factors into preventive frameworks targeting GDM history.