Gestational diabetes and mental health: longitudinal analysis of data from the GEMS randomized trial.

Purpose: There is limited high-quality evidence about perinatal mental health among women with gestational diabetes. We aimed to assess the risks and longitudinal changes in anxiety, depression, and health-related quality of life comparing women with gestational diabetes and those without among a contemporary cohort of pregnant women.

Methods: Prospective cohort study of participants in the GEMS Trial. Women with a singleton pregnancy were eligible if they had a 75-g diagnostic oral glucose-tolerance test between 24 and 32 weeks' gestation, provided written informed consent, and completed questionnaires about anxiety, depression, and health-related quality of life at the study time points.

Results: There were no differences in risk for anxiety (RR 1.13, 95% CI 0.86, 1.49; p = 0.39) or depression (RR 1.08, 95% CI 0.78, 1.50; p = 0.64) between the two groups at 36 weeks' gestation or 6 months postpartum [anxiety: (RR 1.21, 95% CI 0.90, 1.63; p = 0.21); depression: (RR 0.84, 95% CI 0.55, 1.28; p = 0.43]. However, at 36 weeks' gestation participants with gestational diabetes reported better physical functioning, and at 6 months postpartum, better mental functioning (mean difference (MD) in scores 1.28, 95% CI 0.25, 2.30; p = 0.01) although worse physical functioning (MD -2.99, 95% CI -3.90, -2.07; p = < 0.001) compared to participants without.

Conclusion: The risk for poor mental health during the perinatal period does not differ importantly among women diagnosed and treated for gestational diabetes compared to the general pregnant population.