Gestational diabetes and risk of postpartum depressive symptoms: A meta-analysis of cohort studies

Abstract

Background: Previous studies suggested that gestational diabetes may increase the risk of postpartum depression, but the results are inconclusive. We aimed to systematically assess the association between gestational diabetes and risk of postpartum depressive symptoms by a meta-analysis of cohort studies.

Methods: We searched multiple electronic databases for studies that investigated gestational diabetes and risk of postpartum depressive symptoms (including diagnosis of postpartum depression) on December 21, 2018. Pooled relative risks (RRs) and confidence intervals (CIs) of the included articles were calculated using the random-effect model and publication bias was detected using the Egger's and Begg's tests.

Results: We obtained 10 cohort studies with a total population of 2,000,002. Women with gestational diabetes compared with those without it had a significantly increased risk of developing postpartum depressive symptoms (pooled RR = 1.32, 95% CI: 1.09-1.60). There was a high degree of heterogeneity across studies (I² = 69.1%, P for heterogeneity = 0.001). The association appeared to be remarkably modified by study design, and the pooled RRs for prospective and retrospective cohort studies were 1.95 (95% CI: 1.48, 2.57) and 1.16 (95% CI: 1.12, 1.21), respectively (P for interaction = 0.003). In addition, no evidence of heterogeneity was observed in either retrospective cohort studies (I² = 0%, P for heterogeneity = 0.55) or prospective cohort studies (I² = 22.1%, P for heterogeneity = 0.27).

Conclusion: Women with gestational diabetes are at an increased risk of developing postpartum depressive symptoms. Future well-designed prospective studies are needed to confirm our results.

Keywords: Cohort study; Gestational diabetes; Meta-analysis; Postpartum depression; Pregnancy.