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. 2023 Jun 26;13(1):10348.
doi: 10.1038/s41598-023-37387-4.

Inflammation and decreased cardiovagal modulation are linked to stress and depression at 36th week of pregnancy in gestational diabetes mellitus

Manoharan Renugasundari  1 , Gopal Krushna Pal  2 , Latha Chaturvedula  3 , Nivedita Nanda  4 , K T Harichandrakumar  5 , Thiyagarajan Durgadevi  4
Affiliations

Inflammation and decreased cardiovagal modulation are linked to stress and depression at 36th week of pregnancy in gestational diabetes mellitus

Manoharan Renugasundari et al. Sci Rep. .

Abstract

Stress and depression have been reported in gestational diabetes mellitus (GDM). Though inflammation and oxidative stress are associated with depression, there are no reports of link of cardiometabolic risks (CMR) to stress and depression in GDM. Normal pregnant women (control group, n = 164) and women with GDM (study group, n = 176) at 36th week of gestation were recruited for the study. Blood pressure (BP), body composition, heart rate variability (HRV), glycated hemoglobin (HbA1C), markers of insulin resistance, oxidative stress, inflammation and endothelial dysfunction, were assessed. Perceived stress score (PSS), quality of life (QoL) scale, Indian diabetic risk score (IDRS) and Edinburg postnatal depression score (EPDS) were assessed. Association of potential contributors to PSS and EDPS were assessed by correlation and regression analyses. There was significant increase in PSS, EPDS, IDRS scores, HbA1C, malondialdehyde (MDA) (oxidative stress marker) and high-sensitive C-reactive protein and interleukin-6 (inflammatory markers), and significant decrease in total power (TP) of HRV (marker of cardiovagal modulation), QoL and nitric oxide (endothelial dysfunction marker) in study group compared to control group. Though many cardiometabolic risk parameters were correlated with PSS and EPDS, the significant independent association was observed for TP, HbA1C, MDA and interleukin-6. However, interleukin-6 had maximum contribution to PSS (β = 0.550, p < 0.001) and EPDS (β = 0.393, p < 0.001) as demonstrated by multiple regression analysis. Inflammation, oxidative stress, glycation status and decreased cardiovagal modulation are associated with stress and depression at 36th week of gestation in GDM.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Correlation of total power of heart rate variability with psychological scores. EPDS Edinburgh postnatal depression scale, HRV heart rate variability, PSS perceived stress scale.
Figure 2
Figure 2
Correlation of glycated hemoglobin with psychological scores. EPDS Edinburgh postnatal depression scale, HbA1C glycated hemoglobin, PSS perceived stress scale.
Figure 3
Figure 3
Correlation of malondialdehyde with psychological scores. EPDS Edinburgh postnatal depression scale, MDA malondialdehyde, PSS perceived stress scale.
Figure 4
Figure 4
Correlation of interleukin-6 with psychological scores. EPDS Edinburgh postnatal depression scale, IL-6 interleukin-6, PSS perceived stress scale.
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