Gestational diabetes mellitus complicated with depression in pregnant women: a biopsychosocial analysis and intervention strategies

Abstract Objective To investigate the incidence and influencing factors of comorbid depression in pregnant women with gestational diabetes mellitus (GDM), analyze their interaction effects, and propose targeted intervention strategies. Methods A retrospective analysis was conducted on clinical data...

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Main Authors: Yan Wang, Yunxia Quan
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07916-2
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author Yan Wang
Yunxia Quan
author_facet Yan Wang
Yunxia Quan
author_sort Yan Wang
collection DOAJ
description Abstract Objective To investigate the incidence and influencing factors of comorbid depression in pregnant women with gestational diabetes mellitus (GDM), analyze their interaction effects, and propose targeted intervention strategies. Methods A retrospective analysis was conducted on clinical data from 746 pregnant women who underwent regular prenatal examinations at our hospital from March 2022 to March 2024. All participants were screened for GDM using the oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. Based on GDM diagnosis, the cohort was divided into GDM and non-GDM groups, with demographic and clinical indicators compared between groups. For GDM patients, the Hamilton Depression Rating Scale-17 (HAMD-17) was used to assess depressive symptoms, categorizing them into a negative screened group (HAMD-17 score > 7) and a positive screened group (HAMD-17 score ≤ 7). Univariable analysis was performed to identify potential influencing factors, followed by multivariable logistic regression to determine independent associated factors and interaction effects. Results Among 746 participants, 84 were diagnosed with GDM (incidence: 11.26%). Univariable analysis revealed that GDM was significantly associated with advanced maternal age (≥ 35 years), pre-pregnancy overweight/obesity (BMI ≥ 24 kg/m²), adverse pregnancy history, family history of diabetes, polycystic ovary syndrome (PCOS), poor dietary habits, insufficient physical activity, poor sleep quality, and elevated serum estradiol (E2), progesterone (P), and cortisol (Cor) levels (P < 0.05). Multivariable logistic regression confirmed these factors as independent associated factors for GDM (P < 0.05). Among the 84 GDM patients, 27 (32.14%) had comorbid depression. Univariable analysis identified adverse pregnancy history, elevated E2/P/Cor levels, personal/family history of depression, unintended pregnancy, poor glycemic control, GDM-related complications, and low social support (SSRS score < 33) as potential associated factors for depression (P < 0.05). Multivariable analysis further demonstrated that adverse pregnancy history, elevated E2/P/Cor levels, prior depression history, poor glycemic control, and low social support were independent associated factors for comorbid depression (P < 0.05). Interaction analysis using Jvenn ( https://jvenn.toulouse.inrae.fr/app/example.html ) revealed that adverse pregnancy history and elevated E2/P/Cor levels were shared influencing factors for both GDM and comorbid depression. Conclusions (1) Advanced maternal age, pre-pregnancy overweight/obesity, adverse pregnancy history, diabetes family history, PCOS, poor lifestyle habits, and elevated E2/P/Cor levels are independent associated factors for GDM. (2) Adverse pregnancy history, elevated E2/P/Cor levels, prior depression history, poor glycemic control, and low social support are independent associated factors for comorbid depression in GDM patients. (3) Adverse pregnancy history and elevated E2/P/Cor levels represent shared interaction factors influencing both conditions.
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spelling doaj-art-0fcd02edfa3c45479de6ebd830d7c5882025-08-20T03:43:34ZengBMCBMC Pregnancy and Childbirth1471-23932025-08-0125111010.1186/s12884-025-07916-2Gestational diabetes mellitus complicated with depression in pregnant women: a biopsychosocial analysis and intervention strategiesYan Wang0Yunxia Quan1The Sixth Department of Obstetrics, Shijiazhuang Maternal and Child Health HospitalDepartment of Clinical psychology, Shijiazhuang Maternal and Child Health HospitalAbstract Objective To investigate the incidence and influencing factors of comorbid depression in pregnant women with gestational diabetes mellitus (GDM), analyze their interaction effects, and propose targeted intervention strategies. Methods A retrospective analysis was conducted on clinical data from 746 pregnant women who underwent regular prenatal examinations at our hospital from March 2022 to March 2024. All participants were screened for GDM using the oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. Based on GDM diagnosis, the cohort was divided into GDM and non-GDM groups, with demographic and clinical indicators compared between groups. For GDM patients, the Hamilton Depression Rating Scale-17 (HAMD-17) was used to assess depressive symptoms, categorizing them into a negative screened group (HAMD-17 score > 7) and a positive screened group (HAMD-17 score ≤ 7). Univariable analysis was performed to identify potential influencing factors, followed by multivariable logistic regression to determine independent associated factors and interaction effects. Results Among 746 participants, 84 were diagnosed with GDM (incidence: 11.26%). Univariable analysis revealed that GDM was significantly associated with advanced maternal age (≥ 35 years), pre-pregnancy overweight/obesity (BMI ≥ 24 kg/m²), adverse pregnancy history, family history of diabetes, polycystic ovary syndrome (PCOS), poor dietary habits, insufficient physical activity, poor sleep quality, and elevated serum estradiol (E2), progesterone (P), and cortisol (Cor) levels (P < 0.05). Multivariable logistic regression confirmed these factors as independent associated factors for GDM (P < 0.05). Among the 84 GDM patients, 27 (32.14%) had comorbid depression. Univariable analysis identified adverse pregnancy history, elevated E2/P/Cor levels, personal/family history of depression, unintended pregnancy, poor glycemic control, GDM-related complications, and low social support (SSRS score < 33) as potential associated factors for depression (P < 0.05). Multivariable analysis further demonstrated that adverse pregnancy history, elevated E2/P/Cor levels, prior depression history, poor glycemic control, and low social support were independent associated factors for comorbid depression (P < 0.05). Interaction analysis using Jvenn ( https://jvenn.toulouse.inrae.fr/app/example.html ) revealed that adverse pregnancy history and elevated E2/P/Cor levels were shared influencing factors for both GDM and comorbid depression. Conclusions (1) Advanced maternal age, pre-pregnancy overweight/obesity, adverse pregnancy history, diabetes family history, PCOS, poor lifestyle habits, and elevated E2/P/Cor levels are independent associated factors for GDM. (2) Adverse pregnancy history, elevated E2/P/Cor levels, prior depression history, poor glycemic control, and low social support are independent associated factors for comorbid depression in GDM patients. (3) Adverse pregnancy history and elevated E2/P/Cor levels represent shared interaction factors influencing both conditions.https://doi.org/10.1186/s12884-025-07916-2Gestational diabetes mellitusDepressionAssociated factorsInteraction effectsIntervention strategies
spellingShingle Yan Wang
Yunxia Quan
Gestational diabetes mellitus complicated with depression in pregnant women: a biopsychosocial analysis and intervention strategies
BMC Pregnancy and Childbirth
Gestational diabetes mellitus
Depression
Associated factors
Interaction effects
Intervention strategies
title Gestational diabetes mellitus complicated with depression in pregnant women: a biopsychosocial analysis and intervention strategies
title_full Gestational diabetes mellitus complicated with depression in pregnant women: a biopsychosocial analysis and intervention strategies
title_fullStr Gestational diabetes mellitus complicated with depression in pregnant women: a biopsychosocial analysis and intervention strategies
title_full_unstemmed Gestational diabetes mellitus complicated with depression in pregnant women: a biopsychosocial analysis and intervention strategies
title_short Gestational diabetes mellitus complicated with depression in pregnant women: a biopsychosocial analysis and intervention strategies
title_sort gestational diabetes mellitus complicated with depression in pregnant women a biopsychosocial analysis and intervention strategies
topic Gestational diabetes mellitus
Depression
Associated factors
Interaction effects
Intervention strategies
url https://doi.org/10.1186/s12884-025-07916-2
work_keys_str_mv AT yanwang gestationaldiabetesmellituscomplicatedwithdepressioninpregnantwomenabiopsychosocialanalysisandinterventionstrategies
AT yunxiaquan gestationaldiabetesmellituscomplicatedwithdepressioninpregnantwomenabiopsychosocialanalysisandinterventionstrategies