A comparison of the mother-infant relationship in mothers with and without gestational diabetes mellitus:An analysis of the Growing Up in Scotland cohort

Background: There is an increased risk of depressive symptoms in women with gestational diabetes mellitus (GDM). Poor maternal mental health can impact the mother-infant relationship which can cause problems in the perinatal period. However there is little research which examines the mother-infant relationship in women with GDM. Aims: To test the hypotheses that (1) GDM is associated with a perceived difficult mother-infant relationship in the first year of an infant's life in a cohort of women recruited in pregnancy compared to mothers who do not have GDM and (2) poor maternal mental health mediates the relationship between GDM and the mother-infant relationship Study design: A retrospective analysis of a Scottish cohort database using mediation analysis. Subjects: The dataset included 5,289 women (n = 204 GDM, n = 5,085 no GDM). Outcome measures: The Maternal Postnatal Attachment Scale measured the mother-infant relationship. The SF-12 Mental Health Component Score measured maternal mental health. Results: GDM does not predict maternal mental health (path a). Poor maternal mental health is significantly associated with a perceived difficult mother-infant relationship (path b). The direct effect of GDM on the mother-infant relationship (path c) was not statistically significant. The indirect effect of GDM on the mother-infant relationship via maternal mental health (mediator) was also not significant. Conclusion: This is the first robust study examining the impact of GDM on the mother-infant relationship. The study did not support the hypotheses, however the results are of theoretical value, especially in the context of limited research

Depression prevalence based on the Edinburgh Postnatal Depression Scale compared to Structured Clinical Interview for DSM DIsorders classification: Systematic review and individual participant data meta-analysis.

Estimates of depression prevalence in pregnancy and postpartum are based on the Edinburgh Postnatal Depression Scale (EPDS) more than on any other method. We aimed to determine if any EPDS cutoff can accurately and consistently estimate depression prevalence in individual studies. We analyzed datasets that compared EPDS scores to Structured Clinical Interview for DSM (SCID) major depression status. Random-effects meta-analysis was used to compare prevalence with EPDS cutoffs versus the SCID. Seven thousand three hundred and fifteen participants (1017 SCID major depression) from 29 primary studies were included. For EPDS cutoffs used to estimate prevalence in recent studies (≥9 to ≥14), pooled prevalence estimates ranged from 27.8% (95% CI: 22.0%-34.5%) for EPDS ≥ 9 to 9.0% (95% CI: 6.8%-11.9%) for EPDS ≥ 14; pooled SCID major depression prevalence was 9.0% (95% CI: 6.5%-12.3%). EPDS ≥14 provided pooled prevalence closest to SCID-based prevalence but differed from SCID prevalence in individual studies by a mean absolute difference of 5.1% (95% prediction interval: -13.7%, 12.3%). EPDS ≥14 approximated SCID-based prevalence overall, but considerable heterogeneity in individual studies is a barrier to using it for prevalence estimation