Mental health during pregnancy and post-partum in mothers with and without type 1 diabetes: The ENDIA study

Abstract

Introduction: We aimed to compare the mental health of mothers, with and without type 1 diabetes (T1D), during pregnancy and postpartum, and to examine the relationship between glycaemic control and mental health in T1D. Objectives: We hypothesised that mental health in trimester 3 (T3) and post-partum is less favourable in mothers with T1D, and that poorer mental health scores relate directly to glycaemic control. Methods: Participants were 800/946 women enrolled in the Environmental Determinants of Islet Autoimmunity (ENDIA) study, an Australiawide pregnancy-birth prospective cohort following children with a first-degree relative with T1D, from 2016-2020.Women with and without T1D (n=518, 282) completed the Edinburgh Postnatal Depression Scale (EPDS) and Perceived Stress Scale (PSS) during T3, (median [IQR], 34 [32, 36] weeks) and early post-partum (median 14 [13, 16] weeks). Linear mixed regression models were adjusted for parity. Results: Women without T1D were aged mean (SD) 33.1 (4.4) years; 31.9 (4.4) years with T1D. Pre-existing mental health issues requiring psychotropic medications were of similar number in non-T1D n=17 [6%] and T1D n=41 [8%]. EPDS and PSS scores did not differ between non-T1D and T1D mothers at T3 or post-partum (all p≥0.5; Table 1). EPDS scores were less favourable at T3 compared with postpartum (p=0.01), independent of T1D status, and by post-partum 12/47 women had improved to below the threshold (=12) recommended for intervention. HbA1c during pregnancy in 398/518 women (76.8%) with T1D did not relate to EPDS (r2=0.01, p=0.2) or PSS (r2=0.02, p=0.4) scores. Median [IQR] HbA1c was 6.3% [5.8-6.9]. Conclusions: Overall, mental health in late pregnancy and postpartum was not adversely impacted by T1D. Glycaemic control did not relate to mental health scores in mothers with T1D. A generalised improvement in mental health between T3 and post-partum was independent of T1D status.L6365588472021-12-07 <br />