The Association between a Medical History of Depression and Gestational Diabetes in a Large Multi‐ethnic Cohort in the U nited S tates

Background Both major depression and gestational diabetes mellitus ( GDM ) are prevalent among women of reproductive age. Our objective was to determine whether a medical history of depression is related to subsequent development of GDM . Methods The C onsortium on S afe L abor was a US retrospective cohort study of 228 562 births between 2002 and 2008. Exclusion criteria for the present analysis included multiple gestation pregnancies ( n  = 5059), pre‐existing diabetes ( n  = 12 771), deliveries <24 weeks ( n  = 395), site GDM prevalence (<1%) ( n  = 20 721) and missing data on pre‐pregnancy body mass index ( BMI ) ( n  = 61 321). Using generalised estimating equations, we estimated the association between a history of depression and a pregnancy complicated by GDM . Results The final analytic population included 121 260 women contributing 128 295 pregnancies, of which 5606 were affected by GDM . A history of depression was significantly associated with an increased risk of developing GDM (multivariate odds ratio [a OR ] = 1.42 [95% confidence interval ( CI ) 1.26, 1.60]). Adjusting for pre‐pregnancy BMI and weight gain during pregnancy attenuated the association, although it remained statistically significant (a OR  = 1.17 [95% CI 1.03, 1.33]). Conclusions A history of depression was significantly associated with an increased GDM risk among a large multi‐ethnic US cohort of women. If the association is confirmed, depression presents a potentially modifiable risk factor of GDM and provides additional clues to the underlying pathophysiology of GDM .