Diabetes in pregnancy: Worse medical outcomes in type 1 diabetes but worse psychological outcomes in gestational diabetes

Background: Women with diabetes experience an increased risk of adverse pregnancy outcomes. Aim: We aim to describe and quantify the psychological impact of the diagnosis of diabetes in pregnant women with type 1 diabetes and gestational diabetes mellitus (GDM) compared to each other and to their counterparts without diabetes. Design: This is a survey-based study with prospective collection of pregnancy outcome data. Methods: A total of 218 pregnant women (50% with diabetes) were administered questionnaires relating to psychological health. Maternal and neonatal characteristics and pregnancy outcomes were collected. Associations between key psychometric and health outcome variables were examined. Results: At least 25% of women in all three pregnancy groups had scores indicating affective distress in at least one domain. Compared to those with type 1 diabetes, women with GDM evidenced a greater number of uplifts in pregnancy (U=94, P=0.041), but also higher levels of overall anxiety (U=92, P=0.03) and stress (U=82, P < 0.01). Women with GDM also had significantly elevated overall depression scores, compared with the control group (U=34, P=0.02). Both groups of women with diabetes had clinically elevated levels of diabetes-related distress. There were no associations between maternal psychological variables and pregnancy outcomes. Conclusions: This work highlights a potential role for targeted psychological interventions to address and relieve symptoms of anxiety and depression among pregnant women with diabetes.