Frontiers in psychiatry · 2026
Association between first-trimester serum 25(OH)D and EPDS-positive postpartum depressive symptoms in women with gestational diabetes mellitus: a retrospective cohort study.
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He Caijun, Zhang Hongli, Han Shuang, Zhang Liying, Ma Jinhe, Tang Huizi
Аннотация
INTRODUCTION: Gestational diabetes mellitus (GDM) has been associated with an increased risk of postpartum depressive symptoms, while maternal vitamin D status may also be related to perinatal mood disturbances. This study investigated the association between first-trimester serum 25-hydroxyvitamin D [25(OH)D] concentrations and Edinburgh Postnatal Depression Scale (EPDS)-positive postpartum depressive symptoms in women with GDM.
METHODS: This retrospective cohort study included 242 women with GDM. Prenatal depressive and anxiety symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Sequential logistic regression models were adjusted for baseline maternal characteristics, prenatal PHQ-9 and GAD-7 scores, and glycated hemoglobin A1c (HbA1c).
RESULTS: Among 242 women, 69 had EPDS-positive postpartum depressive symptoms. Each 5-ng/mL increase in 25(OH)D was associated with lower odds of EPDS-positive symptoms in the crude model (OR 0.35, 95% CI 0.25-0.48) and after adjustment for baseline characteristics (adjusted OR 0.36, 95% CI 0.25-0.50). After additional adjustment for prenatal PHQ-9 and GAD-7 scores, the association was attenuated and was no longer statistically significant overall (adjusted OR 0.69, 95% CI 0.43-1.12; P = 0.134). Additional adjustment for HbA1c produced similar results. Exploratory stratified analyses using the full Model 2 covariate set showed no statistically significant associations within strata defined by pre-pregnancy BMI, hypertensive disorders of pregnancy, or insulin use, and no significant interactions were detected.
DISCUSSION: These findings suggest that the overall association between first-trimester 25(OH)D and postpartum depressive symptoms was substantially influenced by prenatal mental health status and was not consistently demonstrated after comprehensive covariate adjustment.
METHODS: This retrospective cohort study included 242 women with GDM. Prenatal depressive and anxiety symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Sequential logistic regression models were adjusted for baseline maternal characteristics, prenatal PHQ-9 and GAD-7 scores, and glycated hemoglobin A1c (HbA1c).
RESULTS: Among 242 women, 69 had EPDS-positive postpartum depressive symptoms. Each 5-ng/mL increase in 25(OH)D was associated with lower odds of EPDS-positive symptoms in the crude model (OR 0.35, 95% CI 0.25-0.48) and after adjustment for baseline characteristics (adjusted OR 0.36, 95% CI 0.25-0.50). After additional adjustment for prenatal PHQ-9 and GAD-7 scores, the association was attenuated and was no longer statistically significant overall (adjusted OR 0.69, 95% CI 0.43-1.12; P = 0.134). Additional adjustment for HbA1c produced similar results. Exploratory stratified analyses using the full Model 2 covariate set showed no statistically significant associations within strata defined by pre-pregnancy BMI, hypertensive disorders of pregnancy, or insulin use, and no significant interactions were detected.
DISCUSSION: These findings suggest that the overall association between first-trimester 25(OH)D and postpartum depressive symptoms was substantially influenced by prenatal mental health status and was not consistently demonstrated after comprehensive covariate adjustment.