Effects of diagnostic thresholds for gestational diabetes on perinatal mental health: Data from the GEMS randomised clinical trial.

AIM: To assess the effect of diagnosis using the lower International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria compared with the higher New Zealand criteria on perinatal mental health.

METHODS

Secondary analysis of the GEMS Trial, a randomised trial assessing optimum glycaemic diagnostic thresholds for gestational diabetes. Women completing any questionnaire assessing anxiety (6-item State-Trait Anxiety Inventory >15), depression (Edinburgh Postnatal Depression Scale >12) or health-related quality of life (SF-36) at enrolment, 36 weeks' gestation or 6 months postpartum were eligible. Generalised linear mixed-effects models adjusted for age, BMI, recruitment centre, and gestational age at randomisation generated adjusted relative risks (aRR) and adjusted mean differences (aMD).

RESULTS

Among 3452 women, 1737 (50.3%) were randomised to the lower criteria group and 1715 (49.7%) to the higher criteria group. No significant differences were observed between groups in anxiety, depression, or mental health-related quality of life at 36 weeks' gestation or 6 months postpartum after adjustment for baseline scores. However, women with mild GDM diagnosed and treated under the lower criteria reported better general health, vitality, social functioning, and postpartum mental component summary scores.

CONCLUSION

Use of the IADPSG criteria does not adversely affect maternal perinatal mental health.