Transtorno depressivo maior em gestantes e puérperas com diabetes Mellitus gestacional assistidas em hospital materno infantil de referência em Brasília, Distrito Federal

Abstract

Introduction: Diabetes and depression are serious public health problems. There is no agreement in the literature if Gestational Diabetes Mellitus (GDM) is a risk factor for depression or whether the presence of a depressive condition during pregnancy is a risk factor for the development of GDM. Objective: The goal of this study is to analyze the association between GDM and Major Depressive Disorder (MDD) in pregnancy and its relation with depressive symptoms in the 1st and 4th month of the postpartum period, in pregnant women accompanied at a reference service center in Brasilia, Brazil. Method: Clinical research, prospective and analytical study, convenience sample including 137 pregnant women with GDM. Pregnant women were grouped using the depressive symptom rating scales: Beck II Depression Inventory and Edinburgh Postnatal Depression Scale. For psychiatric diagnosis, the Mini International Neuropsychiatric Interview PLUS Brazilian version 5.0.0/DSM IV instrument was applied. The 137 pregnant women with GDM were divided into the following groups: control (n = 50), pregnant women with mild depressive disorder (n = 29), pregnant women with severe depressive disorder (n = 27) and other mental disorders (n = 31). After the delivery, patients were reevaluated in the first and fourth month postpartum period with new application of the described scales. Results: The prevalence of a major depressive disorder in the studied group was 40.9% (n = 56), with 19.7% (n = 27) of pregnant women with severe depression condition. The groups with pregnant women with major depressive disorder had higher depressive scores compared to other groups in all applications, including postpartum (p=0.000). Regarding the described variables for the evaluation of gestational outcome, there was no statistically significant difference. No correlation was found between depression risk factors and metabolic risk factors for GDM (p>0,05). Conclusion: The high prevalence of MDD in women with GDM, as well as the comorbidities associated with them, increases the significance of early medical screening in pregnant women with risk factors for both diseases. There was no correlation found between the risk factors described in the literature for depression and the risk factors for GDM. However, a significant persistence of depressive symptoms has been observed in the postpartum period in pregnant women with gestational depression.