Mental Health During Late Pregnancy and Postpartum in Mothers With and Without Type 1 Diabetes: The ENDIA Study
Authors: Hall Madeleine , Oakey Helena , Penno Megan A.S. , McGorm Kelly , Anderson Amanda J. , Ashwood Pat , Colman Peter G. , Craig Maria E. , Davis Elizabeth A. , Harris Mark , Harrison Leonard C. , Haynes Aveni , Morbey Claire , Sinnott Richard O. , Soldatos Georgia , Vuillermin Peter J. , Wentworth John M. , Thomson Rebecca L. , Couper Jennifer J. , Harris Mark , Harrison Leonard C. , Haynes Aveni , Kim Ki Wook , Morahan Grant , Oakey Helena , Penno Megan A.S. , Rawlinson William D. , Sinnott Richard O. , Soldatos Georgia , Thomson Rebecca L. , Vuillermin Peter J. , Wentworth John M. , Anderson Amanda J. , Ashwood Pat , Brown James D. , Hu William , Huynh Dao , McGorm Kelly J. , Watson Kelly , Park Yeon , Hamilton-Williams Emma , Beresford Sarah , Bertram Samantha , Bezuidenhout Debra , Brandrick Susan , Butterworth Carlie , Catteau Jacki , Clements Nakita , Gartrell Kyana , Griffiths Helen , Gwiazdzinski Alison , Hall Candice , Harper Gail , Hulley Amanda , Hoffman Mikayla , Kludas Renee , Monagle Christine , Moore Belinda , Ramoso Benjamin , Roberts Alison , Thompson Georgina , Tully Alexandra , Vicary Isabelle , Wood Rosemary , Battersby Rachel , Jullie Teela , Savio Stephanie , Bandala Sanchez Esther , Bediaga Naiara , Hope Chris , Sadlon Tim , Roth Schulze Alexandra , Binkowski Sabrina , Brittain Bek , Bui Minh , Foskett Dylan , Huang Dexing , Kapadia Stuti , Minhaj Asma , Naselli Gaetano , Ngui Katrina , Nguyen Trung , Wood Emily , Yau Cynthia , Cavenett Leanne 
Published: February 2022

OBJECTIVE
Pregnancy and type 1 diabetes are each associated with increased anxiety and depression, but the combined impact on well-being is unresolved. We compared the mental health of women with and without type 1 diabetes during pregnancy and postpartum and examined the relationship between mental health and glycemic control.

RESEARCH DESIGN AND METHODS
Participants were women enrolled from 2016 to 2020 in the Environmental Determinants of Islet Autoimmunity (ENDIA) study, a pregnancy to birth prospective cohort following children with a first-degree relative with type 1 diabetes. Edinburgh Postnatal Depression Scale (EPDS) and Perceived Stress Scale (PSS) were completed during the third trimester (T3) (median [interquartile range] 34 [32, 36] weeks) and postpartum (14 [13, 16] weeks) by 737 women (800 pregnancies) with (n = 518) and without (n = 282) type 1 diabetes.

RESULTS
EPDS and PSS scores did not differ between women with and without type 1 diabetes during T3 and postpartum. EPDS scores were marginally higher in T3: predicted mean (95% CI) 5.7 (5.4, 6.1) than postpartum: 5.3 (5.0, 5.6), independent of type 1 diabetes status (P = 0.01). HbA1c levels in type 1 diabetes were 6.3% [5.8, 6.9%] in T3 and did not correlate with EPDS or PSS scores. Reported use of psychotropic medications was similar in women with (n = 44 of 518 [8%]) and without type 1 diabetes (n = 17 of 282 [6%]), as was their amount of physical activity.

CONCLUSIONS
Overall, mental health in late pregnancy and postpartum did not differ between women with and without type 1 diabetes, and mental health scores were not correlated with glycemic control.