Pregnant Women With Diabetes at Increased Risk of Anxiety, Depression


A recent study found that patients with pre-gestational diabetes reported higher levels of both borderline and abnormal anxiety compared to patients with gestational diabetes.

Pregnant women with diabetes—particularly pre-existing diabetes—are at an increased risk of anxiety and depression, according to research published in the journal Diabetes Epidemiology and Management.1 Researchers said the study’s findings indicate that women with diabetes should be evaluated for the mental health conditions at their first pre-natal visit.

According to the CDC, between 2% and 10% of pregnant women are impacted by gestational diabetes, which is known to have several negative maternal and fetal health risks.2 Although anxiety and depression are known to effect pregnant women with diabetes, previous research results have been inconsistent.

“It is important to address mental health issues during pregnancy especially among diabetic women, due to the bi-directional association between diabetes and anxiety/depression,” the authors wrote. “The presence of anxiety and depression itself can be a prelude to the onset of gestational diabetes, and the possibility of pregnancy complications is higher among diabetic pregnant mothers who have depression and anxiety.”

A team of investigators conducted a study to examine the prevalence of anxiety and depression among pregnant women with diabetes and their predictors. The study cohort included 350 pregnant women with pre-pregnancy or gestational diabetes who were referred to 1 of 109 comprehensive health centers in Qazvin Province, Iran.

Of the included participants, 28.9% had pre-pregnancy diabetes and 71.1% had gestational diabetes. Data on fertility and demographic characteristics, anxiety, depression, partner social support, self-efficacy, medication adherence, and fear of hypoglycemia was collected using different questionnaires and scales.

Investigators found that the prevalence rate was 52% for borderline anxiety, 22.9% for abnormal anxiety, 22.3% for borderline depression, and 57.1% for abnormal depression. Participants with pre-gestational diabetes reported higher levels of both borderline and abnormal anxiety at 84.2%, compared to 71.1 % of patients with gestational diabetes. Borderline and abnormal depression was reported by 94.1% of pre-gestational diabetes patients, compared to 73.5 % of gestational diabetes patients.

Additionally, both low self-efficacy—which refers to “the ability, judgment, and beliefs that are used in a specific situation to achieve a specific goal”—and low spousal support were significant predictors of abnormal anxiety. Fear of hypoglycemia, medication adherence, self-efficacy, partner social support, diabetes type, perceived family economic status, and diabetes treatment were significant predictors of abnormal depression.

“In the present study, the prevalence of both anxiety and depression were high among pregnant women with diabetes,” the authors concluded. “Women with pre-pregnancy diabetes were at higher risk for both borderline and abnormal depression and anxiety compared to those with gestational diabetes. Therefore, pregnant women with diabetes should be evaluated for depression and anxiety in their first prenatal visit.”

1. Salimi HR, Griffiths MD, Alimoradi Z. Prevalence of anxiety and depression among pregnant women with diabetes and their predictors. Diabet Epidemiol Manag. Volume 14, 2024.
2. Gestational Diabetes. Report. CDC. December 30, 2022. Accessed January 31, 2024.
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