Associations Between Prenatal Diabetes Mellitus, Social Determinants of Health, and Maternal Mental Health [ID 1156]

INTRODUCTION: We compare postpartum psychopathology across patients with pregestational type 1/2 diabetes mellitus (PGDM) and those with gestational diabetes mellitus (GDM). METHODS: We collected demographics, social determinants of health, medical comorbidities, psychiatric history, and postpartum psychiatric diagnoses at an inner-city, academic hospital from September 2020 to December 2023. Outcomes across patients with GDM and PGDM were compared using chi-squared and multivariable logistic regression. RESULTS: Of 6,186 pregnancies, 111 (3%) experienced PGDM and 871 (23%) GDM. Of these, 424 (43%) identified as Black, 357 (36%) Hispanic, and 733 (74%) used public health insurance. Patients with PGDM showed higher hemoglobin A 1C values (6.09 versus 6.88 mmol/mol; t(304)=−2.69, P <.01) and increased rates of cesarean delivery (X2(1)=9.30, P <.01), hypertension (X2(1)=9.52, P <.01), neonatal intensive care unit stay (X2(1)=21.65, P <.0001), and medical intensive care unit stay (X2(1)=7.05, P <.01) as compared to those with GDM. Furthermore, the risk of low social connections was higher for patients with PGDM (X2(1)=6.97, P <.01) as compared to GDM. Rates of postpartum or pregnancy-related psychopathology were significantly higher in women with PGDM as compared to those with GDM (X2(1)=21.94, P <.0001). After controlling for measured covariates in a multivariable logistic regression, patients with PGDM remained at higher odds of being diagnosed with a postpartum psychopathology (odds ratio 2.25; 95% CI, 1.40–3.60) than those with GDM. CONCLUSIONS/IMPLICATIONS: As compared to GDM, PGDM was associated with increased odds of postpartum or pregnancy-related psychopathology, and medical and social comorbidities. Provider knowledge of differential risk for patients with PGDM and GDM may improve care.