Factors Associated With Poor Perinatal Mental Health in Women With and Without Gestational Diabetes: Data From a Large Multi‐Ethnic Cohort

ABSTRACT Background Mental health disorders are common during the perinatal period and women with gestational diabetes mellitus (GDM) may be at greater risk than the general pregnant population. Aim We assessed if factors associated with symptoms of anxiety, depression and poor mental health‐related quality of life (HRQoL) differed between women with and without GDM. Materials and Methods Prospective cohort study of participants from the GEMS Trial. Participants completed questionnaires screening for anxiety, depression or HRQoL at enrolment, 36 weeks' gestation and 6 months postpartum. Potential associations were assessed using multivariable logistic regression for each questionnaire at each timepoint. Results Of 4061 participants, 433 (10.7%) were diagnosed with GDM. At enrolment, non‐European ethnicity, obesity, maternal age and previous perinatal death were associated with symptoms of poor mental health (above threshold for any questionnaire) in the overall cohort. Among women with GDM, Other ethnicity (not European, Māori, Pacific or Asian) was associated with increased risk for poor mental health, while Pacific ethnicity was most often associated with poor mental health in women without GDM. Women with obesity (BMI ≥ 30 kg/m 2 ) had a greater risk for poor mental health at baseline in both groups, but only in women without GDM in late gestation. Older age (≥ 40 years) was associated with poor mental health among women with GDM, and younger age (< 30 years) among women without GDM. Conclusion Non‐European ethnicity, obesity and maternal age are associated with poor mental health, but at different time points and different magnitudes of risk in women with and without GDM.