To assess whether or not diabetes is a factor in pre- and post-partum depression, Kozhimannil and her colleagues reviewed data on more than 11,000 women who gave birth between 2004 and 2006. All of the women were continuously enrolled in Medicaid during the study period.
From this low-income population, the researchers found that 15.2 percent of women with diabetes developed depression during or after their pregnancy. In women without diabetes, that number was 8.5 percent. In women who’d never been depressed before, 9.6 percent of those with diabetes developed depression, compared to 5.9 percent of those without the blood sugar condition.
“Health-care facilities need to pay particular attention for depression in women with diabetes during the post-partum period,” said Kozhimannil. “Both diabetes and depression in the post-partum period are treatable.”
Dr. Robert Welch, chairman of obstetrics and gynecology at Providence Hospital in Southfield, Mich., called the new research an interesting study, but said it left some important questions unanswered. For example, he wondered how many of these pregnancies were planned, and exactly how many of the women with diabetes were newly diagnosed?
“A new diagnosis may be overwhelming for a lot of women,” he said.
Also, in a Medicaid population, it can be more difficult to get diabetes well monitored, which could add to the stress these women are already feeling, Welch said. “Diabetes is an expensive disease, and this study calls out the need for additional mid-level providers who have more time to assist in making [a depression] diagnosis,” he said.
Both Welch and Kozhimannil said that while this study was done with low-income women, the findings may be similar for higher-income women, though the stressors may be different.
Welch recommended that no matter what your income, if you’re expecting, you should try to set up a support system before the baby arrives. Try to set up extra help so you’re not alone with the baby day after day, he said.
“Years ago, when you brought a baby home, grandma and other family members were there. Now, grandmothers are working. And, if you have diabetes, too, it’s an overwhelming situation. You’re fatigued from the new baby and have the stress of managing diabetes,” he said.