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Is gestational diabetes associated with adverse maternal and child mental health outcomes?

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Adopted project
2 June 2020 — adopted November 2019 • completed August 2020

Is gestational diabetes associated with adverse maternal and child mental health outcomes?

Gestational diabetes mellitus (GDM) is defined as ‘glucose intolerance with onset during pregnancy’, has a UK prevalence of between five and 10%, and is associated with adverse outcomes for mother and baby.

60%

of mothers with GDM are at increased risk of subsequently developing Type 2 diabetes

Adverse outcomes associated with GDM include obstetric complications and an increased risk of subsequent Type 2 diabetes. Adverse neuro-behavioural outcomes have also been observed in the child, which appear to be inversely correlated with level of glycaemic control and include:

✓

Inattention and hyperactivity

✓

Lower verbal IQ scores

Mental disorders and diabetes

1 in 5
women develop a mental disorder during pregnancy or in the year following birth
2×
higher prevalence of depression in the general diabetic population compared to the non-diabetic population

Mental disorder is the most common morbidity of the perinatal period. Associated adverse outcomes include maternal and fetal complications, and emotional and behavioural problems in the child. Crucially, the outcomes in children from mothers experiencing GDM with co-occurring mental disorder have not been studied.

Recent research suggests that the prevalence of depression in the general diabetic population is twice that of the non-diabetic population, with some research showing an association between depression and both treatment non-adherence and poorer glycaemic control. Given that Type 2 diabetes and GDM share the same pathophysiology of insulin resistance, a study of the relationship between GDM and mental disorder and the influence of mental disorder on future risk of Type 2 diabetes following GDM is timely.

Existing literature finds cross-sectional associations between GDM and mental disorder using screening tools up to four months following childbirth. However, the extent of the risk for mental disorder, subsequent maternal and child health outcomes, and underlying mechanisms remain unclear.

Project aim

To establish the extent to which gestational diabetes mellitus (GDM) is associated with adverse maternal mental health outcomes, and whether mental disorder in those with GDM is associated with subsequent development of Type 2 diabetes and adverse child neuro-behavioural outcomes.

How the study will be carried out

The study is funded by the MRC Clinical Research Training Fellowship, supervised by Professor Louise Howard, Professor Khalida Ismail and Professor Emily Simonoff at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London.

It is divided into four individual sub-studies:

1a

Systematic review and meta-analysis

Prevalence and odds of perinatal mental disorder in women with GDM

1b

Risk for perinatal mental disorder

Assessed from a questionnaire about mental symptoms and diagnoses from primary care records

2

Future risk of Type 2 diabetes

Investigated in women with GDM and antenatal mental disorder, using primary care diagnoses of Type 2 diabetes

3

Neuro-behavioural outcomes in children

Children whose mothers had GDM and antenatal mental disorder, investigated using two measures of the child’s development at ages four and seven

Research collaborators

✓  Bradford Institute for Health Research — Professor John Wright and the Born in Bradford cohort study team

✓  University of Edinburgh — Professor Rebecca Reynolds, Centre for Cardiovascular Science

Patient and public involvement

Two patient and public involvement groups were involved in the proposal’s development and continue to inform the direction of the project:

✓

King’s College London’s Section of Women’s Mental Health Service User Advisory Group

✓

Born in Bradford Parent Governors’ Group

Potential benefits of the research

Exploring the relationships between GDM and mental disorder, and the potential mechanisms for these associations, will help inform the tailoring of healthcare interventions for women with GDM — better supporting their needs and improving longer-term health outcomes for women and their children in south London.

Funded by an MRC Clinical Research Training Fellowship. Adopted by ARC South London in November 2019. Completed August 2020.

Project lead


Dr Claire Wilson

MRC Clinical Research Training Fellow, King’s College London

Publications

Related content

Original source: arc-sl.nihr.ac.uk — NIHR ARC South London legacy content archived May 2026.