Abstract
BACKGROUND: We examine associations between pregestational Type 1 or Type 2 diabetes mellitus (PGDM) versus gestational diabetes mellitus (GDM) with postpartum psychopathology. METHODS: We collected demographics, social determinants of health, medical comorbidities, psychiatric history, and postpartum psychiatric diagnoses at an urban, academic hospital from 9/2020-12/2023. Outcomes across patients with GDM and PGDM were compared with chi-square, t-tests, and multivariable logistic regression. RESULTS: Of 6,186 pregnancies, 111 (3%) experienced PGDM and 871 (23%) GDM. Patients with PGDM showed higher rates of cesarean delivery [X(2) (1) = 9.30, p < 0.01], NICU stay [X(2)(1) = 21.65, p < 0.0001], and MICU stay [X(2)(1) = 7.05, p < 0.01] and higher maximum HbA1c values [7.14 +/- 1.67 mmol/mol versus 6.18 +/- 1.49 mmol/mol; t(304) = 9.92, p < 0.01] as compared to those with GDM. Low social connections, a measured social determinant of health, was higher for patients with GDM (X(2) (1) = 6.97, p < 0.01) as compared to PGDM. Women with PGDM were at double the odds of postpartum psychopathology compared to those with GDM after controlling for several measured covariates (OR = 2.40, 95% CI 1.55-3.73). However, when HbA1c was included in the model, the elevated risk was eliminated (OR = 1.03, 95% CI 0.35-3.04). CONCLUSION: As compared to GDM, PGDM was associated with increased odds of medical and social comorbidities. The relation between PGDM and postpartum psychopathology may be partially explained by elevated HbA1c.