Associations between Gestational Diabetes and Anxiety or Depression: A Systematic Review

Table 1

The effects of anxiety and depression on blood glucose, delivery mode, and maternal and infant outcomes in pregnant women with GDM.

Author, year,	Population	Study design	Emotional indicator	The number of each group	Outcomes	Results
Tong, 2016, China [36]	GDM	RCT	SAS, SDS	Anxiety/depression; No anxiety/depression	Delivery mode; maternal and infant outcomes	Delivery way: anxiety and depression increased the incidence of cesarean section in pregnant women with GDM; Maternal and infant outcomes: anxiety and depression increase the incidence of adverse maternal and infant outcomes in pregnant women with GDM, including pregnancy vomiting, perinatal infection, hydramnios, premature rupture of membranes, postpartum hemorrhage, maternal elevated blood glucose, neonatal preterm birth, low weight, hypoglycemia, and neonatal asphyxia
Xu, 2015, China [37]	GDM	RCT	HAMA, HAMD		Blood glucose delivery mode; Maternal and infant outcomes	Blood glucose: in the anxiety group, fasting blood glucose, blood glucose 2 hours after meal, and glycosylated hemoglobin were increased in GDM pregnant women; Delivery way: cesarean section rate increased; Maternal and infant outcomes: in the anxiety group, adverse maternal and infant outcomes were increased in GDM pregnant women, including postpartum hemorrhage and low neonatal weight
Zhang, 2017, China [38]	GDM	RCT	HAMA		Blood glucose	Blood glucose: fasting blood glucose, 2 h postprandial blood glucose, and glycosylated hemoglobin of GDM pregnant women in the anxiety group were significantly increased
Wen, 2009, China [39]	GDM	RCT	SAS, SDS		Blood glucose	Blood glucose: fasting blood glucose was increased in the anxiety and depression groups
Gilbert, 2019, Malaysia [33]	GDM	Cross-sectional study	DASS-21		Maternal and infant outcomes	Maternal and infant outcomes: neonatal respiratory distress was positively correlated with depressive symptoms
Zhao, 2018, China [40]	GDM	RCT	SDS		Delivery mode; Maternal and infant outcomes	Delivery way: cesarean section rate of GDM pregnant women in the depression group increased significantly; Maternal and infant outcomes: adverse pregnancy outcomes were increased in the depression group, including premature rupture of membranes, postpartum hemorrhage, postpartum infection, macrosomia, neonatal asphyxia, and neonatal hypoglycemia
Packer, 2019, America [41]	GDM	Retrospective cohort study			Maternal and infant outcomes	Maternal and infant outcomes: adverse pregnancy outcomes were increased in the depression group, including preeclampsia, gestational hypertension, and preterm birth
Horsch, 2016, Britain [27]	GDM, 164 NDP	Cross-sectional study	DASS-21		Delivery mode; Maternal and infant outcomes	Maternal and infant outcomes: adverse pregnancy outcomes were increased in the depression group, including preeclampsia, gestational hypertension, and preterm birth
Egan, 2017, Ireland [21]	GDM, 32 DM-1, 108 NDP	Cohort study	DASS-21		Maternal and infant outcomes	Maternal and infant outcomes: there was no statistically significant association between maternal psychological variables and maternal; Hypertension during pregnancy, outcome of birth, preterm delivery, delivery type, or infant Apgar scores

GDM: gestational diabetes mellitus; NDP: nondiabetic pregnancies; DM-1: diabetes mellitus type 1; SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale; DASS-21: Depression, Anxiety, and Stress Scale-21; HAMA: Hamilton Anxiety Scale; HAMD: Hamilton Depression Scale; NICU: Neonatal Intensive Care Unit.