Gestational Diabetes Mellitus and Mental Illness in Alberta

  • Author / Creator
    Beka, Qendresa
  • Introduction: Research has shown a bidirectional relationship between type 2 diabetes and mental illness, and worse health outcomes for patients with both illnesses than those with either condition alone. However, there is limited research on the relationship between mental illness and gestational diabetes mellitus (GDM), and their impact on future health outcomes. This thesis investigated three questions: (1) the impact of GDM on the development of mental illness during pregnancy and post-partum; (2) the impact of mental illness prior to pregnancy on the development of GDM in pregnancy; and (3) the impact of GDM, mental illness, and both illnesses on the development of type 2 diabetes, hypertension and cardiovascular disease (CVD). Methods: Administrative data from a population perinatal health registry was linked to physician claims, hospitalization records and outpatient visits to identify diagnosis of mental illness, diabetes, hypertension and cardiovascular disease among women who delivered in Alberta, Canada between April 1, 1999 and March 31, 2010. For the first study, generalized estimating equations (GEE) were used to determine the odds ratios of developing a mental illness during pregnancy and post-partum among women with GDM. GEE was also used for the second study, determining the odds ratio of GDM comparing women with and without a history of mental illness. The third study used cumulative incidence curves and cox proportional hazards to compare the development of diabetes, hypertension and cardiovascular disease among women with the following conditions during pregnancy: no GDM or mental illness, mental illness only, GDM only, or both GDM and mental illness. Results: GDM in pregnancy was not associated with diagnosis of incident mental illness in pregnancy (OR=1.06, 95%CI=0.98,1.13) or post-partum (OR=1.03, 95%CI=0.97,1.10). Theodds of developing GDM was higher for women with a history of mental illness than without (OR=1.10, 95%CI=1.06,1.14). Women with both GDM and mental illness had the highest hazard rates for diabetes (22.4, 95%CI=19.2, 26.1), hypertension (2.0, 95%CI=1.7,2.3) and CVD (1.7, 95%CI=0.9,3.4). Women with GDM only had a significantly higher risk of diabetes (20.5, 95%CI=18.4, 22.9) and hypertension (1.7, 95%CI=1.6, 1.9) than women with mental illness (1.3, 95%CI=1.1, 1.5) and (1.1, 95%CI=1.1,1.2) respectfully. The risk for cardiovascular disease was higher for women with only mental illness (1.6, 95%CI=1.3, 1.9) than those with only GDM (1.5, 95%CI=1.0, 2.3). Conclusion: GDM does not increase the risk of developing a mental illness in pregnancy or post-partum. However, women with a history of mental disorders prior to pregnancy have an increased risk of GDM. GDM and mental illness in pregnancy each result in increased rates of chronic disease and the highest risk is for women with both GDM and mental illness.

  • Subjects / Keywords
  • Graduation date
  • Type of Item
  • Degree
    Master of Science
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
  • Institution
    University of Alberta
  • Degree level
  • Department
    • Department of Public Health Sciences
  • Specialization
    • Epidemiology
  • Supervisor / co-supervisor and their department(s)
    • Kaul, Padma (Medicine)
  • Examining committee members and their departments
    • Kingston, Dawn (University of Calgary)
    • Kaul, Padma (Medicine)
    • Johnson, Jeff (School of Public Health)
    • McDonald, Sheila (University of Calgary)