Relationships of social support with depression, anxiety and pregnancy outcome in patients with gestational diabetes mellitus in the second and third trimesters

Objective To explore the relationships of social support with depression, anxiety and pregnancy outcome in patients with gestational diabetes mellitus (GDM) in the second and third trimester of pregnancy.

Methods A longitudinal study was conducted to investigate the patients diagnosed with GDM in Yangzhou Maternal and Child Health Hospital from July 2020 to March 2022 by using Social Support Rating Scale (SSRS), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and other tools, and to follow up the pregnancy outcomes.

Results The social support scores of 211 GDM patients were (38.39±6.17), which were in the middle level. There were 102 cases of adverse pregnancy outcomes. Linear regression analysis showed that the working situation of pregnant women significantly affected the total score of social support (P < 0.05), family residence and family economic support during pregnancy affected the objective support score (P < 0.05), and the parity affected the subjective support score (P < 0.05). Workingstatus, husband's education background and family economic support during pregnancy affected the utilization of support (P < 0.05). The results of correlation analysis showed that objective support, utilization of support and total social support were negatively correlated with postpartum hemorrhage (r=-0.194, -0.240, -0.203, P < 0.05). Binary Logistic regression analysis showed that the utilization of support was a protective factor for postpartum hemorrhage (OR=0.440; 95%CI, 0.264 to 0.734; P=0.002), and depression (OR=2.118; 95%CI, 1.088 to 4.125; P=0.027) and pre-pregnancy body mass index (OR=1.223; 95%CI, 1.096 to 1.364; P < 0.001) were risk factors for macrosomia in GDM patients, and husband's education background was a protective factor for macrosomia in GDM patients (OR=0.268; 95%CI, 0.120 to 0.595, P=0.001).

Conclusion The level of social support is closely related to depression and anxiety. Therefore, improving the level of social support in the second and third trimesters of pregnancy is a potential intervention strategy to improve the pregnancy outcome of GDM patients.