{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:02:28Z","timestamp":1765209748799,"version":"3.46.0"},"reference-count":28,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Dysregulation of the hypothalamic\u2013pituitary\u2013adrenal axis is implicated in both gestational diabetes mellitus (GDM) and mood disorders, suggesting a shared pathophysiology. However, the impact of GDM on maternal depressive symptoms, particularly among women with \u201clow and late\u201d fertility, remains poorly characterized. Methods: We compared the risk of postpartum depressive symptoms, assessed on the second postpartum day using the Edinburgh Postnatal Depression Scale (EPDS), with a cut-off score \u2265 12, and the Anhedonia, Anxiety, and Depression subscales, between Northeast Italian women with GDM and control participants with normal oral glucose tolerance tests (OGTT), classified as having \u201clow and late fertility\u201d. Results: Among the 2560 women included in the analysis, 231 (9.02%) had GDM. Compared with controls with normal OGTT, women with GDM were older (36.0 vs. 33.0 years, p &lt; 0.001) and had higher pre-pregnancy BMI (23.4 vs. 21.6 kg\/m2, p &lt; 0.001), but lower gestational weight gain (GWG) (11.0 vs. 13.0 kg, p &lt; 0.001), with no difference in parity [2.00 vs. 1.00, p = 0.5. In addition, GDM was not associated with increased postpartum depressive symptoms (15% EPDS scores \u226512 in both groups, p &gt; 0.9) or with Anhedonia, Anxiety, or Depression subscale scores (p = 0.7). Conclusions: Advanced maternal age and reduced parity, hallmarks of women postponing childbearing, do not appear to confer an increased risk of early postpartum mood comorbidities in the context of GDM. Promoting healthy physical and mental well-being among women in this demographic category requires integrated strategies encompassing nutrition, healthcare, and education.<\/jats:p>","DOI":"10.3390\/jpm15120609","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T15:30:07Z","timestamp":1765207807000},"page":"609","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gestational Diabetes Mellitus and Postpartum Depressive Symptoms in Women with Low and Late Fertility"],"prefix":"10.3390","volume":"15","author":[{"given":"Vincenzo","family":"Zanardo","sequence":"first","affiliation":[{"name":"Division of Perinatal Medicine, Abano Polyclinic, 35031 Abano Terme, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Straface","sequence":"additional","affiliation":[{"name":"Division of Perinatal Medicine, Abano Polyclinic, 35031 Abano Terme, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Volpe","sequence":"additional","affiliation":[{"name":"Division of Perinatal Medicine, Abano Polyclinic, 35031 Abano Terme, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnese","family":"Suppiej","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5712-7692","authenticated-orcid":false,"given":"Tiziana","family":"Battistin","sequence":"additional","affiliation":[{"name":"Department of Neurosciences and Rehabilitation, Paediatrics Section, University of Ferrara, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"10905","DOI":"10.1016\/j.diabres.2021.109050","article-title":"IDF Diabetes Atlas: Estimation of global and regional gestational diabetes mellitus prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group\u2019s criteria","volume":"183","author":"Wang","year":"2022","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"108044","DOI":"10.1016\/j.diabres.2020.108044","article-title":"Maternal age and the risk of gestational diabetes mellitus: A systematic review and meta-analysis of over 120 million participants","volume":"162","author":"Li","year":"2020","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.ejogrb.2009.04.023","article-title":"Scientific Committee of GISOGD Group. Gestational diabetes mellitus in Italy: A multicenter study","volume":"145","author":"Lapolla","year":"2009","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Plows, J.F., Stanley, J.L., Bakker, P.N., Reynolds, C.M., and Vickers, M.H. (2018). The pathophysiology of gestational diabetes mellitus. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19113342"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"826","DOI":"10.4093\/dmj.2024.0491","article-title":"Pregravid weight gain is associated with an increased risk of gestational diabetes","volume":"49","author":"Kim","year":"2025","journal-title":"Diabetes Metab. J."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Alejandro, E.U., Mamerto, T.P., Chung, G., Villavieja, A., Gaus, N.L., Morgan, E., and Pineda-Cortel, M.R.B. (2020). Gestational Diabetes Mellitus: A Harbinger of the Vicious Cycle of Diabetes. Int. J. Mol. Sci., 15.","DOI":"10.3390\/ijms21145003"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists (2020). Macrosomia: ACOG practice bulletin, number 216. Obstet. Gynecol., 135, e18\u2013e35.","DOI":"10.1097\/AOG.0000000000003606"},{"key":"ref_8","first-page":"e67595","article-title":"Hypothalamic-pituitary-adrenal axis: Unveiling the potential mechanisms involved in stress-induced Alzheimer\u2019s disease and depression","volume":"16","author":"Sharan","year":"2024","journal-title":"Cureus"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/acps.12998","article-title":"Depression precedes, but does not follow, gestational diabetes","volume":"139","author":"Clark","year":"2019","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_10","first-page":"9959779","article-title":"Associations between Gestational Diabetes and Anxiety or Depression: A Systematic Review","volume":"27","author":"OuYang","year":"2021","journal-title":"J. Diabetes Res."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Benton, M., Silverio, S.A., and Ismail, K. (2023). \u201cIt feels like medically promoted disordered eating\u201d: The psychosocial impact of gestational diabetes mellitus in the perinatal period. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0288395"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Zanardo, V., Polver, S., Zanardo, B., Volpe, F., Battistin, T., Ghiro, L., and Straface, G. (2025). Gestational Weight Gain and Postpartum Depressive Symptoms in High-income Women with Low and Late Fertility. Eur. J. Obstet. Gynecol. Reprod. Biol., 315.","DOI":"10.1016\/j.ejogrb.2025.114746"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Stoop, I.D. (2017). Late Motherhood in Low-Fertility Countries: Reproductive Intentions, Trends and Consequences. Preventing Age Related Fertility Loss, Springer Nature.","DOI":"10.1007\/978-3-319-14857-1"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1192\/bjp.150.6.782","article-title":"Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale","volume":"150","author":"Cox","year":"1987","journal-title":"Br. J. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"113161","DOI":"10.1016\/j.psychres.2020.113161","article-title":"Psychometric assessment of the Edinburgh Postnatal Depression Scale in an obstetric population","volume":"291","author":"Long","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2014). Diagnosis and classification of diabetes mellitus. Diabetes Care, 37, S81\u2013S90.","DOI":"10.2337\/dc14-S081"},{"key":"ref_17","unstructured":"(2025, June 26). Gravidanza Fisiologica\u2014Epicentro.iss.it. Available online: https:\/\/www.epicentro.iss.it\/materno\/pdf\/LG_Gravidanza.pdf."},{"key":"ref_18","unstructured":"Institute of Medicine and National Research Council Committee to Reexamine IOM Pregnancy Weight Guidelines (2009). Weight Gain During Pregnancy: Reexamining the Guidelines, Institute of Medicine."},{"key":"ref_19","first-page":"139","article-title":"Epidemiology of perinatal depression in Italy: Systematic review and meta-analysis","volume":"59","author":"Camoni","year":"2023","journal-title":"Ann. Dell\u2019Istituto Super. Sanit\u00e0"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1093\/humupd\/dmr026","article-title":"Why do people postpone parenthood? Reasons and social policy incentives","volume":"17","author":"Mills","year":"2011","journal-title":"Hum. Reprod. Update"},{"key":"ref_21","unstructured":"D\u2019Agostino, M., Meregaglia, M., Fattore, G., Ricciardi, W., and de Belvis, A.G. (2025, June 26). Italian Policies Aim to Address Low Birth Rates. Health Syst Policy Monit (HSPM). Available online: https:\/\/eurohealthobservatory.who.int\/monitors\/health-systems-monitor\/updates\/hspm\/italy-2023\/italian-policies-aim-to-address-low-birth-rates."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"54","DOI":"10.2307\/1964934","article-title":"An economic framework for fertility analysis","volume":"6","author":"Easterlin","year":"1975","journal-title":"Stud. Fam. Plan."},{"key":"ref_23","unstructured":"OECD (2024). Society at a Glance 2024: OECD Social Indicators, OECD Publishing."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s13679-022-00485-x","article-title":"Addressing Obesity in Preconception, Pregnancy, and Postpartum: A Review of the Literature","volume":"11","author":"Lim","year":"2022","journal-title":"Curr. Obes. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Siega-Riz, A.M., Bodnar, L.M., Stotland, N.E., and Stang, J. (2020). The current understanding of gestational weight gain among women with obesity and the need for future research. NAM Perspect.","DOI":"10.31478\/202001a"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"106","DOI":"10.21101\/cejph.a3944","article-title":"Body image concerns: Levels, correlates and gender differences among students in the United Kingdom","volume":"22","author":"Dibba","year":"2014","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wu, C.H., Gau, M.L., Cheng, S.F., Lee, T.Y., Chang, Y.J., and Kung, Y.Y. (2023). Excessive gestational weight gain and emotional eating are positively associated with postpartum depressive symptoms among Taiwanese women. BMC Womens Health, 23.","DOI":"10.1186\/s12905-023-02625-4"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"554","DOI":"10.4239\/wjd.v7.i19.554","article-title":"Relationship between depression and diabetes in pregnancy: A systematic review","volume":"7","author":"Ross","year":"2016","journal-title":"World J. Diabetes"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/12\/609\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T15:45:30Z","timestamp":1765208730000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/12\/609"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":28,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jpm15120609"],"URL":"https:\/\/doi.org\/10.3390\/jpm15120609","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,8]]}}}