***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of this study is to prospect ively examine the association between maternal depressive symptoms in early pregnancy and risk of abnormal glucose tolerance ( AGT ) and impaired glucose tolerance ( IGT ) in mid-pregnancy . We evaluated this association among 934 participants in Proyecto Buena Salud , a prospect i ve cohort study of Hispanic ( predominantly Puerto Rican ) women in Western Massachusetts . Depressive symptoms were assessed in early pregnancy using the 10-item Edinburgh Postnatal Depression Scale . Scores ≥13 indicated at least probable minor depression and scores ≥15 indicated probable major depression . AGT and IGT were diagnosed using American Diabetes Association criteria . In early pregnancy , 247 ( 26.5 % ) participants experienced at least minor depression and 163 ( 17.4 % ) experienced major depression . A total of 123 ( 13.2 % ) were classified with AGT and 56 ( 6.0 % ) were classified with IGT . In fully-adjusted models , the odds ratio for AGT associated with minor depression was 1.20 ( 95 % CI 0.77–1.89 ) and for major depression was 1.34 ( 95 % CI 0.81–2.23 ) . The odds ratio for IGT associated with minor depression was 1.22 ( 95 % CI 0.62–2.40 ) and for major depression was 1.53 ( 95 % CI 0.73–3.22 ) . We did not observe an association with continuous screening glucose measures . Findings in this prospect i ve cohort of Hispanic women did not indicate a statistically significant association between minor or major depression in early pregnancy and AGT or screening glucose values in mid-pregnancy . Due to the small number of cases of IGT , our ability to evaluate the association between depression and IGT risk was constrained Background : Depression is a common and disabling complication of post-partum women . There is a paucity of research on postpartum depressive disorders and their predictors in women from Arab countries . Aim : The aim of this study was to determine the prevalence and identify risk factors of postpartum depression among Arab women in Qatar using Edinburgh Postnatal Depression Scale Score ( EPDS ) . Design : This is a prospect i ve cross-sectional study conducted during the period from January 2010 to May 2011 . Setting : Primary healthcare centers of the Supreme Council of Health , State of Qatar . Subjects : A representative sample of 1669 mothers within 6 months after delivery were approached and 1379 ( 82.6 % ) mothers participated in this study . Methods : The study was based on a face-to-face interview with a design ed diagnostic screening question naire . Occurrence of postpartum depressive symptoms was assessed by the EPDS . Also , socio-demographic characteristics , medical and family history , and obstetric variables of patients were collected through a design ed question naire . The diagnostic screening question naire was review ed and calculated the final score which identified the risk cases . Results : The prevalence of postpartum depression among the study sample was 17.6 % . Mothers of age above 35 years ( 49.9 % vs. 39.2 % ; p < 0.001 ) , low education below intermediate level ( 51 % vs. 35.8 % ; p < 0.001 ) , housewives ( 38.7 % vs. 29 % ; p = 0.03 ) , with low monthly income ( QR 5000–9999 ) ( 43.2 % vs. 32.2 % ; p < 0.001 ) were significantly at high risk for postpartum depression . Maternal complications ( 38.7 % vs. 26.1 % ; p < 0.001 ) and caesarean section ( 36.2 % vs. 28.8 % ; p = 0.022 ) were significantly higher among depressed mothers compared to non-depressed women .  Financial difficulties ( OR=2.04 ; p < 0.001 ) , prematurity ( OR=1.64 ; p = 0.025 ) , poor family support ( OR=1.52 ; p = 0.016 ) , dissatisfaction in marital life ( OR=1.26 ; p = 0.005 ) , poor marital relationship ( OR=1.13 ; p = 0.05 ) were the main predictors of postpartum depression . Conclusion : This prevalence of postpartum depression in women living in Qatar was comparable to previous epidemiological research done in developing countries . Financial difficulties , prematurity , lack of family support , and poor marital relationships have been identified as main risk factors for developing postpartum depression BACKGROUND We conducted a r and omized clinical trial to determine whether treatment of women with gestational diabetes mellitus reduced the risk of perinatal complications . METHODS We r and omly assigned women between 24 and 34 weeks ' gestation who had gestational diabetes to receive dietary advice , blood glucose monitoring , and insulin therapy as needed ( the intervention group ) or routine care . Primary outcomes included serious perinatal complications ( defined as death , shoulder dystocia , bone fracture , and nerve palsy ) , admission to the neonatal nursery , jaundice requiring phototherapy , induction of labor , cesarean birth , and maternal anxiety , depression , and health status . RESULTS The rate of serious perinatal complications was significantly lower among the infants of the 490 women in the intervention group than among the infants of the 510 women in the routine-care group ( 1 percent vs. 4 percent ; relative risk adjusted for maternal age , race or ethnic group , and parity , 0.33 ; 95 percent confidence interval , 0.14 to 0.75 ; P=0.01 ) . However , more infants of women in the intervention group were admitted to the neonatal nursery ( 71 percent vs. 61 percent ; adjusted relative risk , 1.13 ; 95 percent confidence interval , 1.03 to 1.23 ; P=0.01 ) . Women in the intervention group had a higher rate of induction of labor than the women in the routine-care group ( 39 percent vs. 29 percent ; adjusted relative risk , 1.36 ; 95 percent confidence interval , 1.15 to 1.62 ; P<0.001 ) , although the rates of cesarean delivery were similar ( 31 percent and 32 percent , respectively ; adjusted relative risk , 0.97 ; 95 percent confidence interval , 0.81 to 1.16 ; P=0.73 ) . At three months post partum , data on the women 's mood and quality of life , available for 573 women , revealed lower rates of depression and higher scores , consistent with improved health status , in the intervention group . CONCLUSIONS Treatment of gestational diabetes reduces serious perinatal morbidity and may also improve the woman 's health-related quality of life OBJECTIVE To examine anxiety levels of women diagnosed with gestational diabetes mellitus ( GDM ) and to compare these with glucose-tolerant ( GT ) women at similar stages of pregnancy . RESEARCH DESIGN AND METHODS Prospect i ve longitudinal study conducted on 50 women with GDM and 50 GT women . All women completed the  Mental Health Inventory ( MHI-5 ) forms  and the  Speilberger State-Trait Anxiety Inventory ( STAI ) at the beginning of the third trimester , antepartum , and 6 weeks postpartum . Specific questions were also assessed using a Likert scale . RESULTS Women with GDM , compared with GT women , had a higher level of anxiety ( state rather than trait ) at the time of the first assessment . However , before delivery and in the postpartum period , there were no significant differences in anxiety scores between the two groups . Women in both groups were positive about being tested for GDM and wished to be tested during future pregnancies . CONCLUSIONS There were no sustained increased levels of anxiety for women diagnosed with GDM . Concerns expressed about causing sustained maternal anxiety by testing for GDM could not be substantiated OBJECTIVE To examine changes in health status among women with gestational diabetes mellitus ( GDM ) and pregnancy-induced hypertension ( PIH ) . METHODS We examined perceived health status changes from the prepregnancy , as recalled at 12 - 20 weeks gestation , to the postpartum period in women with GDM ( n = 64 ) vs. unaffected gravidas ( n = 1233 ) and women diagnosed with PIH ( n = 148 ) vs. unaffected gravidas . We used patient survey and medical record data from a prospect i ve cohort study .  Health status measures included the Short Form-36 scales for physical function , vitality , and self-rated health and the Center for Epidemiologic Studies -Depression Scale ( CES-D ) . Multivariate logistic regression models controlled for age , parity , race , education , prepregnancy body mass index ( BMI ) and exercise levels , food insufficiency , and GDM or PIH during a prior pregnancy . RESULTS Women with PIH more often reported a significant decline in vitality ( odds ratio [ OR ] 1.51 , 95 % confidence interval [ CI ] 1.02 - 2.23 ) and self-rated health ( OR 2.12 , 95 % CI 1.19- 3.77 ) and an increase in depressive symptoms from prepregnancy to postpartum compared with unaffected women ( OR 1.84 , 95 % CI 1.11 - 3.05 ) . Decline in self-rated health was partially mediated by cesarean birth and preterm delivery . Similar proportions of women with GDM and unaffected women reported declines in health status measures . CONCLUSIONS Women with PIH , but not GDM , more often experience significant declines in health status from prepregnancy to postpartum than unaffected women BACKGROUND Although it has been hypothesized that the diabetes-depression relation is bidirectional , few studies have addressed this hypothesis in a prospect i ve setting . METHODS A total of 65 381 women aged 50 to 75 years in 1996 were observed until 2006 . Clinical depression was defined as having diagnosed depression or using antidepressants  , and depressed mood was defined as having clinical depression or severe depressive symptoms , ie , a 5-item Mental Health Index ( MHI-5 ) score of 52 or less . Self-reported type 2 diabetes mellitus was confirmed by means of a supplementary question naire vali date d by medical record review . RESULTS During 10 years of follow-up ( 531 097 person-years ) , 2844 incident cases of type 2 diabetes mellitus were documented . Compared with referents ( MHI-5 score of 86 - 100 ) who had the best depressive symptom scores , participants with increased severity of symptoms ( MHI-5 scores of 76 - 85 or 53 - 75 , or depressed mood ) showed a monotonic elevated risk of developing type 2 diabetes ( P for trend = .002 in the multivariable-adjusted model ) . The relative risk for individuals with depressed mood was 1.17 ( 95 % confidence interval [ CI ] , 1.05 - 1.30 ) after adjustment for various covariates , and participants using antidepressants were at a particularly higher relative risk ( 1.25 ; 95 % CI , 1.10 - 1.41 ) . In a parallel analysis , 7415 cases of incident clinical depression were documented ( 474 722 person-years ) . Compared with nondiabetic subjects , those with diabetes had a relative risk ( 95 % CI ) of developing clinical depression after controlling for all covariates of 1.29 ( 1.18 - 1.40 ) , and it was 1.25 ( 1.09 - 1.42 ) , 1.24 ( 1.09 - 1.41 ) , and 1.53 ( 1.26 - 1.85 ) in diabetic subjects without medications , with oral hypoglycemic agents , and with insulin therapy , respectively . These associations remained significant after adjustment for diabetes-related comorbidities . CONCLUSION Our results provide compelling evidence that the diabetes-depression association is bidirectional Gestational diabetes mellitus ( GDM ) affects 7 % of pregnant mothers , and those with GDM have increased rates of perinatal complications . Major depressive disorder ( MDD ) and its pharmacologic treatments are associated with obesity and adverse pregnancy outcomes . In this prospect i ve study , we investigated the relationship between abnormal GDM screens , maternal mood disorders , and adverse outcomes PURPOSE The purpose of this study was to investigate the effects of using a Coaching Program on Comprehensive Lifestyle Modification with pregnant women who have gestational diabetes . METHODS The research design for this study was a non-equivalent control group quasi-experimental study . Pregnant women with gestational diabetes were recruited from D women 's hospital located in Gyeonggi Province from April to October , 2013 . Participants in this study were 34 for the control group and 34 for the experimental group . The experimental group participated in the Coaching Program on Comprehensive Lifestyle Modification . The program consisted of education , small group coaching and telephone coaching over 4weeks . Statistical analysis was performed using the SPSS 21.0 program . RESULTS There were significant improvements in self-care behavior , and decreases in depression , 
    Output:
    
Importantly , we found limited guidance on the management of women with both  DIP and depression .