Background: Postpartum depression (PPD) is a common mental health condition, and women with elevated prenatal anxiety are at increased risk. Evidence from Kazakhstan remains limited. This study aimed to describe postpartum depressive symptoms and associated factors among women with elevated prenatal anxiety who received routine perinatal care and participated in the PRISM prenatal psychoeducational program. Methods: This prospective single-arm cohort study with postpartum follow-up was conducted in Astana, Kazakhstan. Of 1232 pregnant women screened, 234 women with elevated prenatal anxiety participated in the PRISM program, and 226 completed the postpartum assessment. Because no control group was included, the study was not designed to evaluate the effectiveness of PRISM or establish causal effects. Postpartum depressive symptoms were assessed using the Postpartum Depression Screening Scale–Short Form (PDSS-SF). Descriptive statistics were calculated, and associations with age, parity, and postpartum assessment period were examined using Spearman’s rank correlation and non-parametric tests. Results: The mean PDSS-SF score was 20.65 ± 6.00. Using a cut-off score of ≥17, 158 of 226 participants screened positive for clinically significant depressive symptoms, corresponding to 69.9% (95% confidence interval (CI): 63.6–75.5%). Scores were highest among women assessed between 6 weeks and 6 months postpartum (p < 0.001). Age showed a weak negative correlation with depressive symptoms, whereas parity was not significantly associated. The most frequently reported symptoms were sleep disturbance, loneliness, and depressed mood. Conclusions: A substantial burden of postpartum depressive symptoms was observed in this high-risk cohort. The findings support early identification of prenatal anxiety, continued postpartum screening, and access to appropriate psychological and psychiatric care. Controlled studies are needed to evaluate PRISM and similar preventive programs.

Background/Objectives: Gestational diabetes mellitus (GDM) is a common metabolic complication of pregnancy associated with adverse maternal and neonatal outcomes. Data on GDM in Central Asian populations remain limited. This study aimed to identify factors associated with GDM and evaluate selected obstetric outcomes among pregnant women in Kazakhstan. Methods: A retrospective case–control study based on medical record data was conducted among 256 pregnant women, including 106 women with GDM and 150 women with normal glucose tolerance. GDM was diagnosed using a 75 g oral glucose tolerance test according to the International Association of Diabetes and Pregnancy Study Groups criteria. Demographic, clinical, anthropometric, laboratory, and obstetric data were obtained from medical records. Multivariable logistic regression was used to identify factors statistically associated with GDM. Obstetric outcomes were compared using unadjusted analyses. Results: Women with GDM were older than controls (31.6 ± 5.8 vs. 28.6 ± 5.3 years, p < 0.001) and had a higher pre-pregnancy body mass index (BMI) (29 [25–33] vs. 26 [23–29] kg/m², p < 0.001). Thyroid-stimulating hormone levels were also higher in the GDM group (p = 0.026). In multivariable analysis, pre-pregnancy obesity (adjusted OR 4.54, 95% CI 2.08–9.91; p < 0.001) and educational level (overall p = 0.001) remained associated with GDM, whereas maternal age was not independently associated after adjustment. Hypertension (24.5% vs. 2.0%; p < 0.001), eclampsia (3.8% vs. 0%; p = 0.028), cesarean delivery (52.8% vs. 28.0%; p < 0.001), and fetal macrosomia (21.7% vs. 12.0%; p = 0.037) were more frequent among women with GDM. No significant difference was observed in neonatal birth weight. Conclusions: Pre-pregnancy obesity and educational level were independently associated with GDM. Women with GDM more frequently experienced hypertensive complications, cesarean delivery, and fetal macrosomia; however, these findings were based on unadjusted analyses and should be interpreted cautiously. Further multicenter prospective studies are needed to confirm these findings in Central Asian populations.