Perceived psychosocial stress and glucose intolerance among pregnant Hispanic women

Author Department

Ob/Gyn

Document Type

Article, Peer-reviewed

Publication Date

12-2014

Abstract

AIM:

Prior literature suggests a positive association between psychosocial stress and the risk of diabetes in non-pregnant populations, but studies during pregnancy are sparse. We evaluated the relationship between stress and glucose intolerance among 1115 Hispanic (predominantly Puerto Rican) prenatal care patients in Proyecto Buena Salud, a prospective cohort study in Western Massachusetts (2006-2011).

METHODS:

Cohen's Perceived Stress Scale (PSS-14) was administered in early (mean=12.3weeks gestation; range 4.1-18weeks) and mid- (mean=21.3weeks gestation; range 18.1-26weeks) pregnancy. Participants were classified as having a pregnancy complicated by gestational diabetes mellitus, impaired glucose tolerance, and abnormal glucose tolerance, based on the degree of abnormality on glucose tolerance testing between 24 and 28weeks of gestation.

RESULTS:

The prevalence of gestational diabetes mellitus, impaired glucose tolerance, and abnormal glucose tolerance was 4.1%, 7.2%, and 14.5%, respectively. Absolute levels of early or mid-pregnancy stress were not significantly associated with glucose intolerance. However, participants with an increase in stress from early to mid-pregnancy had a 2.6-fold increased odds of gestational diabetes mellitus (95% confidence intervals: 1.0-6.9) as compared to those with no change or a decrease in stress after adjusting for age and pre-pregnancy body mass index. In addition, every one-point increase in stress scores was associated with a 5.5mg/dL increase in screening glucose level (β=5.5; standard deviation=2.8; P=0.05), after adjusting for the same variables.

CONCLUSION:

In this population of predominantly Puerto Rican women, stress patterns during pregnancy may influence the risk of glucose intolerance.

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