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Diabetes Metab. 2014 Dec;40(6):466-75. doi: 10.1016/j.diabet.2014.05.002. Epub 2014 Jun 16.

Perceived psychosocial stress and glucose intolerance among pregnant Hispanic women.

Author information

1
Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
2
Department of Kinesiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
3
Baystate Medical Center, Springfield, MA, USA.
4
Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA.
5
Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
6
Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
7
Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA.
8
Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA. Electronic address: LCT@schoolph.umass.edu.

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 = 12.3 weeks gestation; range 4.1-18 weeks) and mid- (mean = 21.3 weeks gestation; range 18.1-26 weeks) 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 28 weeks 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.

KEYWORDS:

Epidemiology; Gestational diabetes; Hispanic; Prospective; Psychosocial stress

PMID:
24948416
PMCID:
PMC4810008
DOI:
10.1016/j.diabet.2014.05.002
[Indexed for MEDLINE]
Free PMC Article
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