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Paediatr Perinat Epidemiol. 2015 Jul;29(4):271-80. doi: 10.1111/ppe.12198. Epub 2015 Jun 5.

The Risk of Gestational Diabetes Mellitus Following Bereavement: A Cohort Study from Denmark and Sweden.

Author information

1
Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
2
Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
3
Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA.
4
Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
5
Section for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
6
Research Program for Mental Child Health, Department of Public Health, Aarhus University and Institute of Handicap and Communication, Aarhus, Denmark.

Abstract

BACKGROUND:

We investigated whether bereavement of a close family member - a source of severe psychological stress exposure - the year before pregnancy is associated with gestational diabetes mellitus (GDM).

METHODS:

We studied pregnant women with livebirths in Denmark during 1994-2008 and with births in Sweden during 1987-2006 (n = 2,569,446). We obtained data on death of women's parents, siblings, and older children, and on demographic and health- and pregnancy-related factors through linkage between nationwide registers.

RESULTS:

In multivariable models, death of a close relative the year before pregnancy was associated with a 14% increased odds of GDM [95% confidence intervals (CIs) 1.03, 1.26]. The odds ratios corresponding to the loss of a child, parent, and sibling were 1.51 (95% CI: 1.17, 1.95), 1.12 (95% CI: 1.00, 1.25), and 0.68 (95% CI: 0.40, 1.25), respectively. Deaths due to cardiovascular diseases or diabetes were more closely related to the risk of GDM than other types of deaths. We found no association between unnatural deaths and the risk of GDM.

CONCLUSIONS:

Death of a close relative the year before pregnancy was associated with a modestly increased GDM risk. Our findings according to the relative's cause of death suggest that differences in screening for GDM among exposure groups and residual confounding by familial factors related to metabolic and cardiovascular diseases may have contributed to this association. If there is a causal stress effect on GDM in this predominantly Nordic population, it is most likely small.

KEYWORDS:

bereavement; cohort study; gestational diabetes mellitus; stress

PMID:
26053686
DOI:
10.1111/ppe.12198
[Indexed for MEDLINE]

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