Relationships between early-life family poverty and relative socioeconomic status with gestational diabetes, preeclampsia, and hypertensive disorders of pregnancy later in life

• Published in: Annals of epidemiology 2023-10, Vol.86, p.8-15
• Main Authors: Bittner, Julia M.P., Gilman, Stephen E., Zhang, Cuilin, Chen, Zhen, Cheon, Bobby K.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Diabetes, Gestational - epidemiology; Diabetes, Gestational - etiology; Eclampsia; Female; Gestational diabetes mellitus; Humans; Hypertension, Pregnancy-Induced - epidemiology; Hypertensive disorders of pregnancy; Life course epidemiology; Longitudinal Studies; Poverty; Pre-Eclampsia - epidemiology; Pre-Eclampsia - etiology; Preeclampsia; Pregnancy; Pregnancy Complications; Relative socioeconomic status; Risk Factors; Social Class; Socioeconomic status; Subjective socioeconomic status
• ISSN: 1047-2797; 1873-2585; 1873-2585
• DOI: 10.1016/j.annepidem.2023.08.002

Low early-life absolute and relative socioeconomic status (SES) may contribute to socioeconomic disparities in pregnancy complications (i.e., gestational diabetes mellitus [GDM], preeclampsia/eclampsia [PE], hypertensive disorders of pregnancy [HDP; preeclampsia/eclampsia, gestational hypertension, chronic hypertension]), but their independent associations with pregnancy complications have not been studied. This study investigated associations of early-life poverty and relative SES with risks of GDM, PE, and HDP. National Longitudinal Study of Adolescent to Adult Health data were used (GDM n = 802; PE n = 813; HDP n = 801). Objective poverty was defined as wave I low-income or receipt of federal nutrition assistance benefits. Relative SES was self-reported at wave V (ages 33–39) by asking whether the participant’s family was financially worse off than average when growing up. Logistic regressions assessed relationships between poverty, relative SES, and self-reported lifetime diagnoses of GDM, PE, or HDP. Lifetime prevalences of GDM, PE, and HDP were 9.23%, 12.00%, and 21.93%, respectively. Low relative SES (odds ratio: 2.04 [1.07, 3.89]) and poverty (odds ratio: 1.81 [0.97, 3.38]) were independently associated with GDM but not with PE or HDP. Early-life poverty and relative SES are associated with GDM; understanding the mechanisms underlying these associations may help identify novel intervention targets to reduce socioeconomic disparities in GDM. •Family poverty during adolescence is associated with the risk of later GDM.•Low, but not high, relative SES when growing up is associated with later GDM risk.•Neither early-life family poverty nor relative SES are associated with PE or HDP.