Perceived psychosocial stress and glucose intolerance among pregnant Hispanic women

• Published in: Diabetes & metabolism 2014-12, Vol.40 (6), p.466-475
• Main Authors: Silveira, M.L, Whitcomb, B.W, Pekow, P, Braun, B, Markenson, G, Dole, N, Manson, J.E, Solomon, C.G, Carbone, E.T, Chasan-Taber, L
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Diabetes, Gestational - ethnology; Diabetes, Gestational - psychology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Epidemiology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Gestational diabetes; Glucose Intolerance - ethnology; Glucose Intolerance - psychology; Hispanic; Hispanic Americans - psychology; Humans; Internal Medicine; Medical sciences; Pregnancy; Prevalence; Prospective; Prospective Studies; Psychosocial stress; Socioeconomic Factors; Stress, Psychological - complications; Stress, Psychological - ethnology; Stress, Psychological - metabolism; Young Adult
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2014.05.002

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 5.5 mg/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.