DIABETES
WOMEN’S HEALTH
Preconception stress can increase gestational diabetes risk
A Harvard study examining women's preconception stress levels found a link between assisted reproductive techniques and heightened blood glucose
January 9, 2024
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Women with increased levels of preconception stress during fertility treatments show increases in pregnancy glucose levels, particularly when conceiving using intrauterine insemination (IUI), a recent study from Harvard Medical School has demonstrated."We found that maternal stress, evaluated before pregnancy, is negatively associated with cardiovascular health, measured as glucose levels during pregnancy," said Lidia Mínguez-Alarcón, Harvard Medical School, Brigham and Women's Hospital and Harvard.Conception with the use of assisted reproductive techniques is known to be associated with an increased risk for adverse metabolic conditions and glucose dysregulation in pregnancy.With some studies further showing stress can affect glucose metabolism, Mínguez-Alarcón and her colleagues conducted the Environment and Reproductive Health (EARTH) Study, a prospective cohort study investigating stress levels among women enrolled in the Massachusetts General Hospital Fertility Center, in Boston, between 2004 and 2019.The women's self-reported preconception stress levels were compared with blood glucose levels in late pregnancy, assessed as part of screening for gestational diabetes.In the analysis of 398 women, participants had a median age of 35 years at study entry and a median body mass index (BMI) of 23.4 kg/m2.Psychological assessment was conducted with the short version of the validated Perceived Stress Scale 4 (PSS-4) psychological stress survey, and the women had a median PSS-4 score of 5, ranging from 0 to 14 on a scale of 0-16, with 16 representing the highest stress. Questions on the survey include "How often have you felt difficulties were piling up so high that you could not overcome them?" with responses including never, almost never, sometimes, fairly often, and very often.Their mean pregnancy blood glucose level (mg/dL), assessed at a median of 26 weeks of pregnancy with a 1-hour nonfasting, 50-g glucose load test, was 119 mg/dL.Overall, 82 women (21%) had abnormal gestational glucose levels (≥ 140 mg/dL) post glucose load.
The research is published in the Journal of the Endocrine Society.