title: A prospective cohort study of modifiable risk factors for gestational diabetes among Hispanic women: design and baseline characteristics.
abstract: OBJECTIVE
  Women diagnosed with gestational diabetes mellitus (GDM) are at high risk for future diabetes, with rates of GDM consistently higher in Hispanic than non-Hispanic white women. Currently recognized risk factors for GDM are absent in up to half of affected women, and studies addressing modifiable risk factors for GDM in Hispanic women are sparse.
  
  
  METHODS
  Proyecto Buena Salud is an ongoing prospective cohort study of Hispanic women in Massachusetts designed to assess physical activity, psychosocial stress, and GDM risk. Bilingual interviewers recruit prenatal care patients early in pregnancy and assess activity, trait anxiety, perceived stress, and depressive symptoms using validated questionnaires.
  
  
  RESULTS
  Baseline characteristics of the first 632 participants are presented. Women were predominantly young (69% <24 years), were unmarried (87%), and had low levels of education (48% had less than high school). Women with high acculturation were less likely to live with a partner (OR: 0.6, 95% CI 0.4-0.8) than women with low acculturation. Few participants met physical activity guidelines during pregnancy (5.2%). Levels of perceived stress (mean 26.9 +/- 7.1), trait anxiety (mean 41.6 +/- 10.4), and depressive symptoms (33.2%) were high.
  
  
  CONCLUSIONS
  Proyecto Buena Salud represents a high-risk population of pregnant Hispanic women who are predominantly inactive, with higher levels of perceived stress, trait anxiety, and depressive symptoms compared to predominantly non-Hispanic white cohorts studied earlier. Therefore, Proyecto Buena Salud provides a unique opportunity to prospectively evaluate modifiable risk factors for GDM. Findings will inform prenatal behavioral intervention programs designed to address modifiable GDM risk factors.
authors.affiliation: Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, 715 North Pleasant Street, Amherst, MA 01003-9304, USA. LCT@schoolph.umass.edu
authors.forename: Lisa
authors.initials: L
authors.lastname: Chasan-Taber
authors.forename: Renée Turzanski
authors.initials: RT
authors.lastname: Fortner
authors.forename: Audra
authors.initials: A
authors.lastname: Gollenberg
authors.forename: John
authors.initials: J
authors.lastname: Buonnaccorsi
authors.forename: Nancy
authors.initials: N
authors.lastname: Dole
authors.forename: Glenn
authors.initials: G
authors.lastname: Markenson
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology / Q000208:ethnology; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control; D004522:Educational Status; D015444:Exercise; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008404:Massachusetts / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000208:ethnology; D011795:Surveys and Questionnaires; D055815:Young Adult