title: Perceived psychosocial stress and glucose intolerance among pregnant Hispanic women.
abstract: OBJECTIVE
  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 5.5mg/dL increase in screening glucose level (β=5.5; standard deviation=2.8; P=0.05), after adjusting for the same variables.
  
  
  CONCLUSIONS
  In this population of predominantly Puerto Rican women, stress patterns during pregnancy may influence the risk of glucose intolerance.
authors.affiliation: Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Silveira
authors.affiliation: Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
authors.forename: B W
authors.initials: BW
authors.lastname: Whitcomb
authors.affiliation: Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
authors.forename: P
authors.initials: P
authors.lastname: Pekow
authors.affiliation: Department of Kinesiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Braun
authors.affiliation: Baystate Medical Center, Springfield, MA, USA.
authors.forename: G
authors.initials: G
authors.lastname: Markenson
authors.affiliation: Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: N
authors.initials: N
authors.lastname: Dole
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Manson
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Solomon
authors.affiliation: Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA.
authors.forename: E T
authors.initials: ET
authors.lastname: Carbone
authors.affiliation: Division of Biostatistics & Epidemiology, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA. Electronic address: LCT@schoolph.umass.edu.
authors.forename: L
authors.initials: L
authors.lastname: Chasan-Taber
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000208:ethnology* / Q000523:psychology*; D005260:Female; D018149:Glucose Intolerance / Q000208:ethnology* / Q000523:psychology*; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications / Q000208:ethnology* / Q000378:metabolism; D055815:Young Adult
keywords: Epidemiology; Gestational diabetes; Hispanic; Prospective; Psychosocial stress