Introduction
The influence of women's childhood psychosocial environment and subsequent preconception
mental health on risk of developing gestational diabetes mellitus is unclear. This
study examines this relationship.
Methods
Data from a population-based cohort study, the Australian Longitudinal Study on Women's
Health, were used. A total of 6,317 women with no pre-existing diabetes were followed
from 1996 (aged 18–23 years) until 2015. Gestational diabetes mellitus diagnosis was
self-reported. Exposures to eight subcategories of adverse childhood experiences were
recalled. Individual subcategories and total number of adverse childhood experiences
were examined. Log-binomial regression models with generalized estimating equations
were used to estimate RRs and 95% CIs. Analyses were adjusted for early life, preconception,
and antenatal gestational diabetes mellitus risk factors. Effect modification by preconception
mental health was tested using cross-product terms. Analyses were conducted in 2018.
Results
Among 11,556 pregnancies, 4.7% were complicated by gestational diabetes mellitus.
Compared with women not exposed to adverse childhood experiences, exposure to any
three adverse childhood experiences (6% of women, adjusted RR=1.73, 95% CI=1.02, 3.01)
or four or more adverse childhood experiences (7%, adjusted RR=1.76, 95% CI=1.04,
2.99) was associated with elevated gestational diabetes mellitus risk in women with
preconception depressive symptoms. Among the subcategories of adverse childhood experiences,
physical abuse, and household substance abuse were associated with higher gestational
diabetes mellitus risk. Adverse childhood experiences were not associated with gestational
diabetes mellitus in women without depressive symptoms before pregnancy (p=0.01, for interaction).
Conclusions
These findings suggest that, in addition to primary prevention of childhood adversity,
strategies to curb poor mental health trajectories among women exposed to adverse
childhood experiences may contribute to prevention of gestational diabetes mellitus.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Increasing prevalence of gestational diabetes mellitus: a public health perspective.Diabetes Care. 2007; 30: S141‒S146
- Prevalence of gestational diabetes and risk of progression to type 2 diabetes: a global perspective.Curr Diab Rep. 2016; 16: 7
- The diabetic intrauterine environment: short and long-term consequences.in: Kim C Ferrara A Gestational Diabetes During and After Pregnancy. Springer-Verlag, London, UK2010: 227‒239
- Maternal comorbidities during gestational diabetes mellitus: obstetrical complications, prematurity, and delivery.in: Kim C Ferrara A Gestational Diabetes During and After Pregnancy. Springer-Verlag, London, UK2010: 215‒226
- Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health.Lancet. 2018; 391: 1830‒1841
- Association between age at menarche and gestational diabetes mellitus: the Australian Longitudinal Study on Women's Health.Am J Epidemiol. 2017; 185: 554‒561
- Preconception care to reduce maternal and childhood mortality and morbidity.WHO Press, Geneva2013www.who.int/maternal_child_adolescent/documents/concensus_preconception_care/en/Date accessed: April 26, 2019
- Pre-pregnancy counselling.Published 2017
- The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: “Think Nutrition first”.Int J Gynecol Obstet. 2015; 131: S213‒S253
- Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study.Am J Prev Med. 1998; 14: 245‒258
- The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis.Lancet Public Health. 2017; 2: e356‒e366
- Lifetime maternal experiences of abuse and risk of pre-natal depression in two demographically distinct populations in Boston.Int J Epidemiol. 2011; 40: 375‒384
- Childhood and adolescent adversity and cardiometabolic outcomes: a scientific statement from the American Heart Association.Circulation. 2018; 137: e15‒e28
- Pre-pregnancy dietary patterns and risk of gestational diabetes mellitus: results from an Australian population-based prospective cohort study.Diabetologia. 2015; 58: 2726‒2735
- Physical activity and the risk of gestational diabetes mellitus: a systematic review and dose–response meta-analysis of epidemiological studies.Eur J Epidemiol. 2016; 31: 967‒997
- Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study.BMJ. 2014; 349: g5450
- A prospective study of pregravid determinants of gestational diabetes mellitus.JAMA. 1997; 278: 1078‒1083
- A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period.Diabetologia. 2016; 59: 2594‒2602
- History of mood or anxiety disorders and risk of gestational diabetes mellitus in a population-based cohort.Diabet Med. 2018; 35: 147‒151
- Preconceptional and maternal obesity: epidemiology and health consequences.Lancet Diabetes Endocrinol. 2016; 4: 1025‒1036
- Maternal childhood adversity, prepregnancy obesity, and gestational weight gain.Am J Prev Med. 2016; 50: 463‒469
- Metabolic consequences of stress during childhood and adolescence.Metabolism. 2012; 61: 611‒619
- Biological embedding of childhood adversity: from physiological mechanisms to clinical implications.BMC Med. 2017; 15: 135
- Childhood adversities and depression in adulthood: current findings and future directions.Clin Psychol. 2017; 24: 140‒153
- Maltreatment in childhood substantially increases the risk of adult depression and anxiety in prospective cohort studies: systematic review, meta-analysis, and proportional attributable fractions.Psychol Med. 2016; 46: 717‒730
- A life course approach to reproductive health: theory and methods.Maturitas. 2010; 65: 92‒97
- Abuse in childhood or adolescence and gestational diabetes: a retrospective cohort study.Am J Prev Med. 2016; 50: 436‒444
- Women's Health Australia: Recruitment for a national longitudinal cohort study.Women & Health. 1998; 28: 23‒40
- Cohort profile: the Australian Longitudinal Study on Women's Health.Int J Epidemiol. 2005; 34: 987‒991
- Agreement between self-reported perinatal outcomes and administrative data in New South Wales, Australia.BMC Pregnancy Childbirth. 2015; 15: 161
- Development of the perceived stress questionnaire for young women.Psychol Health Med. 2002; 7: 189‒201
- The MOS 36-item short-form health survey (SF−36): I. Conceptual framework and item selection.Med Care. 1992; 30: 473‒483
- Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale).Am J Prev Med. 1994; 10: 77‒84
- The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle-aged women in a study of iron supplementation.Aust N Z J Public Health. 2000; 24: 576‒583
- Statistical analysis of correlated data using generalized estimating equations: an orientation.Am J Epidemiol. 2003; 157: 364‒375
- Stata multiple-imputation reference manual: release. 15. Stata Press, College Station, TX2017
- Multiple significance tests: the Bonferroni method.BMJ. 1995; 310: 170
- Chapter 4: Single mediator model details.Introduction to Statistical Mediation Analysis: Multivariate Applications. Routledge, New York, NY2013
- Chapter 5: Multiple mediator model.Introduction to StatisticalMediation Analysis: Multivariate Applications. Routledge, New York, NY2013: 103-127
VanDerWeele T. Chapter 2. Mediation: Introduction and regression-based approaches. In: Explanation in Causal Inference. New York, NY: Oxford University Press; 2015:20-64.
- The link between adverse childhood experiences and diabetes.Curr Diab Rep. 2016; 16: 54
- Adverse childhood experiences and risk of type 2 diabetes: a systematic review and meta-analysis.Metabolism. 2015; 64: 1408‒1418
- Association of childhood adversities and early-onset mental disorders with adult-onset chronic physical conditions.Arch Gen Psychiatry. 2011; 68: 838‒844
- Childhood adversities and adult cardiometabolic health: does the quantity, timing, and type of adversity matter?.J Aging Health. 2015; 27: 1311‒1338
- A prospective investigation of physical health outcomes in abused and neglected children: new findings from a 30-year follow-up.Am J Public Health. 2012; 102: 1135‒1144
- Using path analysis to examine the relationship between sexual abuse in childhood and diabetes in adulthood in a sample of U.S. adults.Prev Med. 2018; 108: 1‒7
- Early adverse experiences and the developing brain.Neuropsychopharmacology. 2016; 41: 177‒196
- Neuroimaging of child abuse: a critical review.Front Hum Neurosci. 2012; 6: 52‒75
- The traumatic stress response in child maltreatment and resultant neuropsychological effects.Aggress Violent Behav. 2011; 16: 87-97
- Current research trends in early life stress and depression: review of human studies on sensitive periods, gene-environment interactions, and epigenetics.Exp Neurol. 2012; 233: 102‒111
- Early-life adversity and physical and emotional health across the lifespan: a neuroimmune network hypothesis.Biol Psychiatry. 2016; 80: 23‒32
- Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress.J Psychosom Res. 2002; 53: 865‒871
- Adverse childhood experiences, allostasis, allostatic load, and age-related disease.Physiol Behav. 2012; 106: 29‒39
- Stability and change in retrospective reports of childhood experiences over a 5-year period: findings from the Davis Longitudinal Study.Psychol Aging. 2009; 24: 715‒721
- Validity of adult retrospective reports of adverse childhood experiences: review of the evidence.J Child Psychol Psychiatry. 2004; 45: 260‒273
Article info
Publication history
Published online: July 25, 2019
Identification
Copyright
© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
