Exploring the Psychosocial Predictors of Gestational Diabetes and Birth Weight
Insights
Maternal stress, depression, and abuse did not predict gestational diabetes mellitus (GDM). However, stress impacted birth weight (BW), highlighting an opportunity for nurses to screen for and manage maternal stressors.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Gestational diabetes mellitus (GDM) and birth weight (BW) are critical indicators of maternal and infant health.
- Sociodemographic and behavioral factors significantly influence pregnancy outcomes.
- The impact of psychological stressors like depression, abuse, and stress on GDM and BW requires further elucidation.
Purpose of the Study:
- To identify key sociodemographic and behavioral predictors of GDM and BW.
- To investigate the influence of maternal stress, depression, and abuse on GDM and BW, controlling for sociodemographic variables.
Main Methods:
- Retrospective correlational study utilizing Utah birth certificate data (2009-2011).
- Analysis of 4,682 live births, including sociodemographic data, BMI, and self-reported stress, depression, and abuse.
- Hierarchical stepwise logistical regression to determine predictors of GDM and BW.
Main Results:
- Cumulative depression, stress, and abuse were not found to be predictors of GDM.
- Cumulative stress emerged as a significant predictor of BW.
- Higher GDM incidence was associated with poverty, older maternal age, lower education, non-White race, obesity, and prenatal depression.
Conclusions:
- Maternal stress, while not a predictor of GDM, significantly influences birth weight.
- Depression and abuse did not predict GDM or BW in this cohort.
- Nurses have an opportunity to screen for and manage maternal stressors to positively impact birth weight outcomes.
Objective:
To determine the best sociodemographic and behavioral predictors for gestational diabetes mellitus (GDM) and birth weight (BW) and whether stress, depression, or abuse influences GDM and BW after controlling for sociodemographic variables.
Design:
Retrospective correlational.
Setting:
Utah Pregnancy Risk Monitoring System and birth certificate data.
Participants:
We analyzed data from the birth certificates of 4,682 women with live births between 2009 and 2011 in Utah. During that time, a total of 143,373 live births occurred in the state. Data were predominantly from non-Hispanic White, married, or partnered women with average age of 27.5 years and average body mass index (BMI) of 25.1.
Methods:
Stress, cumulative depression, and abuse were operationalized based on previous analysis, and control and covariate data (e.g., age, BMI, race, ethnicity, education, marital status) were collected. Bivariate analysis was used to identify associations between variables, and a hierarchical stepwise logistical regression was conducted to identify best predictors of GDM and BW.
Results:
We did not find that cumulative depression, stress, or abuse was a predictor of GDM, and only cumulative stress was a predictor of BW. More incidences of GDM were observed in women who were poor, older, less educated, non-White, obese, or experienced depression during pregnancy.
Conclusion:
Unlike depression or abuse, stress is often overlooked by providers. This finding represents an unmet opportunity for nurses to screen for and assist women with stressors to positively affect birth weight.
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