Maternal perceived discrimination and association with gestational diabetes

Area of Science:

• Reproductive Health
• Psychosocial Epidemiology
• Metabolic Disorders

Background:

• Maternal psychosocial stress and discrimination are linked to adverse pregnancy outcomes.
• Chronic stress responses, including metabolic and immune dysregulation, may be activated by perceived discrimination.
• The impact of perceived discrimination on gestational diabetes mellitus development is not well understood.

Purpose of the Study:

• To investigate the association between perceived maternal discrimination and the incidence of gestational diabetes mellitus.
• To explore the mediating role of prepregnancy obesity in this relationship.

Main Methods:

• Prospective cohort study of 595 pregnant women in the US (2013-2015).
• Williams Discrimination Scale used to assess perceived discrimination, dichotomized at the 75th percentile.
• Logistic regression and mediation analysis adjusted for demographic and clinical factors.

Main Results:

• Higher perceived discrimination (top quartile) was significantly associated with an increased risk of gestational diabetes mellitus (aOR, 2.11).
• Obesity mediated 22.6% of the association between perceived discrimination and gestational diabetes mellitus.
• Women with gestational diabetes mellitus were older, more likely to be multiparous, and have lower incomes.

Conclusions:

• Perceived discrimination is a risk factor for developing gestational diabetes mellitus.
• Obesity is a significant mediator in the pathway linking discrimination to gestational diabetes mellitus.
• Further research into mechanistic pathways is warranted.