Exploring the Psychosocial Predictors of Gestational Diabetes and Birth Weight

J Obstet Gynecol Neonatal Nurs. 2015 Nov-Dec;44(6):760-71. doi: 10.1111/1552-6909.12754. Epub 2015 Sep 24.

Abstract

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.

Keywords: Pregnancy Risk Assessment Monitoring System (PRAMS); birth weight; cumulative stress; depression; gestational diabetes; stress.

MeSH terms

  • Adolescent
  • Adult
  • Birth Weight*
  • Body Mass Index
  • Cohort Studies
  • Databases, Factual
  • Depression / complications
  • Diabetes, Gestational / epidemiology*
  • Diabetes, Gestational / etiology
  • Diabetes, Gestational / psychology*
  • Female
  • Humans
  • Infant, Newborn
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome*
  • Prenatal Care / organization & administration*
  • Psychology
  • Retrospective Studies
  • Risk Assessment
  • Spouse Abuse / statistics & numerical data
  • Stress, Psychological / complications
  • Utah
  • Young Adult