Study examines stress and gestational diabetes among Latinas

By Patrick J. Callahan

Lisa E. Chasan-Taber, associate professor of Epidemiology, has received a five-year, $2.29 million grant from the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases. She will study how physical activity and psychosocial stress affect the risk of gestational diabetes mellitus (GDM) among Latinas.

Chasan-Taber will work with a team of scientists that includes Penelope S. Pekow, Public Health, Barry S. Braun, Exercise Science, and John P. Buonaccorsi, Mathematics and Statistics. They will study 1,824 women, predominantly Puerto Rican pre-natal care patients, from Baystate Medical Center in Springfield. The study is designed to increase understanding of the biological and social determinants of GDM, to identify the characteristics of pregnant women who are especially susceptible to the disease and suggest intervention strategies to prevent GDM.

“Gestational diabetes unmasks an underlying predisposition to type 2 diabetes that may re-emerge permanently in later life,” Chasan-Taber says. “In this way, a woman''s experience during pregnancy is offering a window into her future health—a window that does not exist in men. In this sense, pregnancy can be viewed as a maternal stress test.”

Gestational diabetes is the most common complication of pregnancy. It occurs when pregnant women who have never had diabetes before have high blood sugar (glucose) levels during pregnancy. If untreated, this condition can harm the baby. Women diagnosed with GDM are also at substantially increased risk of developing type 2 diabetes. It is estimated that half of women diagnosed with GDM will go on to develop type 2 diabetes within five years of diagnosis. In addition, rates of GDM are two-to-four times higher in Latinas as compared to non-Latina whites. Therefore, the major aims of this proposal are to evaluate new and timely hypotheses regarding modifiable determinants of GDM among Latinas.

The study calls for recruiting prenatal care patients at their first prenatal care visit, at eight to 12 weeks into the pregnancy. Bilingual interviewers will obtain detailed information on a variety of factors including physical activity patterns and psychosocial stress and physical conditions. Diet, cigarette smoking, substance abuse, medical and obstetric history, acculturation and socio-demographic factors will also be sought.

Weight will be measured. Two subsequent interviews, conducted at the time of routine ultrasound, in weeks 18-20 of pregnancy, and at GDM screening between weeks 24 to 28 will update information on the variables of interest. Lab reports will be abstracted for GDM screen results. After delivery of the baby, medical records will be abstracted to confirm incident GDM.

The proposal was developed by a multidisciplinary team of scientists and social scientists whose continued interactions throughout the study will bring new dimensions to understanding the biological and social determinants of GDM, identifying the characteristics of pregnant women who are especially susceptible to GDM, and suggesting intervention strategies to prevent GDM, Chasan-Taber says.