EFFECTS OF ALLOSTATIC LOAD ON GESTATIONAL DIABETES MELLITUS AND PRETERM LABOR: ANALYSIS OF A CHINESE COHORT

Problem statement: To demonstrate the relationship between allostatic load (AL), a measure of cumulative chronic stress during pregnancy, and the subsequent risk of gestational diabetes mellitus (GDM) and preterm labor. Methods: We conducted a cohort study and enrolled pregnant women who met the inclusion criteria. Our primary exposure was their AL in the second trimester, evaluated by a composite score of nine indicators (body mass index, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, plasma albumin, creatinine, total cholesterol, cortisol, and hypersensitive C-reactive protein). The outcome included the risk of GDM and spontaneous preterm birth. Multivariable logistic regression was performed to estimate the association between AL scores and the risk of GDM and preterm birth, adjusted for potential confounders. Results: A total of 601 women were enrolled in this analysis. Their median AL score was 2 with a range of 0-5. GDM was identified in 83/601(13.8%) while spontaneous preterm birth occurred in 41/601 (6.8%). After adjusting for potential confounding factors, we found high AL score was significantly associated with the risk of GDM (adjusted odds ratio [aOR] 1.42, 95%CI 1.15-1.76) and preterm labor (aOR 1.38, 95%CI 1.04-1.82). In addition, a significant inverse association was observed between AL scores and days of pregnancy (p-value = 0.009). Conclusion: Women with a higher AL score in the second trimester may have a higher risk of GDM and preterm birth. The assessment of AL and chronic stress during prenatal visits may help improve maternal and child health.

The authors declare no competing interests.