HIV Insight: Gestational Diabetes

INTRODUCTION:

Early life abuse has been linked to later Type 2 diabetes, but its association with gestational diabetes has not been examined. The aim of this study was to examine the association between childhood and adolescent abuse victimization and risk of gestational diabetes in the Nurses' Health Study II.

METHODS:

Participants were asked about experiences of physical and sexual abuse in childhood or adolescence in 2001 and about history of pregnancy complications in 2009. Mothers of singleton live births who provided information on their abuse history comprised the study sample. Modified Poisson regression was used to estimate risk ratios and 95% CIs for gestational diabetes as a function of physical and sexual abuse victimization. Analyses were conducted in 2014-2015.

RESULTS:

Of 45,550 women in the analysis, 8% reported severe physical abuse and 11% reported forced sexual activity in childhood or adolescence. Approximately 3% (n=3,181) of pregnancies were complicated by gestational diabetes. In adjusted models, severe physical abuse was associated with a 42% greater gestational diabetes risk (risk ratio=1.42, 95% CI=1.21, 1.66) relative to no physical abuse. Forced sexual activity was associated with a 30% greater risk (95% CI=1.14, 1.49). Women with histories of both physical and sexual abuse were at higher risk than women exposed to a single type of abuse. These associations were not explained by overweight status in early adulthood or prior to pregnancy.

CONCLUSIONS:

Childhood and adolescent victimization is associated with increased risk of gestational diabetes in adult women.

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By: Mason SM1, Tobias DK2, Clark CJ3, Zhang C4, Hu FB5, Rich-Edwards JW6.

1Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: smmason@umn.edu.
2Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
3Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota.
4Epidemiology Branch, Division of Intramural Population Health Research, National Institute of Child Health and Development, Bethesda, Maryland.
5Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
6Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.