Maternal stress and blood sugar metabolization during pregnancy, and associations with adverse outcomes.

怀孕期间母亲的压力和血糖代谢及其与不良后果的关联。

• 批准号: 10644295
• 负责人: Anna M Strahm
• 金额: $ 28.14万
• 依托单位: SANFORD RESEARCH/USD
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10644295
• 关键词: African American; American Indians; Anxiety; Blood Glucose; Characteristics; Child; Complications of Diabetes Mellitus; Data; Diagnosis; Family history of; Gestational Diabetes; Glucose; Health; Heritability; Individual; Laboratories; Maternal Health; Medical Records; Mental Health; Modeling; Mothers; Native Americans; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Outcome; Participant; Pathway interactions; Patients; Physiological; Pregnancy; Pregnancy Outcome; Pregnant Women; Process; Prospective Studies; Psychophysiology; Psychosocial Factor; Research; Retrospective Studies; Risk; Risk Factors; Role; Rural Population; Stress; Testing; Woman; advanced maternal age; adverse outcome; adverse pregnancy outcome; biopsychosocial factor; care providers; ethnic identity; experience; glucose metabolism; health disparity; high body mass index; improved; innovation; insight; maternal depression; maternal stress; novel; perinatal outcomes; population health; prenatal health; prevent; prospective; racial and ethnic; racial disparity; recruit; stress reactivity

Gestational diabetes mellitus (GDM) impacts an estimated 3% to 9% of pregnancies, increasing the risk of serious health complications for mother and child. The identified risk factors for developing GDM include both individual characteristics (e.g., higher body mass index, advanced maternal age) and heritable factors (e.g., family history of Type 2 diabetes, historically marginalized racial/ethnic identity). However, approximately 50% of GDM diagnoses occur in the absence of any known risk factor(s). Additional research on biopsychosocial factors related to glucose metabolism, such as mental health and stress processes, may help to identify individuals at risk. We hypothesize that there will be associations between maternal mental health, glucose metabolization, and GDM related adverse pregnancy outcomes that are moderated by stress, and that the magnitude of the of these associations underlay GDM health disparities experienced by African American (AA) and Native American (NA) women in comparison to non- Hispanic white (NHW) women. This project will: 1) identify stress-related variables that moderate associations between maternal mental health and GDM-related health outcomes; 2) delineate associations among maternal mental health, stress, glucose metabolization, and related adverse outcomes, differ among AA, NA, and NHW women; and 3) increase our understanding of how psychophysiological stress reactivity interacts with maternal stress and mental health, to predict glucose metabolization during pregnancy, and associations with adverse perinatal outcomes. A retrospective study of 4,845 de-identified pregnancy-related medical records of Sanford Health patients, and a prospective study which follows 150 pregnant women recruited from Sanford Health prenatal care providers will be conducted. Data from medical records and prospective assessments will be used to identify associations between maternal health, mental health, blood glucose metabolization and pregnancy outcomes. Indicators of stress will be tested as moderators in these associations. These analyses will identify which combinations of maternal depression, anxiety, and stress, are associated with increased risk of GDM and GDM related outcomes. The retrospective study will compare the impact of modeled associations, among women of NA, AA, and NHW heritage, with results that will provide insights as to the role of psychosocial factors in GDM related health disparities among AA and NA women. The prospective study, participants will complete a laboratory stress task while we assess physiological markers of stress reactivity. Results from the prospective study will provide novel information about the role of physiological pathways by which combinations of maternal mental health and stress impact blood sugar metabolization. We aim to improve our ability to identify women at risk and prevent GDM and related complications.

妊娠期糖尿病(GDM)影响了大约3%到9%的妊娠，增加了严重 母亲和孩子的健康并发症。已确定的发生妊娠期糖尿病的危险因素包括个体 特征(例如，较高的体重指数、较高的产妇年龄)和可遗传因素(例如 二型糖尿病、历史上被边缘化的种族/民族认同)。然而，大约50%的妊娠期糖尿病诊断 在没有任何已知危险因素的情况下发生(S)。与葡萄糖相关的生物、心理、社会因素的进一步研究 新陈代谢，如心理健康和压力过程，可能有助于识别处于危险中的个人。我们假设 产妇的心理健康、葡萄糖代谢和妊娠期糖尿病相关不良反应之间存在关联。 妊娠结局受到压力的影响，而这些关联的大小是妊娠期糖尿病的基础 非裔美国人(AA)和印第安人(NA)女性与非美国人之间的健康差距 西班牙裔白人(Nhw)女性。该项目将：1)确定与压力相关的变量，以缓和 产妇心理健康和妊娠期糖尿病相关健康结局之间的关系；2)描述产妇之间的关系 精神健康、压力、葡萄糖代谢和相关的不良后果在AA、NA和NHW之间有所不同。 以及3)增加我们对心理生理应激反应如何与母亲 压力和心理健康，以预测怀孕期间的葡萄糖代谢，以及与不良反应的关系 围产儿结局。桑福德4845例不明原因妊娠相关病历的回顾性研究 健康患者，以及一项前瞻性研究，跟踪调查了从Sanford Health产前招募的150名孕妇 将对照顾者进行调查。来自医疗记录和前瞻性评估的数据将用于确定 孕妇健康、心理健康、血糖代谢与妊娠结局的关系。 压力指标将作为这些关联的主持人进行测试。这些分析将确定哪些组合 母亲抑郁、焦虑和压力的增加与妊娠期糖尿病和妊娠期糖尿病相关结局的风险增加有关。 这项回溯性研究将在NA、AA和NHW妇女中比较模型化关联的影响。 遗产，结果将提供关于心理社会因素在妊娠期糖尿病相关健康差异中的作用的见解 在AA和NA女性中。在前瞻性研究中，参与者将完成一项实验室应激任务，而我们将评估 应激反应的生理标志物。前瞻性研究的结果将提供关于 母亲心理健康和应激共同影响血糖的生理途径的作用 新陈代谢。我们的目标是提高我们识别处于危险中的妇女和预防妊娠期糖尿病及相关并发症的能力。