Intimate Partner Violence: A Risk Factor for Gestational Diabetes

Abstract

The early detection and management of gestational diabetes mellitus (GDM) is an important public health goal. GDM, which is defined as a glucose intolerance that develops during pregnancy, affects about 14% of pregnancies globally, and without effective treatment, it is associated with adverse short- and long-term maternal and neonatal outcomes. Risk-factor screening is an acceptable and affordable strategy to enable risk stratification and intervention. However, common biological risk factors such as overweight or obesity, excessive gestational weight gain, and family history of diabetes often have poor predictive ability, failing to identify a large proportion of women at risk of developing GDM. Accumulating evidence implicate psychosocial factors in contributing to GDM risk. As such, intimate partner violence (IPV), through its contributing effects on maternal stress and depression, presents a plausible risk factor for GDM. Experiencing IPV during pregnancy may dysregulate the hypothalamus–pituitary–adrenal (HPA) axis, leading to increased cortisol secretion and insulin resistance. These effects may exacerbate the insulin-resistant environment characteristic of pregnancy, thus increasing GDM risk. This review explores the relationship between IPV and GDM. We highlight studies that have linked IPV with GDM and propose a biological mechanism that connects IPV and GDM. Recommendations for IPV screening strategies to prevent GDM are discussed.

Effect of intimate partner violence in pregnancy on maternal and perinatal outcomes at the Korle Bu teaching hospital, Ghana: An observational cross sectional study

“…Our study found no significant association between gestational diabetes and IPV, so agree with Pheiffer et al 27 ; a larger population‐based research is needed to examine this association.…”

“…Similar observations were reported from Nigeria, Uganda, Afghanistan, and Iran suggesting that education and marital status were not associated with domestic violence in pregnancy. 7,9,11,18,23 Our study found no significant association between gestational diabetes and IPV, so agree with Pheiffer et al 27 ; a larger populationbased research is needed to examine this association.…”

Risk Factors for Recurrence of Gestational Diabetes Mellitus and Its Correlation with Maternal and Infant Prognosis

“… The clinical symptoms and signs examination and laboratory index met the diagnostic criteria for GDM in Obstetrics and Gynecology (9th edition) [ 4 ]. Average-dimensional singleton pregnancy.…”

“…Patients are usually advised to start with diet and exercise therapy, and insulin is recommended if blood glucose is not well controlled [ 3 ]. Recurrent GDM is determined if a woman with a history of GDM has abnormal glucose metabolism during pregnancy again and meets the diagnostic criteria for GDM [ 4 ]. Patients with gestational diabetes may return to normal blood glucose for a certain period after delivery, but more than half of patients with GDM will eventually become type 2 diabetic within the next 10–20 years, and there is growing evidence that their offspring are at risk of developing obesity and diabetes, with an increased risk of adverse cardiovascular events [ 5 ].…”

Pregnancy complications and intimate partner violence: The moderating role of prenatal posttraumatic stress symptoms

“…Accounting for these factors could enhance the examination of IPV and PTSS on pregnancy outcomes apart from potential preexisting conditions. Additionally, future research should examine how IPV exposure and PTSS are associated with biomarkers (e.g., mRNA, placental hormones; Barchitta et al., 2017) linked with pregnancy complications, as environmental stress may exacerbate these factors (Pheiffer et al., 2020). Finally, longitudinal designs are necessary to assess IPV exposure and PTSS over time to understand how they coalesce to amplify the risk of pregnancy complications.…”