Symptoms of Posttraumatic Stress Disorder are Associated with Altered Glucose Parameters in Early and Late Gestation

Margaret H Bublitz; Micheline R Anderson; Laura Sanapo; Victoria N Scarfo; Ghada Bourjeily

doi:10.1055/s-0043-1772749

Symptoms of Posttraumatic Stress Disorder are Associated with Altered Glucose Parameters in Early and Late Gestation

Am J Perinatol. 2023 Aug 24. doi: 10.1055/s-0043-1772749. Online ahead of print.

Authors

Margaret H Bublitz^{1

2

3}, Micheline R Anderson^{2

3}, Laura Sanapo^{1

3}, Victoria N Scarfo³, Ghada Bourjeily^{1

3}

Affiliations

¹ Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
² Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
³ Department of Research Women's Medicine Collaborative, The Miriam Hospital, Providence, Rhode Island.

PMID: 37619599
DOI: 10.1055/s-0043-1772749

Abstract

Objective: Posttraumatic stress disorder (PTSD) is associated with increased risk for insulin resistance and the development of diabetes outside of pregnancy. In pregnancy, emerging evidence suggests that PTSD is associated with increased risk for gestational diabetes; however, it is not yet known how PTSD is associated with disruptions in glucose processing across gestation. Therefore, the aim of the current study was to test associations between PTSD symptoms and glucose parameters in early and late gestation among pregnant people without a history of pregestational diabetes.

Study design: Two 34 participants were included in these analyses. PTSD symptoms were measured using the PTSD Checklist for DSM-5 (PCL-5) in early gestation. Fasting blood samples were collected at approximately 12 and 32 gestational weeks and were used to calculate β-cell function and insulin sensitivity.

Results: Participants were 31 years old (standard deviation [SD] = 6) with body mass index (BMI) of 36 kg/m² (SD = 7) at enrollment, 26% reported their ethnicity as Hispanic, 62% reported their race as White, 17% Black, 2% Asian, 3% Native American, 9% more than one race, and 11% unknown/not reported. Hierarchical linear regression analyses revealed that, after adjusting for several covariates including maternal age, race, ethnicity, BMI, apnea hypopnea index, and depressive symptoms, PTSD symptoms were positively associated with β-cell function in early (β = 0.230, p = 0.016) and late gestation (β = 0.238, p = 0.037).

Conclusion: Higher PTSD symptoms were associated with greater insulin secretion over pregnancy in this sample. More research is needed to replicate these findings and evaluate the effects of treatment of PTSD on mitigating the risk for gestational diabetes.

Key points: · We examined associations among symptoms of PTSD and glucose parameters over pregnancy.. · Symptoms of PTSD were positively associated with β-cell function over pregnancy.. · Symptoms of PTSD were not associated with insulin resistance over pregnancy..