Researchers from Mass General Brigham have discovered that stress levels before conception can impact a woman’s blood sugar levels, a key indicator of heart health. The study focused on women undergoing fertility treatments, and found that preconception stress was associated with higher blood sugar levels, particularly for women using intrauterine insemination (IUI) and those with a higher socioeconomic status. The findings were published in the Journal of the Endocrine Society.
„The prevalence of stress has increased over the years, especially among couples struggling with infertility. We wanted to investigate how this stress affects health during pregnancy, which can have long-term implications for both mother and child,“ said Lidia Mínguez-Alarcón, PhD, MPH, Bpharm, corresponding author and reproductive epidemiologist at the Brigham’s Channing Division of Network Medicine, and co-researcher of the Environment and Reproductive Health (EARTH) study.
Mínguez-Alarcón and her colleagues analyzed data from the EARTH study, conducted from 2004 to 2019 at the Massachusetts General Hospital Fertility Center. The study included 398 women aged 18 to 45 who reported experiencing preconception stress. The researchers gathered additional clinical and sociodemographic information, including family and medical history, use of consumer goods, and smoking history.
The average age of the women at the start of the study was 35, with the majority being of white ethnicity (83%), non-smokers (78%), and having at least a college degree (64%). Three hundred of the women conceived using assisted reproductive technologies such as IUI or in vitro fertilization (IVF). Glucose testing was performed on average in the 26th week of pregnancy, one hour after the women consumed a 50-gram glucose solution. A blood sugar level of 140 mg/dL or less was considered normal.
The researchers found that 82 of the women had unusually high blood sugar levels, which is a measure of cardiovascular health. Previous studies have shown that women with a history of gestational diabetes (GD) during pregnancy have an increased risk of developing type 2 diabetes and cardiovascular problems later in life, including calcification of the heart arteries.
The team found that women reporting higher preconception stress had higher average glucose levels. Additionally, women who became pregnant through IUI experienced both higher stress and higher blood sugar levels compared to those who became pregnant through IVF. The study also revealed that women with a higher socioeconomic status during pregnancy exhibited higher levels of preconception stress and higher blood sugar levels. The middle family income was used to measure socioeconomic status.
„Working women with higher income and education levels may be engaged in demanding, time-intensive jobs and are often responsible for balancing workplace demands with household duties and child care,“ said Mínguez-Alarcón. „It has been shown that women with higher education levels are exposed to higher job stress. Considering the positive connection between education level and income, it is possible that this explanation also applies to women with higher income.“ However, the limitations of the study include its predominantly white, high-socioeconomic status group of women seeking fertility treatment. Self-reports of perceived stress may also introduce participant bias. Future research could examine additional variables such as sleep quality or neighborhood safety, as well as the effects of preconception stress on infant health. „Our findings are crucial for public health given the increasing rates of stress over the years and its impact on cardiovascular health,“ said Mínguez-Alarcón. „Women can try to reduce their stress levels through various strategies, such as increased physical activity, avoiding alcohol and drugs, maintaining a healthy diet, and avoiding isolation. Our study has the potential to spark important discussions given the limited literature in this area.“
Mínguez-Alarcón, L., et al. (2024) Vorurteilsstress und Schwangerschaftsserumglukosespiegel bei Frauen, die ein Fruchtbarkeitszentrum besuchen. Zeitschrift der Endocrine Society. doi.org/10.1210/jendso/bvad152.