How Educational Attainment Modifies the Relationship between Perceived Stress and the Risk of Developing Gestational Diabetes Open Access

Abstract

Objective Gestational diabetes mellitus affects 5 to 10% of pregnancies in the United States and poses health risks for both mother and child. While perceived stress has been suggested as a risk factor for gestational diabetes, the modifying role of educational attainment remains unclear. Using data from the nuMoM2b cohort of over 10,000 nulliparous women, this study examined whether education level alters the relationship between perceived stress and gestational diabetes.

 

Methods Stress was measured using a 10-item version of the validated Cohen Perceived Stress Scale. Gestational diabetes was diagnosed based on medical records or based on abnormal results from glucose tolerance tests. Logistic regression models were used to assess the relationship between stress and gestational diabetes, adjusting for age, body mass index, physical activity, and race/ethnicity and including interaction terms for education.

 

Results When incorporating an interaction term for educational attainment, our results were null across all levels of stress and education. 

 

Conclusions Findings suggest that perceived stress in early pregnancy is not a strong predictor of gestational diabetes and that educational attainment does not modify this relationship.

Table of Contents

Table of Contents

Chapter 1: Literature Review.. 1

Background. 1

Prevalence of Stress. 2

Methods of Measuring Stress. 2

Stress and Gestational Diabetes. 3

Indirect Links between Stress and Gestational Diabetes. 4

Maternal Education and Gestational Diabetes 4

Summary and Remaining Gaps in Knowledge. 5

References 6

Table. 9

Chapter 2. 11

Introduction. 11

Methods. 12

Results 15

Discussion/Conclusion. 17

Public Health Implications. 19

Tables and Figures 24

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Degree	M.S.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	Perceived Stress Maternal Health Gestational Diabetes
Committee Chair / Thesis Advisor	Penelope P. Howards, Emory University

Last modified

Primary PDF

Thumbnail	Title	Date Uploaded	Actions
	How Educational Attainment Modifies the Relationship between Perceived Stress and the Risk of Developing Gestational Diabetes ()	2025-04-22 16:31:44 -0400	Press to Select an action Download

Supplemental Files

Thumbnail	Title	Date Uploaded	Actions