Am J Perinatol
DOI: 10.1055/s-0043-1772749
Original Article

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

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
Micheline R. Anderson
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
Laura Sanapo
1   Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
3   Department of Research Women's Medicine Collaborative, The Miriam Hospital, Providence, Rhode Island
Victoria N. Scarfo
3   Department of Research Women's Medicine Collaborative, The Miriam Hospital, Providence, Rhode Island
1   Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
3   Department of Research Women's Medicine Collaborative, The Miriam Hospital, Providence, Rhode Island
› Author Affiliations
Funding This work was supported National Heart Lung and Blood Institute (grant nos.: R01HL130702 and HL130702-4S to G.B.; R01HL157288 to M.H.B.).


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.

Data Availability Statement

The datasets generated during and/or analyzed in the current study are available from the corresponding author upon reasonable request.

Publication History

Received: 13 July 2023

Accepted: 21 July 2023

Article published online:
24 August 2023

© 2023. Thieme. All rights reserved.

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