Stressed women undergoing fertility treatment risk weak heart health

Women attending fertility clinics faced increased blood sugar levels during pregnancy if they were under stress before conceiving, researchers have reported.

High blood sugar levels during pregnancy indicates weak cardiovascular health, which means clinicians should be mindful of stress during preconception, say the US-based researchers.

Study author Dr Lidia Mínguez-Alarcón, of Harvard Medical School, Massachusetts, USA, said: “Stress prevalence has increased over the years, particularly for couples who are not able to conceive naturally.

“We wanted to evaluate how this stress affects health during pregnancy, which can affect both the mother and child in the long term.”

Their findings are published in the Journal of the Endocrine Society.

“We found that maternal stress, evaluated before pregnancy, is negatively associated with cardiovascular health, measured as glucose levels during pregnancy,” she said.

“Our results highlight the importance of considering preconception as a sensitive window of stress in relation to cardiovascular health during pregnancy. A few ways women can lower their stress levels include being more active, avoiding alcohol and drugs, eating healthy and avoiding isolation.”

The authors analysed self-reported stress levels in 400 women at the Massachusetts General Hospital Fertility Center in Boston, Mass, before they became pregnant and measured their blood sugar levels in late pregnancy.

The participants had a median age of 35 years at study entry, and 83% were white, 78% reported never smoking and 64% were at least college educated.

They found women with high levels of stress before pregnancy were more likely to have high blood sugar during pregnancy. Glucose testing was done at a median of 26 weeks into pregnancy and taken one hour after the women drank a 50g glucose solution. A blood sugar that was equal to or less than 140 mg/dL was considered normal.

Those who conceived through intrauterine insemination (IUI) had higher stress and blood sugar levels than those who conceived through in vitro fertilisation (IVF).

“This may be explained by the fact that IUI treatment has shown less effectiveness as an infertility treatment compared to IVF, so women undergoing IUI may experience more distress compared to those going through IVF,” Dr Mínguez-Alarcón said.

The researchers also found stress and blood sugar levels were higher among women with high socioeconomic status.

“It has previously been shown that those with a higher education level experience greater levels of job stress, with stronger associations found in women than in men,” she said.

“Given that education level is positively associated with salary, it is possible that this explanation applies to women with higher incomes as well. Professional women are often also responsible for balancing demands in the workplace with household duties and childcare.”

Mínguez-Alarcón L, Chagnon O, Tanak A et al. Preconception Stress and Pregnancy Serum Glucose Levels Among Women Attending a Fertility Center. Journal of the Endocrine Society 4 January 2024; doi: 10.1210/jendso/bvad152

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