The Complex Relationship between Stress and Gestational Diabetes: Mechanisms and Interventions for Maternal and Fetal Health

Atiyeh Javaheri; Sedigheh Ekraminasab; Seyedeh Elham Shams; Hossein Neamatzadeh

doi:10.18502/wjpn.v7i1.17326

Atiyeh Javaheri Department of Obstetrics and Gynecology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Sedigheh Ekraminasab Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Seyedeh Elham Shams Department of Pediatrics, Hamadan University of Medical Sciences, Hamadan, Iran
Hossein Neamatzadeh Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/wjpn.v7i1.17326

Keywords: Gestational diabetes, Stress, Cortisol, Inflammation, Insulin resistance, Cognitive-behavioral therapy

Abstract

Gestational diabetes mellitus (GDM) is a prevalent complication during pregnancy that poses risks to both maternal and fetal health. This study aims to elucidate the intricate relationship between stress and the development of GDM, highlighting how stress-related hormonal fluctuations and behavioral changes—such as increased cortisol levels, inflammation, disrupted sleep patterns, and poor dietary choices— contribute to insulin resistance and glucose dysregulation. We examine the influence of stress on hormonal and lifestyle factors associated with GDM and evaluate interventions that manage stress-related metabolic disturbances. Elevated levels of stress hormones (like cortisol and adrenaline) and inflammatory markers (such as IL-6 and TNF-α) are linked to an increased risk of GDM due to their detrimental effects on insulin sensitivity. Our findings suggest that effective interventions, including mindfulness practices, cognitive-behavioral therapy, and regular physical activity, can reduce cortisol levels and enhance glucose regulation. This underscores the necessity of addressing both the metabolic and psychological dimensions of GDM. Current evidence supports the integration of stress-reduction strategies—such as mindfulness, cognitive-behavioral therapy, and exercise—into GDM management, as they can improve glycemic control by lowering cortisol and enhancing insulin sensitivity. Recognizing stress as a modifiable risk factor for GDM is crucial for improving maternal and fetal outcomes, emphasizing the importance of incorporating stress management into GDM prevention and treatment protocols.