Association Between Maternal Mood State and Glycemic Response to a Mixed-Meal Among Latina Pregnant Women With Overweight and Obesity

Abstract

ObjectivesTo investigate if maternal positive and negative affect state is associated with the glucose and insulin response to a standardized breakfast shake among Latina pregnant women with overweight and obesity. MethodsN = 31 non-diabetic Latina pregnant women, at gestational age 28–30 weeks, with a pre-pregnancy BMI 25–35 Kg/m2 consumed a standardized breakfast shake in the morning after an overnight fast of at least 10 hours. The Positive and Negative Affect Scale was completed while consuming the drink. Blood samples collected at fasting and 6 postprandial time points (15, 30, 45, 60, 90,120 mins) were assayed for glucose and insulin and values were log-transformed for normality. The area-under-the-curve (AUC) for glucose, insulin, glucose: insulin ratio were computed as well as the Matsuda index of insulin sensitivity (SI). ResultsThe median (IQR) values for positive and negative affect scores were 33 (27–40) and 11 (10–14) respectively. Categorizing the affect scores as high or low based on the median value, the mean AUC for glucose, insulin, and SI did not differ according to affect state (p > 0.05). However, women with a lower positive affect score had lower insulin AUC (F-1.2, p = 0.063), and consequently, a greater AUCglucose: insulin (F = 3.9, p = 0.007), which persisted after adjustment for maternal age, gestational age and BMI. A post-hoc analysis revealed significantly higher glucose: insulin ratio values at fasting (F = 0.58, p = 0.013) and 15min (F = 10.37, p = 0/008) and 60min (F = 2.65, p = 0.021) postprandial timepoints in those with low vs high positive affect. No differences in the glucose/insulin ratio were detected across levels of negative affect. ConclusionsContrary to expectations, higher positive affect in late pregnancy (i.e., more positive mood state) was associated with a less favorable postprandial insulin response in this cohort, contributing to a higher ratio of glucose: insulin, which is a sensitive predictor of insulin resistance. There is potential for unmeasured confounding which may have contributed to this unexpected direction of association between maternal affect state and insulin response in pregnant Latina women, which deserves further attention in future research. Funding SourcesNational Institute of Child Health and Human Development.