Adverse childhood experiences linked to higher gestational diabetes risk

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Diabetes research and clinical practice Published June 1, 2026 Medically reviewed June 1, 2026 Study authors: Fadhilah Salma Nur, Burton Sam, Wilson Claire A, Benton Madeleine PubMed ↗ DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider that adverse childhood experiences may be associated with a modestly increased risk of gestational diabetes.

A systematic review and meta-analysis of observational studies investigated the association between adverse childhood experiences before age 18 and the risk of gestational diabetes mellitus. The analysis found that exposure to adverse childhood experiences was associated with a higher odds of developing gestational diabetes. A cumulative dose-response effect was also observed, with each additional experience linked to increased risk.

The authors note that the included studies were observational, which limits the ability to establish causality. The certainty of the evidence was not formally rated in this review. The analysis was based on a large aggregate sample from the included studies.

The findings support a life-course approach to maternity care, suggesting that early life stressors may have implications for later pregnancy health. However, the clinical relevance must be interpreted cautiously due to the non-causal nature of the association.

Clinicians should consider these results as part of a broader assessment of patient history, recognizing that many factors contribute to gestational diabetes risk.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

PMID42013918

View Original Abstract ↓

Gestational diabetes mellitus (GDM) has consequences for maternal and offspring health. Adverse childhood experiences (ACEs) contribute to GDM risk, but findings have been inconsistent. We synthesised evidence using a systematic review and meta-analysis of observational studies on ACEs before age 18 and GDM, including dose-response effects. Nine databases were searched from inception to 30 May 2025 based on a PROSPERO-registered protocol (CRD420251035754). Studies without extractable estimates or assessing diabetes not restricted to gestational onset were excluded. Two reviewers independently screened studies, extracted data, and assessed risk of bias using ROBINS-E. Random-effects models pooled adjusted odds ratios (aORs), with dose-response analyses using the Greenland-Longnecker method. Thirteen studies met eligibility criteria, 11 contributed to meta-analysis (n = 326,797). ACE exposure was associated with higher odds of GDM (aOR 1.15, 95% CI 1.12-1.18; I = 0%). A cumulative dose-response effect was observed, with each additional ACE increasing GDM odds (aOR 1.13, 95% CI 1.08-1.19). This study extends prior work by incorporating dose-response modelling, updated pooled estimates from recent cohorts, a pregnancy-focused risk window, and consideration of mediating and moderating pathways. Overall, ACEs are associated with increased risk of GDM, supporting a life-course approach to maternity care.

Adverse childhood experiences linked to higher gestational diabetes risk

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Adverse childhood experiences linked to higher gestational diabetes risk

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Triple oral therapy with metformin, SGLT-2, and DPP-4 inhibitors lowers HbA1c better than dual regimens in adults with type 2 diabetes

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Clinical research that matters. Delivered to your inbox.

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