Adverse childhood experiences linked to higher gestational diabetes riskEarly life stress may raise risk of gestational diabetes in later pregnancy

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

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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.

This large review combined data from many observational studies to look at the link between childhood experiences and pregnancy health. Researchers examined records for more than 326,000 people to see if adverse childhood experiences, known as ACEs, were connected to gestational diabetes mellitus. The group included individuals who faced difficult events before age 18. The analysis found that exposure to these childhood adversities was associated with higher odds of developing gestational diabetes. Specifically, the data showed an increased risk with a measure of 1.15. The study also found a dose-response effect, meaning the risk increased with each additional adverse experience, with a measure of 1.13 per extra event. No safety concerns were reported because the study looked at disease risk rather than drug side effects. Readers should understand this shows a link between early life stress and later pregnancy complications. This supports a life-course approach to maternity care, suggesting that early life history matters for pregnancy outcomes. More research is needed to confirm these findings and understand the exact reasons behind this connection.

What this means for you:

Early life stress is linked to higher odds of gestational diabetes in pregnancy based on this large review.

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 riskEarly life stress may raise risk of gestational diabetes in later pregnancy

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Adverse childhood experiences linked to higher gestational diabetes riskEarly life stress may raise risk of gestational diabetes in later pregnancy

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