TOPLINE:

Women with exposure to any adverse childhood experience (ACE) had 15% higher odds of developing gestational diabetes than those with no such experience, with the odds increasing by roughly 13% for each additional ACE.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis to evaluate whether women exposed to ACEs before the age of 18 years had a higher risk of developing gestational diabetes.
• They identified 13 studies, of which 11 observational cohort or cross-sectional studies comprising 326,797 participants were pooled in the meta-analysis; most were from high-income countries.
• Exposure to ACEs was assessed using the Centers for Disease Control and Prevention-Kaiser ACE‑10 questionnaire in five studies, and others used culturally adapted versions or different instruments.
• To harmonise exposure categories across studies, the authors defined "low" exposure to ACEs as no or one ACE and used each study's original cutoff (either at least two or at least three ACEs) to define "high" exposure.

TAKEAWAY:

• Across eight studies, women with exposure to any ACE had 15% higher odds of gestational diabetes than those with no exposure to ACEs (pooled adjusted odds ratio [aOR], 1.15; 95% CI, 1.12-1.18).
• In eight studies, high exposure to ACEs was linked to 29% higher odds of gestational diabetes than low exposure (pooled aOR, 1.29; 95% CI, 1.08-1.53).
• In five studies, each additional ACE was associated with a 13% increase in the odds of gestational diabetes (pooled aOR, 1.13; 95% CI, 1.08-1.19).

IN PRACTICE:

"[The study] results reinforce a life-course perspective on GDM [gestational diabetes], in which psychosocial exposures contribute alongside established biomedical risk factors. Integrating trauma-informed principles into maternity care and strengthening prevention of childhood adversity may therefore represent important, complementary strategies for improving maternal and offspring metabolic health," the authors wrote.

SOURCE:

This study was led by Salma Nur Fadhilah, MD, King's College London, London, England. It was published online on April 19, 2026, in Diabetes Research and Clinical Practice.

LIMITATIONS:

Most of the included studies were cross-sectional or retrospective, limiting causal inferences and introducing the possibility of recall bias. Definitions, timing, and severity of ACEs varied across studies, and the adjustment for key confounders (such as prepregnancy BMI, socioeconomic status, and maternal mental health) was inconsistent. Because most data came from high-income countries, the findings may not be generalisable to low- and middle-income countries.

DISCLOSURES:

This study did not receive any funding, and the authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.