Nutrition-related Risk Factors for Gestational Diabetes Mellitus: a Case-control Study

  Objective  To identify nutrition-related risk factors for gestational diabetes mellitus (GDM), so as to provide guidance for improvement of maternal nutrition and health management.

  Methods  Subjects were selected with multi-stage continuous proportionate sampling from the women who visited Department of Obstetrics of Peking Union Medical College Hospital and received glucose tolerance test in 24-28 gestational weeks during the period from December 2014 to May 2015. A total of 150 confirmed GDM cases were enrolled, and 150 non-GDM gravida were selected into control group. General condition and dietary status of the GDM group and the control group were investigated using a food frequency questionnaire (FFQ). Nutrition-related risk factors for GDM were identified using Logistic regression analysis.

  Results  Univariate analysis showed that GDM was significantly associated with family history of type 2 diabetes mellitus, preconception body mass index (BMI), history of GDM, fruits intake, proportion of refined grains, daily meat intake, frequency of high fat diet consumption, daily salt intake, daily oil intake, daily nuts intake, frequency of eating out, consumption of sugary drinks, and physical activity (P < 0.05). Multivariate Logistic regression analysis indicated that preconception BMI (OR=1.628, 95% CI:1.079-2.456), family history of type 2 diabetes mellitus (OR=1.761, 95% CI:1.001-3.069), history of GDM (OR=7.855, 95% CI:1.982-31.125), fruits intake (OR=1.457, 95% CI:1.148-1.849), refined grains(OR=1.350, 95% CI:1.008-1.808), high fat diet (OR=1.398, 95% CI:1.066-1.833), and physical inactivity (OR=1.257, 95% CI:1.111-1.422) were related to GDM(P < 0.05).

  Conclusions  High preconception BMI, family history of type 2 diabetes mellitus, history of GDM, over intake of fruits, high proportion of refined grains, frequent intake of high fat diet, and physical inactivity may increase the risk of GDM.