Dietary Pattern During Pregnancy Association Between With Risk Of Gestational Diabetes Mellitus

BackgroundGestational diabetes mellitus(GDM)is a special type of diabetes,which refers to the different degrees of impaired glucose tolerance occurring or first discovered during pregnancy and is a common pregnancy complication.It is found that dietary nutrition is an important factor in the development of GDM.Traditional nutrition studies are mostly limited to the effect of single(or a few)nutritional factors on GDM.However,the nutrients consumed by individuals are not isolated.There is an interaction between food,nutrients,and nutrients and food.Nutrients or food do not reflect the combined effects of nutritious diets.Compared with traditional nutrition,the dietary pattern is analyzed from the perspective of overall diet,considering the comprehensive effects of various food and nutrients,and evaluating the relationship between dietary nutrition and diseases.Therefore,it is more important to apply the dietary pattern method to explore the relationship between nutrition diet and GDM.In this study,we investigated the dietary nutrition during pregnancy to obtain dietary patterns during pregnancy,analyzed the correlation between dietary pattern during pregnancy with the risk of GDM,so as to provide a scientific basis for dietary prevention of GDM.Objective(1)Investigate women lifestyle and diet during pregnancy to obtain dietary patterns during pregnancy.(2)Exploring the correlation between dietary patterns during pregnancy and risk of GDM,and to provide scientific basis for the prevention of GDM.Materials and MethodsAmong gravidas who went to three grade ?-A hospitals of Nanjing for antenatal examination from March to August 2017,seven hundred pregnancines were enrolled from 20~28 gestational weeks.Patient's characteristics(age,height,body mass index,education level,family monthly income,smoking and drinking history),dietary intake and physical activity during pregnancy were collected.The 75 g oral glucose tolerance test(OGTT)screening results of pregnant women were followed up.The analysis of Student's t test,variance(ANOVA)and rank test were used to compare differences among multiple data,and factor analysis method were used to obtain patterns.Multivariate logistic regression model and linear trend test were used to analyze the correlation between the main dietary patterns and the risk of GDM.ResultsAfter excluding pregnancy who lost to follow-up,six hundred and eight-one gravidas were analyzed in all.Results were as follows:(1)One hundred and forty-four cases(21.15%)pregnant women were diagnosed with GDM.Pregnant women in gestational age,marital status,education level,family average monthly income,height,weight gain during pregnancy,physical activity during pregnancy,early pregnancy nausea,vomiting,nutritional supplements of GDM group had no significant difference with the non-GDM group(P>0.05);But there were significant differences in age,pre-pregnancy BMI,parity,family history of diabetes,history of adverse pregnancy,and hemoglobin(P>0.05).(2)A total of seven dietary patterns were obtained,including animal organ meat-fruits dietary pattern;fungus-vegetables and eggs dietary pattern;staple food dietary pattern,dessert-drink and meat dietary pattern;milk dietary pattern;beansdietary pattern and tubers dietary pattern.(3)There was no significant difference in age,occupation,education level,family income per month,smoking and drinking history,nausea,vomiting,pre-pregnancy BMI and other general information among different dietary patterns(P>0.05).(4)GDM group in scores of quartiles in organ meat-fruits dietary pattern,dessert-drink and meat dietary pattern,milk dietary pattern and tubers dietary pattern of non-GDM group(P<0.05).(5)Multivariate logistic regression analysis and linear trend test show that the organ meat-fruits dietary pattern,dessert-drink and meat dietary pattern,and tubers dietary pattern can increase the risk of GDM,and with the improvement of the score of dietary pattern factors,the risk of GDM increased significantly.The risk of GDM in pregnant women with the organ meat-fruits dietary pattern factor score of the highest quartile(Q3,Q4)were higher than that of pregnant women with a score of lowest quartile(Q1)(OR=2.023,95%CI: 1.108~ 3.693),(OR=3.065,95%CI: 1.690~ 5.559);Compared to the Q1,Q4 of dessert-drink and meat dietary pattern(OR=2.610,95%CI:1.465~4.652)and tubers dietary pattern scores(OR=2.997,95%CI: 1.547~ 5.058)were associated with a high risk of GDM.There was no significant correlation between milk dietary patterns with the risk of GDM.(6)There was a statistically significant difference in the distribution of energy and cholesterol intake among different dietary patterns(P<0.05).The meat-fruits dietary pattern,dessert-drink and meat dietary pattern in the total energy and cholesterol intake were significantly higher than other dietary patterns(P<0.05).However there was no significant difference in the distribution of the three major nutrient supply ratios among different dietary patterns(P>0.05).There was a significant difference in food distribution among different dietary patterns(P<0.05).Conclusion(1)Total of seven dietary patterns during pregnancy were extracted,among which organ meat-fruits dietary pattern,dessert-drink and meat dietary pattern and potato diets increased the risk of GDM.(2)In clinical practice,medical staff should guide pregnant women to choose a reasonable dietary pattern,pay more attention to the diet status and dietary patterns during pregnancy,and provide overall and personalized dietary guidance from the perspective of dietary patterns,so as to achieve early prevention of GDM.