| Objective:Gestational diabetes mellitus(gestational diabetes mellitus,GDM)is associated with a variety of maternal and fetal adverse outcomes,affecting the recent and long-term health of maternal and fetal health.The incidence of GDM varies widely globally and the diagnostic criteria have been continuously updated in recent decades.As a disease closely related to lifestyle,early intervention in terms of diet and physical activity becomes the most cost-effective way to prevent GDM.There are many studies exploring the relationship between diet,physical activity and GDM,but the results are not completely consistent.This cross-sectional study was based on the‘Northeast Natural population Cohort-Maternal and Child Cohort’to explore the situation of diet and physical activity of pregnant women and the association between dietary pattern,physical activity and GDM so as to provide reasonable dietary and physical activity guidance for the prevention and treatment of GDM in the second trimester in Shenyang,Liaoning Province.Methods:A total of 2399 individuals were included in this study,and a cross-sectional analysis was used to explore the association between dietary patterns,physical activity and GDM.Basic information,diet history,physical examination results,and biochemical indicators were obtained through questionnaires,physical examination,and biological sample information.The 110 food items were divided into 27 food groups,and four dietary patterns were obtained by factor analysis method:"visceral dietary pattern","animal dietary pattern","beverage dietary pattern"and"plant dietary pattern";The t-test,analysis of variance and chi-square test were used to compare various index differences,including dietary pattern,physical activity,age,pre-pregnancy body mass index(body mass index,BMI),income,education.For data meeting a normal distribution is expressed as the mean±standard deviation(standard deviation,SD),Those that do not meet the normal distribution are expressed as the median(interquartile spacing),and the categorical variables are expressed as the number of cases(percentage or rate).The association of dietary pattern,physical activity and GDM were analyzed by logistic regression,expressed by odds ratio(odds ratio,OR)and 95%confidence interval(95%confidence interval,95%CI),and stratified by age and pre-pregnancy BMI.Results:Among the 2399 subjects included,the mean age was 30.73±3.70 years;pre-pregnancy BMI was 22.28±3.79 kg/m~2;513 GDM patients with a prevalence of 21.38%;GDM group and non-GDM group showed statistical differences in age,pre-pregnancy BMI,birth history,abortion history and family history of diabetes(P<0.05).After multivariate adjustment,the logistic regression results showed that:(1)No correlation between dietary pattern and the incidence of GDM;After the stratification of pre-pregnancy BMI,no associations were also found in the BMI<24 kg/m~2 population and in the≥24 kg/m~2 population;There is an interaction between"beverage diet pattern"and pre-pregnancy BMI(P<0.05),the rest of the diet pattern did not interact with pre-pregnancy BMI;After stratification of age,no correlation between dietary pattern and the incidence of GDM in<35 and≥35 years population.There was no interaction between the dietary pattern and the pre-pregnancy BMI;(2)The third tertile T3 of moderate intensity physical activity,OR(95%CI)was 0.71(0.55-0.93);Moderate and high intensity physical activity OR(95%CI)was 0.76(0.59-0.98);After stratification of pre-pregnancy BMI,overall activity,moderate intensity,moderate and high intensity physical activity T3 versus T1 in BMI<24 kg/m~2,ORs(95%CI)were 0.70(0.50-0.96),0.58(0.40-0.80),0.57(0.40-0.80);no above correlation was found in the BMI≥24kg/m~2 population;All physical activity was interactive with pre-pregnancy BMI(P<0.05);After stratification for age,no association of physical activity with the risk of GDM was found in<35 and≥35 years group;there was no interaction between physical activity and age;(4)There was a koinonia between moderate intensity physical activity and the four dietary patterns,any other physical activity has no koinonia with any dietary pattern.Conclusions:Mid-trimester women should properly perform moderate,moderate and high intensity physical activity to prevent the occurrence of GDM,and no association of dietary pattern was found with GDM. |
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