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. 2020 Feb 10;19(1):13.
doi: 10.1186/s12937-020-00529-9.

Maternal dietary patterns and risk of gestational diabetes mellitus in twin pregnancies: a longitudinal twin pregnancies birth cohort study

Li Wen  1   2   3 , Huisheng Ge  4 , Juan Qiao  1   2   3 , Lan Zhang  1   2   3 , Xuyang Chen  1   2   3 , Mark D Kilby  5   6 , Ying Zhou  1   2   3 , Jie Gan  1   2   3 , Richard Saffery  7 , Jianying Yan  8 , Chao Tong  9   10   11 , Hongbo Qi  12   13   14   15 , Philip N Baker  16
Affiliations

Maternal dietary patterns and risk of gestational diabetes mellitus in twin pregnancies: a longitudinal twin pregnancies birth cohort study

Li Wen et al. Nutr J. .

Abstract

Background: Gestational diabetes mellitus (GDM) is correlated with an increased risk of adverse perinatal outcomes for both the mother and offspring. Previous research has reported correlations between maternal dietary patterns and GDM, but such evidence for twin pregnancies is lacking. This study aimed to identify maternal dietary patterns in the second trimester and investigate their relationships with the risk of GDM among women who were pregnant with twins in China.

Methods: A longitudinal twin pregnancies birth cohort study of women who were pregnant with twins in China was conducted. Maternal dietary intake in the second trimester was recorded by using a food frequency questionnaire prior to the diagnosis of GDM among participants from the prospective twin pregnancies birth cohort in Chongqing City. GDM was diagnosed with a 75 g 2-h oral glucose tolerance test at 23-26 weeks of gestation. Dietary patterns were identified by principal components analysis, and the correlations between dietary pattern and GDM were examined using multivariable logistic regression analyses.

Results: Of the 324 participants, 101 (31.2%) were diagnosed with GDM. Four dietary patterns were identified: a vegetable-based pattern, a poultry-and-fruit-based pattern, a sweet-based pattern and a plant-protein-based pattern. Multivariate analysis showed that none of the dietary patterns were correlated with the risk of GDM among women who were pregnant with twins, but the sweet-based dietary pattern, which was associated with a higher GDM risk for quartile 4 versus quartile 1 (OR 2.69; 95% CI: 1.09, 6.66) among non-overweight women (prepregnancy BMI < 24.0).

Conclusion: Dietary patterns were not correlated with later GDM risk among women who were pregnant with twins in western China, whereas a high intake of sweets was associated with a higher risk for GDM among women who were not overweight prior to pregnancy.

Trial registration: ChiCTR-OOC-16008203. Retrospectively registered on 1 April 2016.

Keywords: China; Dietary patterns; Gestational diabetes; Twin pregnancies.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart showing selection of participants included in this analysis from LoTiS study
Fig. 2
Fig. 2
Associations between sweets-based pattern score quartiles and the risk of gestational diabetes mellitus, stratified by pre-pregnancy body mass index levels (< 24.0 vs. ≥ 24.0). Adjusted for other dietary pattern, maternal age, ethnicity, education level, parity, smoking status, chorionicity, mode of conception, previous history of GDM and family history of DM. (●) represents women with BMI < 24.0 kg/m2; (■) represents women with BMI ≥ 24.0 kg/m2
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