Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran.
Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, Tehran, Iran.
BMC Pregnancy Childbirth. 2023 Sep 8;23(1):647. doi: 10.1186/s12884-023-05960-4.
Limited data is available on the association between adherence to the Mediterranean diet during early pregnancy and risk of gestational diabetes (GDM) in countries located in the Middle East, one of the regions with the highest prevalence of GDM.
A total of 647 pregnant mothers were included in the present prospective birth cohort study in Iran. Dietary intake was assessed by a 90-item food frequency questionnaire during the first trimester of pregnancy. Cases of GDM were ascertained by a two-step approach with a 50-g screen followed by a 100-g oral glucose tolerance for those who tested positive. Cox proportional hazard model was used to calculate the hazard ratio and 95%CI of GDM across tertiles of the Mediterranean diet score, while controlling for a wide range of potential confounders.
A total of 647 pregnant mothers were included, of whom 77 mothers were diagnosed with GDM during their pregnancy. The average age of the mothers was 28.8 ± 5.1 years. In the multivariable analysis, being in the third tertile of the score of adherence to the Mediterranean diet was associated with a 41% lower risk of developing GDM as compared to those in the first tertile (adjusted hazard ratio: 0.59, 95%CI: 0.35, 0.99).
Based on our findings, greater adherence to the Mediterranean diet during early pregnancy may be associated with a lower risk of developing GDM in Iranian women. Larger cohort studies are needed to confirm the findings.
在中东地区，妊娠糖尿病（GDM）的发病率是全球最高的地区之一，但关于孕早期遵循地中海饮食与 GDM 风险之间关联的相关数据有限。
本前瞻性出生队列研究共纳入了 647 名伊朗孕妇。在妊娠早期，通过 90 项食物频率问卷评估饮食摄入情况。对检测结果为阳性的孕妇，采用两步法（50g 筛查和 100g 口服葡萄糖耐量试验）来确定 GDM 病例。使用 Cox 比例风险模型来计算地中海饮食评分三分位数与 GDM 之间的风险比（HR）和 95%置信区间（CI），同时控制了多种潜在混杂因素。
共纳入了 647 名孕妇，其中 77 名孕妇在怀孕期间被诊断为 GDM。母亲的平均年龄为 28.8±5.1 岁。在多变量分析中，与处于第一三分位的孕妇相比，处于地中海饮食依从性评分第三三分位的孕妇发生 GDM 的风险降低了 41%（调整后的 HR：0.59，95%CI：0.35，0.99）。
基于我们的研究结果，孕早期地中海饮食的依从性越高，伊朗女性发生 GDM 的风险可能越低。需要更大的队列研究来证实这一发现。
