Feng Huan, Sun Huangyang, Chen Xiaoxi, Song Lijuan
Medical Matters Office, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology Wuhan 430000, Hubei, China.
Obstetrical Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology Wuhan 430000, Hubei, China.
Am J Transl Res. 2025 Mar 15;17(3):1925-1937. doi: 10.62347/AQVC5045. eCollection 2025.
Gestational diabetes mellitus (GDM) poses significant health risks during pregnancy, with dietary adherence being crucial for effective management. This study aims to identify factors influencing dietary compliance to enhance patient outcome.
This retrospective cohort study analyzed 189 GDM patients from Wuhan Children's Hospital between January 2021 and June 2023. The patients were categorized into good and poor dietary adherence groups using the Perceived Dietary Adherence Questionnaire. Variables such as demographic data, disease duration, educational attainment, income, employment status, obstetric history, and dietary sources, were collected. Knowledge levels were evaluated using the Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ), and social support was assessed by the Medical Outcomes Study Social Support Survey.
A multifactorial logistic regression model was developed to predict poor dietary compliance, and the risk factors included lower educational attainment (Coefficient: 1.249; Odds Ratio (OR): 3.487), lower income (Coefficient: 2.282; OR: 3.602), and takeout breakfasts (Coefficient: 0.838; OR: 2.311). Improved GDM knowledge (Coefficient: -0.344; OR: 0.709) and social support levels (Coefficient: -0.072; OR: 0.931), unemployment (Coefficient: -0.935; OR: 0.392), and obstetric history (Coefficient: -0.980; OR: 0.375) were protective factors against poor compliance. The multifactorial logistic regression model was formulated as follows: () = 0 + 1 () + 3 () + 4 () + 5 () + 6 () + 7 (). The model demonstrated robust predictive power with an area under the curve (AUC) of 0.854 in internal validation and 0.972 in external validation. Calibration plots indicated good agreement between predicted and observed outcomes, supporting the model's reliability and clinical utility.
The study identified key demographic, behavioral, and social determinants affecting dietary compliance in GDM patients. Critical factors include education levels, household income, employment, breakfast source, GDM knowledge, and social support. These insights can inform interventions to enhance dietary adherence and optimize GDM management strategies in clinical settings. Our multifactorial logistic regression model displays high predictive accuracy and serves as a practical tool for assessing dietary compliance risks, facilitating personalized patient care.
妊娠期糖尿病（GDM）在孕期会带来重大健康风险，坚持饮食对有效管理至关重要。本研究旨在确定影响饮食依从性的因素，以改善患者预后。
这项回顾性队列研究分析了2021年1月至2023年6月期间来自武汉儿童医院的189例GDM患者。使用感知饮食依从性问卷将患者分为饮食依从性良好组和不良组。收集了人口统计学数据、病程、教育程度、收入、就业状况、产科病史和饮食来源等变量。使用妊娠期糖尿病知识问卷（GDMKQ）评估知识水平，通过医学结局研究社会支持调查评估社会支持。
建立了一个多因素逻辑回归模型来预测饮食依从性差，危险因素包括较低的教育程度（系数：1.249；比值比（OR）：3.487）、较低的收入（系数：2.282；OR：3.602）和外卖早餐（系数：0.838；OR：2.311）。GDM知识的提高（系数：-0.344；OR：0.709）、社会支持水平的提高（系数：-0.072；OR：0.931）、失业（系数：-0.935；OR：0.392）和产科病史（系数：-0.980；OR：0.375）是防止依从性差的保护因素。多因素逻辑回归模型的公式如下：（）=0+1（）+3（）+4（）+5（）+6（）+7（）。该模型在内部验证中的曲线下面积（AUC）为0.854，在外部验证中的AUC为0.972，显示出强大的预测能力。校准图表明预测结果与观察结果之间具有良好的一致性，支持该模型的可靠性和临床实用性。
该研究确定了影响GDM患者饮食依从性的关键人口统计学、行为和社会决定因素。关键因素包括教育水平、家庭收入、就业、早餐来源、GDM知识和社会支持。这些见解可为干预措施提供参考，以提高饮食依从性并优化临床环境中的GDM管理策略。我们的多因素逻辑回归模型显示出较高的预测准确性，可作为评估饮食依从性风险的实用工具，促进个性化患者护理。
