Effects of individual dietary intervention on blood glucose level and pregnancy outcomes in patients with gestational diabetes mellitus: a retrospective cohort study

Abstract

Background: Gestational diabetes mellitus (GDM) increases the incidence of adverse outcomes in pregnant women. Individual diet intervention (IDI) was developed in our center through collaboration with nutritionists to treat GDM and prevent further complications. We then aimed to analyze the effects of IDI on the level of blood glucose and pregnancy outcomes in pregnant women with GDM.

Methods: We retrospectively enrolled pregnant women with GDM between April 2016 and March 2020. Participants in the control group received routine GDM care, and those in the study group received extra IDI on the basis of routine GDM care. Demographic and clinical characteristics of participating pregnant women were retrospectively collected. The study outcomes were the status of blood glucose control after 6 weeks of IDI or conventional intervention and pregnancy outcomes. Univariable and multivariable logistic regression analyses were sequentially performed to determine the predictors of proper blood glucose control and risk factors of adverse pregnancy outcomes in the study population.

Results: A total of 817 pregnant women who had been diagnosed as GDM were enrolled in this study, including 435 admitted between April 2016 to March 2018 who received conventional medication and 382 who were admitted between April 2018 to March 2020 and received IDI. Generally, there was no significant difference in baseline characteristics between study and control groups. Glycated hemoglobin (HbA1c) level after intervention was statistically lower in the study group than in the control group (5.6±0.9 vs. 5.5±0.7, P=0.006). Multivariable logistic regression analysis revealed that IDI was a predictor of proper blood glucose control in GDM participants (P=0.003). There were more cesarean sections and cases of macrosomia in the control group than the study group, showing statistical difference (35.9% vs. 28.5%, P=0.026; 8.7% vs. 4.7%, P=0.023, respectively). According to multivariable logistic regression analysis, IDI was identified as playing a protective role against cesarean section in GDM participants (P=0.034) and it could reduce the incidence of macrosomia in GDM participants (P=0.028).

Conclusions: This novel pattern of IDI may not only help stabilize blood glucose levels in pregnant women with GDM, but also reduce the incidence of adverse outcomes to a certain extent.

Keywords: Gestational diabetes mellitus (GDM); blood glucose level; individual dietary intervention (IDI); pregnancy outcomes; retrospective cohort study.