Periconceptional glycemic index and the risk of gestational diabetes mellitus and a large-for-gestational-age infant
Year: 2025
Type: article
Abstract: OBJECTIVES: We determined whether the glycemic index (GI), a metric of dietary carbohydrate impact on blood glucose, in early pregnancy was associated with the risk of gestational diabetes mellitus (GDM) or a large-for-gestational-age (LGA) infant among nulliparous individuals. METHODS: This is a secondary analysis of individuals without pregestational diabetes enrolled in the prospective United States-based Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be multisite cohort. The exposure was average periconceptual GI calculated from the Block Food Frequency Questionnaire. GI scores were categorized in quartiles from Q1 (best, reference) to Q4 (worst). Outcomes were diagnosis of GDM based on third-trimester screening and LGA birth per sex- and gestational-age standardized birthweight ≥90th percentile. Secondarily, we assessed for effect modification by dietary quality and neighborhood-level food access. RESULTS: Among 7742 assessed participants, the median GI was 49.8 (IQR: 47.4, 52.1), and 94.9% had a low or favorable GI score (≤55). The highest quartile of GI was not associated with GDM (aRR: 1.17; 95% CI: 0.85-1.62), but Q3 was associated with an increased risk of GDM versus Q1 (Q3 vs. Q1 5.0% vs 3.9%: aRR: 1.46, 95% CI 1.07-1.99). GI was not associated with an LGA infant. There was no evidence of effect modification by dietary quality or food access (P ≥ 0.05 for both). CONCLUSIONS: In a prospective cohort of nulliparous individuals with predominantly low GI in early pregnancy, the GI was not consistently associated with GDM or LGA birth. Further studies are needed to better understand the mechanisms by which diet-based glycemia may affect pregnancy outcomes.
Source: Nutrition
Institutions: The Ohio State University, Brown University, Indiana University Indianapolis, University of Utah, University of Pennsylvania, University of California, Irvine, Eastern Virginia Medical School, Northwestern University, University of Pittsburgh, Magee-Womens Research Institute, Columbia University Irving Medical Center, Columbia University, RTI International
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,870
Funders: Ohio State University, National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Child Health and Human Development, Office of Behavioral and Social Sciences Research, Office of Research on Women's Health, Office of Disease Prevention, National Center for Advancing Translational Sciences, Office of Disease Prevention and Health Promotion, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Office of Data Science Strategy
Awards: G1421591325, Preterm Birth in Nulliparous Women: An Understudied Population at Great Risk, Pregnancy as a Window to Future Cardiovascular Health: Adverse Pregnancy Outcomes, Indiana Clinical and Translational Sciences Institute, G2759231441, G2915998857, Pregnancy as a Window to Future Cardiovascular Health, Preterm Birth in Nulliparous Women: An Understudied Population at Great Risk, UCLA Clinical and Translational Science Institute, Preterm Birth in Nulliparous Women: An Understudied Population at Great Risk , G3555406479, G3811829134, G3956464655, G409319813, G4133694970, Pregnancy as a Window for Future Cardiovascular Health, Pregnancy as a Window to Future Cardiovascular Health, Pregnancy as a Window to Future Cardiovascular Health, Pregnancy as a Window to Future Cardiovascular Health, Pregnancy as a Window to Future Cardiovascular Health, G589439662, Pregnancy as a Window to Future Cardiovascular Health, G6398870566, G7356709694, Preterm Birth in Nulliparous Women: An Understudied Population at Great Risk, G7664677164, Pregnancy as a Window to Future Cardiovascular Health, Clinical and Translational Science Collaborative of Cleveland, Institute for Clinical and Translational Science, Dissecting the Genetic Etiology of Preterm Birth in Nulliparous Women, Continuation of the NuMoM2b Heart Health Study, G936184327
OpenAlex ID: W4413513336