title: Lifestyle patterns in early pregnancy linked to gestational diabetes mellitus diagnoses when using IADPSG criteria. The St Carlos gestational study.
abstract: Early-pregnancy lifestyle (EPL) could influence the development of gestational diabetes mellitus(GDM), depending on the diagnostic criteria used.
  
  
  
  We studied EPL in 1750 pregnant women using Carpenter-Coustan criteria(CCc), and in 1526 with the International Association of Diabetes and Pregnancy Study Groups criteria(IADPSGc).
  
  
  
  GDM risk factors were assessed in women between 24 and 28 weeks of gestational age during two consecutive years. A semiquantitative frequent-food-consumption questionnaire was used to evaluate lifestyle during pregnancy. Multiple logistic regression analysis was conducted to assess GDM risk with different lifestyle patterns.
  
  
  
  Using IADPSGc, the GDM ORs (95%CI) for intake/week were: nuts >3 times: 0.59 (0.39-0.91; p < 0.015), refined cereals ≤1 serving: 0.72(0.58-0.89; p < 0.003), juices <4 servings: 0.77 (0.62-0.95; p < 0.017), cookies and pastries <4 servings: 0.71(0.57-0.89; p < 0.003) as compared to opposite habits. No significant nutritional patterns were found to be significant using CCc. The OR (95%CI) for GDM with none of the four risk patterns as compared to having three-four risk factors was 0.21(0.07-0.62; p < 0.005), remaining significant after stratification by BMI, age, obstetric events, parity and family history. The multiple logistic regression model including nutritional categories and pregestational BMI, age, obstetric history, parity, personal/family history, had an area under the curve(AUC) of the receiver operating curve(ROC) for the probability to predict GDM of 0.66 (CI 95%: 0.63-0.69; p < 0.001).
  
  
  
  Our study is the first to identify four early-pregnancy nutritional patterns associated with the GDM when using IADPSGc. Adherence to a low-risk nutritional pattern from early pregnancy on could be an effective strategy for GDM prevention.
authors.affiliation: Endocrinology and Nutrition Department, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Ruiz-Gracia
authors.affiliation: Endocrinology and Nutrition Department, Spain; Facultad de Medicina, Departamento de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Duran
authors.affiliation: Preventive Medicine Department, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Fuentes
authors.affiliation: Endocrinology and Nutrition Department, Spain; Facultad de Medicina, Departamento de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Rubio
authors.affiliation: Endocrinology and Nutrition Department, Spain; Facultad de Medicina, Departamento de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Runkle
authors.affiliation: Endocrinology and Nutrition Department, Spain.
authors.forename: Evelyn F
authors.initials: EF
authors.lastname: Carrera
authors.affiliation: Clinical Laboratory Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Torrejón
authors.affiliation: Endocrinology and Nutrition Department, Spain; Facultad de Medicina, Departamento de Medicina, Universidad Complutense de Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Bordiú
authors.affiliation: Endocrinology and Nutrition Department, Spain.
authors.forename: Laura Del
authors.initials: LD
authors.lastname: Valle
authors.affiliation: Endocrinology and Nutrition Department, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: García de la Torre
authors.affiliation: Clinical Laboratory Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain.
authors.forename: Ana R
authors.initials: AR
authors.lastname: Bedia
authors.affiliation: Endocrinology and Nutrition Department, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Montañez
authors.affiliation: Endocrinology and Nutrition Department, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Familiar
authors.affiliation: Endocrinology and Nutrition Department, Spain; Facultad de Medicina, Departamento de Medicina, Universidad Complutense de Madrid, Spain. Electronic address: acallepascual@hotmail.com.
authors.forename: Alfonso L
authors.initials: AL
authors.lastname: Calle-Pascual
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000517:prevention & control; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D000072001:Diet, Healthy / Q000208:ethnology; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D015994:Incidence; D008019:Life Style / Q000208:ethnology; D039382:Maternal Nutritional Physiological Phenomena / Q000208:ethnology; D050177:Overweight / Q000208:ethnology / Q000503:physiopathology* / Q000517:prevention & control; D010349:Patient Compliance / Q000208:ethnology; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D057566:Self Report; D013030:Spain / Q000453:epidemiology; D015430:Weight Gain
keywords: Diagnosis; Gestational diabetes mellitus; IADPSG; Lifestyle