Combined healthy lifestyle in early pregnancy and risk of gestational diabetes mellitus: A prospective cohort study.

Objective: To examine the association of a combined healthy lifestyle in early pregnancy with gestational diabetes mellitus (GDM) risk. Design, setting and population: A Chinese prospective cohort study with 6980 pregnant women. Methods: Individual modifiable lifestyle factors were assessed in early pregnancy and a combined lifestyle score was derived from the sum of the lifestyle factors, with a higher score indicating a healthier lifestyle. The association of a combined healthy lifestyle with GDM risk was examined. Main outcome measures: Gestational diabetes mellitus was diagnosed in middle pregnancy according to the International Association of Diabetes and Pregnancy Study Group criteria or diagnoses in medical records. Results: Overall, 501 (7.2%) pregnant women were diagnosed with GDM. Being physically active (total energy expenditure in upper three quintiles, i.e. ≥100.1 metabolic equivalent of task [MET]‐hours/week; odds ratio [OR] 0.76, 95% confidence interval [CI] 0.63–0.92), healthy diet (total intake of vegetables and fruits ≥5 times/day; OR 0.74, 95% CI 0.59–0.94), sufficient sleep (night‐time sleep duration ≥7 hours/night; OR 0.66, 95% CI 0.48–0.90) and healthy weight (early‐pregnancy BMI <24.0 kg/m2; OR 0.57, 95% CI 0.46–0.71) were associated with lower GDM risk. The GDM risk decreased linearly across the combined lifestyle score (Ptrend <0.001): women with 2, 3 and 4 lifestyle factors compared with those with 0–1 factor had 38% (OR 0.62, 95% CI 0.46–0.84), 57% (OR 0.43, 95% CI 0.31–0.58) and 66% (OR 0.34, 95% CI 0.22–0.52) lower risks of GDM, respectively. Conclusion: A healthy lifestyle in early pregnancy was associated with a substantially lower GDM risk. [ABSTRACT FROM AUTHOR]