Lifestyle-Related Risk Factors of Gestational Diabetes Mellitus in Iran: The Mother and Their Children's Health (Match) Cohort Study



Rezazadeh S ; Yazdanicharati J ; Pirjani R ; Mousavinasab N ; Sepidarkish M
Source: Journal of Mazandaran University of Medical Sciences Published:2025

Abstract

Background and purpose: Gestational diabetes mellitus (GDM) is a prevalent condition with significant implications for maternal and neonatal health. This study aimed to investigate the association between lifestyle-related risk factors and GDM among pregnant women. Materials and methods: The prospective cohort study included 1,845 pregnant women recruited at Arash Women’s Hospital in Tehran, between February 2020 and August 2021. Eligible participants were between 18 and 45 years old, in the early stages of pregnancy (<12 weeks gestation), and free from metabolic or chronic diseases. Sociodemographic and lifestyle data were collected via face-to-face interviews at four time points. Anthropometric measurements, physical activity, dietary intake, and sleep quality were assessed using standardized protocols. GDM was diagnosed through a 75-gram oral glucose tolerance test conducted between 24 and 28 weeks of gestation. Associations between lifestyle factors and GDM were estimated using multivariable modified Poisson regression models. Results: The prevalence of GDM was 19.78%. Higher maternal age (adjusted risk ratio [aRR]: 1.047; 95% CI: 1.031–1.063) and greater pre-pregnancy body mass index (aRR: 1.014; 95% CI: 0.995–1.034) were associated with increased risk. Higher carbohydrate intake was positively associated with GDM risk (aRR: 1.001; 95% CI: 1.001–1.002), whereas moderate-to-vigorous physical activity showed a protective effect (aRR: 0.757; 95% CI: 0.670–0.856). Poor sleep quality (aRR: 1.436; 95% CI: 1.191–1.732) and lower income levels (aRR: 0.932; 95% CI: 0.870–0.998) were also significant predictors of GDM. Conclusion: Considering the crucial role of lifestyle factors in preventing gestational diabetes mellitus, it is recommended that prenatal care programs focus on promoting regular physical activity, improving sleep quality, and modifying dietary patterns, particularly with regard to controlling carbohydrate intake. Additionally, designing educational and supportive interventions tailored to the socioeconomic status of different groups can help reduce the risk of this condition and its associated adverse outcomes. © 2025 Elsevier B.V., All rights reserved.