Abstract

Background and Objectives: This study aims to investigate the impact of ultra-processed food (UPF) intake and the Chinese Diet Balance Index for Pregnancy (DBI-P) index on cesarean section rates and neonatal weight among women with gestational diabetes mellitus (GDM). Methods and Study Design: This study was a retrospective cohort study involving 279 GDM patients. We have collected dietary data, pregnancy information, and calculated UPF intake and the Chinese Diet Balance Index for Pregnancy (DBI-P) index. The impact of UPF exposure and dietary factors on low birth weight and macrosomia was analyzed using logistic regression. Results: This study revealed widespread insufficient consumption of several food groups among the GDM population. Specifically, compared with the UPF non-exposed group, the UPF-exposed group had a significantly higher rate of insufficiency in vegetables (Z = -4.94, p <0.001) and dairy products (Z = -2.28, p = 0.007), but a lower intake of plant oils (Z = -2.16, p = 0.03). After adjusting for several factors, the logistic regression results showed that UPF exposure was a risk factor for cesarean section (OR = 1.74, p = 0.046). Moreover, GDM patients who were overweight or obese before pregnancy faced a higher risk of a cesarean section when exposed to UPFs (OR = 4.13, 95%CI(1.35, 12.6)). Conclusions: Patients with GDM showed an unbalanced dietary intake pattern, which was more pronounced in the group with higher exposure to UPFs. However, prenatal UPF exposure did not significantly affect the patients' oral glucose tolerance test (OGTT) results. Nonetheless, excessive UPF consumption during pregnancy may increase the risk of cesarean section.

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