Association of diet during pregnancy with adverse pregnancy outcomes: a cross-sectional study of pregnant women 20-44 years of age

Background Gestational weight gain (GWG) and gestational diabetes mellitus (GDM), as two major adverse pregnancy outcomes, could be affected by diet patterns, and GWG also influenced GDM. Therefore, we aimed to explore the four diet quality scores and two adverse pregnancy outcomes in a more macroscopic way. Methods 667 women for GWG part and 333 women for GDM part who were pregnant from the National Health and Nutrition Examination Survey (NHANES), aged 20 to 44 years, were involved in this study, respectively. Four diet quality scores including dietary inflammatory index (DII), dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index-2015 (HEI-2015), and Alternative Healthy Eating Index–2010 (AHEI-2010) were chosen in this study. Results The results of the logistic regression showed that HEI increasing reduced the risk of insufficient GWG (P = 0.002), OR was 0.888(0.825,0.956). A-HEI increasing reduced the risks of insufficient GWG and excessive GWG (P = 0.002, P < 0.001), ORs were 0.840(0.754,0.935) and 0.797(0.729,0.871), respectively. Increased DII was a risk factor for the development of GDM (P = 0.012), OR was 1.931(1.163,3.205), and DASH increasing reduced the risk of GDM (P = 0.028), OR was 0.677(0.479,0.957). These associations were robust after excluding the diabetic patients. For pregnant women with GWG, DASH was negatively associated with the risk of GDM. Conclusion Adherence to healthy dietary pattern was associated with decreased risk of adverse pregnancy outcomes. We recommended advanced maternal age women adhere to HEI-2015 and AHEI-2010 to prevent GWG. For pregnant women with GWG, adherence to DASH was beneficial to GDM.