Association between oxidative balance score and gestational diabetes mellitus risk: a case-control study

Gestational diabetes mellitus (GDM) is a common pregnancy complication closely associated with increased oxidative stress. The Oxidative Balance Score (OBS) integrates dietary and lifestyle factors influencing oxidative stress, yet its relationship with GDM remains unclear.

In this case-control study, 150 pregnant women with GDM and 170 healthy controls were recruited from primary healthcare centers in Urmia, Iran. Dietary intake was assessed using a validated 168-item Food Frequency Questionnaire (FFQ), and OBS was calculated based on dietary and lifestyle pro-oxidant and antioxidant components. Logistic regression models were used to examine the association between OBS tertiles and GDM risk, adjusting for potential confounders.

Women with GDM had significantly lower total OBS (18.37 ± 8.77 vs. 20.64 ± 10.98, p = 0.041) and dietary OBS (16.1 ± 6.46 vs. 17.89 ± 8.66, p = 0.036) compared to controls. key antioxidant nutrient intake, including riboflavin, folate, magnesium, and zinc, were significantly lower in the GDM group (p < 0.05). In contrast, lifestyle OBS was significantly higher in the GDM group (4.05 ± 1.4 vs. 3.65 ± 1.62, p = 0.018). Women in the highest OBS tertile had a 23% lower risk of GDM (aOR = 0.77; 95% CI: 0.48-0.92). Higher dietary and lifestyle OBS were also inversely associated with GDM risk.

A higher OBS, particularly in its dietary and lifestyle components, is associated with a reduced risk of GDM. These findings highlight the importance of antioxidant-rich diets and lifestyle modifications in GDM prevention.