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Cited by 0Gestational Diabetes Research and ManagementBirth, Development, and HealthDiabetes, Cardiovascular Risks, and Lipoproteins

Maternal nutritional status and the risk of metabolic syndrome in pregnancy: implications for public health nutrition

Open access
Wu, Yu, Gao, Zhengxiang, Gou, Yu, Yan, Lingyi, Duan, Yifei·2026·Frontiers in Public Health
DOI 10.3389/fpubh.2026.1862412PMC PMC13368915
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Abstract

Background: Maternal nutritional status is considered essential for metabolic adaptation during pregnancy. Both malnutrition and obesity are associated with metabolic abnormalities; however, the link between these factors and metabolic syndrome (MetS) in pregnancy remains poorly studied from a public health perspective. Aim: The aim of the current study was to evaluate the association between nutritional status and the risk of metabolic syndrome in pregnant females. Methods: In a retrospective observational study, data were collected from the medical records of 850 pregnant women from tertiary care hospitals between November 2023 and May 2025. Assessment of nutritional status was carried out using dietary and body mass index (BMI). MetS was diagnosed based on the presence of three or more metabolic conditions. Logistic regression was employed to identify significant risk factors, adjusting for various covariates. Results: MetS was diagnosed in 24.7% of cases. Patients with MetS were found to have higher BMI, dietary calorie intake, fat, and sugar consumption, and lower fibre consumption ( p < 0.001). Risk factors of MetS included poor nutritional habits (AOR = 2.45), insufficient fibre intake (AOR = 2.12), increased BMI (AOR = 2.76), and excessive dietary fat intake (AOR = 1.89). There appeared to be a dose–response effect between fibre intake and MetS. Conclusion: Nutrition status is significantly associated with the risk of MetS during pregnancy. Findings suggest that nutritional evaluation and intervention are important strategies in public health nutrition.

AI snapshot

Written from the paper’s full text.

TL;DR

In a retrospective study of 850 pregnant women, maternal nutritional status was significantly associated with metabolic syndrome (MetS) in pregnancy, which was diagnosed in 24.7% of participants. Poor diet quality, low fibre intake, high fat/sugar intake, and higher BMI were independent risk factors after adjustment.

Key findings

  • MetS was diagnosed in 24.7% (n ≈ 210) of 850 pregnant women. Women with MetS had higher BMI (30.2 ± 5.1 vs. 25.4 ± 4.2 kg/m²), higher energy intake (2,520 ± 430 vs. 2,280 ± 390 kcal/day), higher fat and sugar intake, more processed food intake, and lower fibre intake (16.2 ± 5.4 vs. 23.4 ± 6.1 g/day), all p < 0.001.
  • Adjusted logistic regression found inadequate diet quality (AOR = 2.45, 95% CI 1.78–3.36), low fibre intake (AOR = 2.12, 95% CI 1.54–2.91), high fat intake (AOR = 1.89, 95% CI 1.34–2.67), high sugar intake (AOR = 1.76, 95% CI 1.28–2.41), and maternal overweight/obesity BMI ≥ 25 kg/m² (AOR = 2.76, 95% CI 2.01–3.79), all p < 0.001; physical inactivity (AOR = 1.68, p = 0.002) and family history of diabetes (AOR = 1.59, p = 0.006) were also significant.
  • Fibre intake showed a dose–response pattern: MetS prevalence was 34.8% with low fibre, 24.6% with moderate fibre, and 15.9% with adequate fibre; high triglycerides were 49.2%, 36.5%, and 22.4%, respectively.
  • The multivariable model was statistically significant (χ² = 168.4, p < 0.001; Nagelkerke R² = 0.38; Hosmer–Lemeshow p = 0.62; VIF < 2.5 for all variables).

Methods

  • Retrospective observational study using medical records from tertiary care hospitals and antenatal clinics between November 2023 and May 2025; about 1,150 antenatal records were screened, yielding a final analytical sample of 850 pregnant women.
  • Eligible participants were women aged 18–45 years with singleton pregnancies and complete clinical, biochemical, and dietary records; exclusions included pre-existing metabolic or endocrine disorders, multiple pregnancies, incomplete records, and known fetal anomalies.
  • Nutritional status was assessed using BMI and dietary intake from 24-h dietary recall and food-frequency questionnaires; MetS was defined as ≥3 of elevated fasting glucose ≥95 mg/dL, triglycerides ≥150 mg/dL, HDL <50 mg/dL, and elevated blood pressure (SBP ≥130 mmHg or DBP ≥85 mmHg). Multivariable logistic regression adjusted for maternal age, parity, education, residence, physical activity, family history of diabetes, and maternal BMI.

Limitations

  • The paper states that the retrospective design cannot establish causality, unmeasured confounding may remain, and dietary data from 24-h recall and food-frequency questionnaires are susceptible to recall bias, reporting errors, and measurement error.
  • The paper states that pre-pregnancy BMI was often unavailable, prenatal BMI was used as a surrogate and may be affected by gestational weight gain, assessment timing varied, micronutrient status was not assessed in detail, physical activity was generalized, and record exclusion may introduce selection bias with limited generalizability.
  • The paper also notes possible reverse causality because women diagnosed with metabolic abnormalities may have changed dietary habits after antenatal counselling; the text makes evident that waist circumference was not available in all records and was excluded from the MetS definition, and dietary data were abstracted from routine clinical records rather than a dedicated validated research food-frequency questionnaire.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3389/fpubh.2026.1862412

Cites

39 of 39 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

17 of 26 cited sources checked · 6 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Pregnancy is a metabolically dynamic condition.

    “Pregnancy is a metabolically dynamic condition, and an inappropriate nutritional status may contribute to metabolic alterations, making the person susceptible to metabolic disorders and poor pregnancy outcomes (1, 2).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [1] Grieger, 2018, Metabolic syndrome in pregnancy and risk for adverse pregnancy outcomes: a prospective cohort of nulliparous women, PLoS Med source
    • cites [2] Corrales, 2021, Obesity and pregnancy, the perfect metabolic storm, Eur J Clin Nutr source
  • Premisecitation

    Metabolic syndrome has been very prevalent among women who have gestational diabetes mellitus, especially in the second trimester of pregnancy.

    “Metabolic syndrome has also been very prevalent among women who have GDM, especially in the second trimester of pregnancy (12).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [12] Bartáková, 2024, Metabolic syndrome prevalence in women with gestational diabetes mellitus in the second trimester of gravidity, J Clin Med source

      The Results (§3.1; page unavailable) report metabolic syndrome in 22.6% of women with GDM at 24–28 weeks of pregnancy. The paper studied prevalence in the second trimester but did not compare trimesters, so it does not establish that prevalence is especially high then. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Premisecitation

    Women with pregnancy complications have a higher risk of developing metabolic syndrome in the future.

    “In addition, women with pregnancy complications have a higher risk of developing metabolic syndrome in the future, which underscores the importance of pregnancy as an important period to measure metabolic health (3).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [3] Aldridge, 2022, Prevalence of metabolic syndrome in women after maternal complications of pregnancy: an observational cohort analysis, Front Cardiovasc Med source

      The Discussion reports metabolic syndrome in 36% of women with a major prior pregnancy complication at six months postpartum and cites a comparison of 34% after hypertensive pregnancy versus 5% after normotensive pregnancy. However, it says the study could not assess whether metabolic syndrome developed after pregnancy or progressed over time; some participants may already have had it before conception. The claim's implication of future development goes beyond those findings. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • Premisecitation

    Women who have had gestational diabetes mellitus before are especially vulnerable to developing metabolic syndrome.

    “Women who have had GDM before are especially vulnerable to developing metabolic syndrome, and maternal dietary issues are also contributing factors (11).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [11] Hasbullah, 2022, Maternal and dietary factors are associated with metabolic syndrome in women with a previous history of gestational diabetes mellitus, Int J Environ Res Public Health source
  • Findingown data

    Poorly-nourished women in the study were more likely to develop metabolic syndrome.

    “Poorly-nourished women in our study were more likely to develop metabolic syndrome, which agrees with the results of Habibi et al. (20), who found that unfavourable metabolic profiles in pregnancy are closely associated with gestational metabolic disorders.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Habibi et al. [20] Habibi, 2022, Maternal metabolic factors and the association with gestational diabetes: a systematic review and meta-analysis, Diabetes Metab Res Rev source
  • May combine two claims. 17
  • Classified as probably not a substantial claim. 24

  • May combine two claims.

    Premisecitation

    High energy intake and imbalances in protein, fat, and carbohydrate ratios contribute to insulin resistance, dyslipidemia, and increased metabolic risk.

    “There is evidence that high energy intake and imbalances in protein, fat, and carbohydrate ratios contribute to insulin resistance, dyslipidemia, and increased metabolic risk (4).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [4] Khammarnia, 2024, Maternal macronutrient and energy intake during pregnancy: a systematic review and meta-analysis, BMC Public Health source

      The Discussion (page not provided) links excessive saturated-fat consumption during pregnancy to insulin resistance and later cardiovascular disease in offspring. It does not establish that high energy intake or imbalanced protein, fat, and carbohydrate ratios cause those outcomes, and it does not mention dyslipidemia. The claim also omits the paper’s pregnancy and offspring context. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingcitation

    Higher fibre consumption and low-glycemic diets were correlated with better metabolic profiles.

    “Higher fibre consumption and low-glycemic diets were correlated with better metabolic profiles, which agrees with Sun et al. (27), who showed that dietary fibre supplementation can enhance glycemic control in pregnant women.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Sun et al. [27] Sun, 2022, Effects of additional dietary fiber supplements on pregnant women with gestational diabetes: a systematic review and meta-analysis of randomized controlled studies, Nutrients source

  • May combine two claims.

    Premisecitation

    Inappropriate nutritional status may contribute to metabolic alterations, making the person susceptible to metabolic disorders and poor pregnancy outcomes.

    “Pregnancy is a metabolically dynamic condition, and an inappropriate nutritional status may contribute to metabolic alterations, making the person susceptible to metabolic disorders and poor pregnancy outcomes (1, 2).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [1] Grieger, 2018, Metabolic syndrome in pregnancy and risk for adverse pregnancy outcomes: a prospective cohort of nulliparous women, PLoS Med source

      The Introduction describes pregnancy as metabolically altered and identifies obesity as a risk factor for adverse pregnancy outcomes. The Discussion (Health implications and clinical relevance) says metabolic syndrome in early pregnancy may identify women at increased risk for complications. Neither passage establishes that inappropriate nutritional status causes the metabolic alterations or disorders described in the claim. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [2] Corrales, 2021, Obesity and pregnancy, the perfect metabolic storm, Eur J Clin Nutr source

  • May combine two claims.

    Premisecitation

    Healthy eating habits, especially Mediterranean diets, are associated with a lower incidence of metabolic syndrome and improved glycemic control during the postpartum phase.

    “Conversely, healthy eating habits, especially Mediterranean diets, have been associated with a lower incidence of metabolic syndrome and improved glycemic control during the postpartum phase (5).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [5] Melero, 2023, An early mediterranean-based nutritional intervention during pregnancy reduces metabolic syndrome and glucose dysregulation rates at 3 years postpartum, Nutrients source

  • May combine two claims.

    Premisecitation

    There is a close relationship between maternal dietary trends and metabolic health, as well as the risk of non-communicable disease development in children, such as obesity, insulin resistance, and metabolic syndrome.

    “There is a close relationship between maternal dietary trends and metabolic health, as well as the risk of non-communicable disease development in children, such as obesity, insulin resistance, and metabolic syndrome (15).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [15] Wilkins, 2021, Maternal nutrition and its intergenerational links to non-communicable disease metabolic risk factors: a systematic review and narrative synthesis, J Health Popul Nutr source

      The Background describes a possible link between sub-optimal maternal nutrition and later offspring metabolic risk factors, including overweight or obesity and impaired glucose tolerance. But the Discussion reports a link chiefly for famine exposure in some contexts and no consistent support for maternal dietary intake; the review focuses on adult offspring, not children, and does not establish the claimed close relationship across obesity, insulin resistance, and metabolic syndrome. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    Nutritional factors are independent of the confounder, supporting their clinical significance, as shown in Figure 3.

    “Nutritional factors are independent of the confounder, supporting their clinical significance, as shown in Figure 3.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Poor quality of diet, low level of fibre, excess intake of fat and sugar, high BMI, lack of physical activity and family history of diabetes were independently linked with high odds of metabolic syndrome.

    “Poor quality of diet, low level of fibre, excess intake of fat and sugar, high BMI, lack of physical activity and family history of diabetes were found to be independently linked with high odds of metabolic syndrome.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Dietary inadequacy, insufficient intake of nutrients, and less exercise were found to be significant factors leading to metabolic dysregulation in pregnant women.

    “Dietary inadequacy, insufficient intake of nutrients, and less exercise were found to be significant factors leading to metabolic dysregulation in pregnant women.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Metabolic syndrome in pregnancy is not caused by a single abnormality but by a combination of metabolic disruptions, with lipid abnormalities and obesity being of key importance.

    “The clustering effect demonstrates that metabolic syndrome cannot be caused by a single abnormality but by a combination of metabolic disruptions, with lipid abnormalities and obesity being of key importance.”
    • Also stated in: § Prevalence and clustering of metabolic syndrome components · hedged
      “The data show that multiple metabolic abnormalities are more clustered in the MetS group, suggesting that metabolic syndrome is not defined by individual metabolic abnormalities but by their interplay.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Poor quality of the diet and unhealthy eating habits, including night eating, are lifestyle factors associated with negative metabolic outcomes in children.

    “Poor quality of the diet and unhealthy eating habits, including night eating, are the lifestyle factors associated with negative metabolic outcomes in children, which further support the long-term effects of maternal nutritional exposures (16).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [16] Chen, 2025, Maternal pregnancy diet quality, night eating, and offspring metabolic health: the GUSTO study, Pediatr Res source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Waist circumference was not included in the final operational definition because it was not reported in all retrospective clinical medical records.

    “Access to waist circumference was not reported in all retrospective clinical medical records and was therefore not included in the final operational definition.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    In the current analysis, maternal BMI was considered an environmental nutritional factor rather than a diagnostic component of metabolic syndrome in regression modelling, thereby reducing statistical overlap between the exposure and outcome variables.

    “In the current analysis, maternal BMI was considered an environmental nutritional factor rather than a diagnostic component of metabolic syndrome in regression modelling, thereby reducing statistical overlap between the exposure and outcome variables.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The participant selection process followed a structured sequence of identification, eligibility screening, exclusion, and final inclusion to ensure methodological transparency and minimize selection bias.

    “The participant selection process followed a structured sequence of identification, eligibility screening, exclusion, and final inclusion to ensure methodological transparency and minimize selection bias.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Multivariable logistic regression was used to estimate the independent association between maternal nutritional status and metabolic syndrome after accounting for confounding effects of covariates.

    “Multivariable logistic regression analyses were performed to estimate the independent association between maternal nutritional status and metabolic syndrome, after accounting for the confounding effects of these covariates.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The multivariable regression model was adjusted for maternal age, parity, education level, residence, physical activity status, family history of diabetes, and maternal BMI.

    “Adjusted for maternal age, parity, education level, residence, physical activity status, family history of diabetes, and maternal BMI.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisereasoning

    Maternal obesity and gestational diabetes mellitus are significant risk factors leading to metabolic syndrome in and after pregnancy.

    “Some of the significant risk factors leading to metabolic syndrome in and after pregnancy are maternal obesity and gestational diabetes mellitus (GDM).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Goodness-of-fit and multicollinearity were measured using model diagnostics.

    “Goodness-of-fit and multicollinearity were measured using model diagnostics.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Metabolic syndrome classification was performed using measurements taken during the same period of the antenatal assessment, where possible, to reduce temporal variability between clinical and nutritional variables.

    “To reduce temporal variability between clinical and nutritional variables, metabolic syndrome classification was performed using measurements taken during the same period of the antenatal assessment, where possible.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    A standardized data abstraction protocol was used to ensure consistency and accuracy.

    “A standardized data abstraction protocol was used to extract data to ensure consistency and accuracy.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Nutritional intake estimates were derived from routinely documented clinical dietary assessments rather than from a dedicated research-administered validated food frequency questionnaire.

    “Nutritional intake estimates were derived from routinely documented clinical dietary assessments rather than from a dedicated research-administered validated food frequency questionnaire.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Missing data were few and handled using pairwise deletion, allowing the maximum number of available observations in each analysis.

    “There were only a few missing values, and these were handled using pairwise deletion, which allowed the maximum number of available observations in each analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductreasoning

    The inclusion of several variables enabled the detection of interrelated risk factors, providing a more comprehensive picture of how nutritional and lifestyle factors interact to produce metabolic effects.

    “Also, the inclusion of several variables enabled the detection of interrelated risk factors, providing a more comprehensive picture of how nutritional and lifestyle factors interact to produce metabolic effects.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The associations were observed during routine antenatal care rather than using an established protocol to measure milestones over time, which could have contributed to variability in timing of assessments.

    “The associations were observed during routine antenatal care rather than using an established protocol to measure milestones over time, which could have contributed to the variability in timing of assessments.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Maternal nutritional status is significant for offspring health, supporting the idea of fetal metabolic programming.

    “Our results also imply that maternal nutritional status is significant for offspring health, supporting the idea of fetal metabolic programming.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The study gives a global evaluation of maternal nutritional status by integrating dietary patterns, physical activity, and metabolic indicators.

    “To begin with, it gives a global evaluation of maternal nutritional status with the integration of various dimensions, such as dietary patterns, physical activity, and metabolic indicators, and enables you to assess factors leading to metabolic syndrome during pregnancy in a holistic way.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The results should be interpreted with caution because of the possibility of reverse causality.

    “The results should also be interpreted with caution for the possibility of reverse causality.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study population may not fully represent broader populations, potentially limiting the generalizability of the findings.

    “Additionally, the study population may not fully represent broader populations, potentially limiting the generalizability of the findings.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study design does not provide opportunities to establish causal relationships between maternal nutritional status and the onset of metabolic syndrome, as observed associations may be due to unmeasured confounding.

    “The first is that the study design does not provide opportunities to establish causal relationships between the mother’s nutritional status and the onset of metabolic syndrome, as the observed associations may be due to unmeasured confounding.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    External factors such as socioeconomic status, cultural dietary practices, access to healthcare, and variations in physical activity may not have been fully controlled and could have influenced both nutritional status and metabolic outcomes.

    “External factors such as socioeconomic status, cultural dietary practices, access to healthcare, and variations in physical activity may not have been fully controlled and could have influenced both nutritional status and metabolic outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The possibility that BMI during pregnancy could be affected by gestational weight gain cannot be fully ruled out.

    “The possibility that BMI during pregnancy could be affected by gestational weight gain cannot be fully ruled out.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    Nutritional data may be influenced by recall bias, and dietary intake assessment can be affected.

    “Nutritional data may be influenced by the recall bias, and the dietary intake assessment can be affected, as Pan et al. (24) also note.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Pan et al. [24] Pan, 2023, Association of diet quality during pregnancy with maternal glucose metabolism in Chinese women, Br J Nutr source

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    These findings suggest that maternal nutrition and lifestyle factors may represent important considerations in antenatal metabolic risk assessment and preventive health strategies.

    “These findings suggest that maternal nutrition and lifestyle factors may represent important considerations in antenatal metabolic risk assessment and preventive health strategies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Because anthropometric measures during pregnancy may only partially reflect physiological GWG, some overlap between maternal adiposity and metabolic risk cannot be ruled out.

    “Because anthropometric measures during pregnancy may only partially reflect physiological GWG, some overlap between maternal adiposity and metabolic risk cannot be ruled out.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Early identification of women at increased metabolic risk may support targeted nutritional counselling and lifestyle-focused antenatal interventions.

    “Early identification of women at increased metabolic risk may support targeted nutritional counselling and lifestyle-focused antenatal interventions, although prospective studies are needed to confirm causality and the effectiveness of interventions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Pre-pregnancy BMI was not always recorded in the retrospective clinical data, and prenatal BMI was used as a surrogate marker of the mother's nutritional status.

    “Furthermore, pre-pregnancy BMI was not always recorded in the retrospective clinical data, and prenatal BMI was used as a surrogate marker of the mother’s nutritional status.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study lacked detailed biochemical assessment of micronutrient status, which could have provided additional insight into nutrient-specific metabolic effects.

    “The study also lacked detailed biochemical assessment of micronutrient status, which could have provided additional insight into nutrient-specific metabolic effects.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Although missing data were limited, retrospective record-based studies inherently carry the risk of incomplete documentation and exclusion of records with insufficient data, which may introduce selection bias.

    “Although missing data were limited, retrospective record-based studies inherently carry the risk of incomplete documentation and the exclusion of records with insufficient data, which may introduce selection bias.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Physical activity assessment was relatively generalized and may not have adequately captured differences in intensity or duration among participants.

    “Physical activity assessment was relatively generalized and may not have adequately captured differences in intensity or duration among participants.”
    Quote in the paperNot a substantial claim
38 of 38

  • The paper relies on this without support.

    The sample size of 850 was sufficient to identify statistically significant relationships between maternal nutritional status and metabolic syndrome with adequate power.

    “The sample size of 850 was deemed sufficient to identify statistically significant relationships between maternal nutritional status and metabolic syndrome, with adequate power.”

  • The paper relies on this without support.

    The link between nutritional status and metabolic syndrome in pregnancy remains poorly studied from a public health perspective.

    “Both malnutrition and obesity are associated with metabolic abnormalities; however, the link between these factors and metabolic syndrome (MetS) in pregnancy remains poorly studied from a public health perspective.”

  • The paper relies on this without support.

    Much current literature focuses on individual nutrients or specific components of the diet and does not consider maternal nutrition as a whole, integrated approach.

    “Much of the current literature focuses on individual nutrients or specific components of the diet and does not consider maternal nutrition as a whole, integrated approach.”

  • The paper relies on this without support.

    Variations in study design, population characteristics, and timing of nutritional evaluation complicate the generalisation of conclusions.

    “Moreover, variations in study design, population characteristics, and timing of nutritional evaluation complicate the generalisation of conclusions.”

  • The paper relies on this without support.

    There is a lack of context-specific evidence, especially from low- and middle-income contexts, where dietary habits and access to healthcare vary greatly.

    “This also lacks context-specific evidence, especially from low- and middle-income contexts, where dietary habits and access to healthcare vary greatly.”

  • The paper relies on this without support.

    The link between nutrition and metabolic syndrome is under-researched in most populations, especially low- and middle-income countries.

    “Secondly, the research addresses a significant and recent public health issue, namely the link between nutrition and metabolic syndrome, which is under-researched in most populations, especially low- and middle-income countries.”

  • The paper relies on this without support.

    Gestational weight gain is a factor known to contribute to metabolic syndrome and complications.

    “The weight gain is one of the factors that are known to contribute to metabolic syndrome and complications.”

  • The paper relies on this without support.

    Pre-pregnancy BMI is a more reliable indicator of baseline metabolic risk than prenatal BMI.

    “Pre-pregnancy BMI was a more reliable indicator of baseline metabolic risk, but data were incomplete and difficult to incorporate into the present analysis.”
8 of 8

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • MetS group averages fewer than three qualifying abnormalities

    Major

    Diagnosis requires at least three of the four listed abnormalities, but their prevalences in the MetS group sum to 267.9%. That is only 2.679 abnormalities per person on average, so these figures cannot describe a group in which everyone meets the diagnostic threshold.

  • BMI is presented as a MetS component despite being excluded from the definition

    Minor

    Table 3 places elevated BMI among the MetS components, but the stated diagnostic definition lists four components and does not include BMI. This leaves it unclear whether BMI was counted in the table's component total.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Yaktine, 2010, Weight Gain During Pregnancy: Reexamining the Guidelines

Cited by

Still being checked.

Authors
Wu, Y., Gao, Z., Gou, Y., Yan, L., & Duan, Y.
Affiliations
Sichuan University (CN)
Corresponding author
Duan, Yifei
ORCID
Duan, Yifei
Venue
Frontiers in Public Health
Publisher
Frontiers Media SA
Published
2026-07-01
Volume
14
Pages
1862412-1862412
ISSN
2296-2565 (ISSN-L)
DOI
10.3389/fpubh.2026.1862412
PMC
PMC13368915
OpenAlex
W7166868657
Cited by
0
References
39
FWCI
0.00
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Public Health (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • PubMed Central (submittedVersion, cc-by)
Funders
Sichuan University (22H0816)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
maternal nutritional status, malnutrition, maternal obesity, body mass index, dietary fiber intake, dietary fat intake, dietary habits, risk factors, public health nutrition
MeSH terms
Adult, Female, Humans, Nutritional Status, Pregnancy, Pregnancy Complications, Public Health, Retrospective Studies, Risk Factors, Body Mass Index, Metabolic Syndrome, Maternal Nutritional Physiological Phenomena

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-20.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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