Preconception and pregnancy artificially sweetened beverage consumption and its association with adverse pregnancy outcomes: findings from the Australian longitudinal study on women's health

Abstract

Background and aim: Exposure to artificial sweeteners has been linked to adverse health outcomes. We aimed to examine the association between preconception and pregnancy artificially sweetened beverage (ASB) consumption and adverse pregnancy outcomes.

Methods: We analysed data from 3,653 women from the Australian Longitudinal Study on Women's Health (ALSWH). A generalized linear mixed model and augmented inverse probability weighting estimator were used to estimate the relative risk and average treatment effect (ATE), respectively.

Results: The incidence of gestational diabetes mellitus (GDM), hypertensive disorder of pregnancy (HDP), and preterm birth (PTB) in the preconception exposure group was 9.1 %, 6.7 %, and 4.3 %, while it was 8.6 %, 7.5 %, and 4.0 % in the pregnancy exposure group, respectively. The adjusted relative risk (aRR) of frequent ASB consumption (≥5 drinks/week) during pregnancy compared with none were 1.88 (95 % CI: 1.12-3.14) for GDM, 1.59 (95 % CI: 0.86-2.93) for HDP, and 1.22 (95 % CI: 0.36-3.99) for PTB. The ATE of frequent ASB intake during pregnancy compared to none was 0.06 (95 % CI: 0.01-0.11). The association between preconception ASB exposure and all outcomes remain uncertain.

Conclusion: Frequent ASB consumption during pregnancy is associated with a higher risk of GDM, while its association with HDP and PTB remains inconclusive.

Keywords: Artificially sweetened beverage; Australia; Gestational diabetes; Preconception; Pregnancy; Preterm birth.