Background: This study was conducted to determine the major dietary patterns and their
association with risk of gestational diabetes mellitus (GDM); and to compare the level of
glycemic control among women with and without GDM. Method: This is a case-control study
was conducted in the primary healthcare centers, in the year 2021, among 210 pregnant
women, with gestational age ≥ 24 weeks, aged 20-40 years (70 cases and 140 controls matched
for age and geographical location), selected by a purposive sampling method. A validated semi-
quantitative food frequency questionnaire and the international physical activity questionnaire
short-form were used. Furthermore, the demographic-socioeconomic and medical history data
were collected using an interview-based questionnaire. The WHO criteria were used for the
diagnosis of GDM. Additionally, the HbA1c was used as a marker of glycemic control.
Statistical analysis was performed using SPSS version 22. Results: The principle component
analysis show two major dietary patterns (Healthy and unhealthy). After adjustment for
confounding variables, women in the lowest tertile of the healthy dietary pattern had a lower
odd for GDM [OR, CI 95%: 0.730 (0.596-.895); P-value 0.002]; whereas women in the lowest
tertile of the unhealthy dietary pattern had a higher odd for GDM [OR, CI 95%: 3.41 (0.033-
0.154); P-value 0.003]. Conclusion: The healthy dietary pattern may be associated with a
lower risk of GDM; whereas the unhealthy dietary pattern may be associated with a high risk of
GDM in Gaza Strip, Palestine.