(P27-030-25) Effect of Pregnancy and Preconception Exposure to Low-or-no Calorie Sweetener on Adverse Pregnancy Outcomes: Finding From Australian Longitudinal Study on Women's Health

Objectives: To determine the effect of pregnancy and preconception artificially sweetened beverage consumption on adverse pregnancy outcomes.

Methods: We analysed data from the Australia Longitudinal Study on Women’s Health (ALSWH). For gestational diabetes mellitus (GDM) and hypertensive disorder of pregnancy (HDP), we analysed 3,653 women (1,485 women for pregnancy exposure assessment and 2,168 women for preconception exposure assessment: mutually exclusive samples). For preterm birth (PTB), we included 2,796 women (1,123 for pregnancy exposure assessment and 1,673 for preconception exposure assessment: also, mutually exclusive samples). A generalized linear mixed model with a log link function was used to examine the association between ASB exposure during pregnancy and preconception and adverse pregnancy outcomes such as GDM, HDP, and PTB. We further estimated the average treatment effect (ATE) of ASB intake on all outcomes using augmented inverse probability weighting estimator.

Results: The mean (SD) age of the women was 33.3(4.5) and 33.7(4.7), while the mean (SD) maternal BMI in kg/m2 was 25.6(5.4) and 25.4(5.7) for the pregnancy and preconception exposure group, respectively. The incidence of GDM, HDP, and PTB in the pregnancy exposure group was 8.6%, 7.5%, and 4.0%, while in the preconception exposure group was 9.1%, 6.7%, and 4.3, respectively. The relative risk (RR) of consumption ≥5 serves/week of ASB during pregnancy compared to no consumption was 1.88 [95% CI: 1.12-3.14], 1.59 [95% CI: 0.86-2.93], and 1.22 [95% CI: 0.36-3.99] for GDM, HDP, and PTB, respectively. The risk of frequent preconception ASB intake compared to no or rare intake was 1.41 [95% CI: 0.91-2.16], 1.17 [95% CI: 0.68-2.01], and 0.93 [95% CI: 0.41-2.07] for GDM, HDP, and PTB, respectively. ASB intake ≥5 drinks/ week during pregnancy increased the probability of GDM by 6% [ATE = 0.06, 95% CI: 0.01-0.11]. The effect of ASB on GDM was mediated by maternal BMI.

Conclusions: ASB intake during pregnancy is associated with increased risk of GDM, with a pronounced effect for frequent intake. The findings regarding the effect of pregnancy exposure to ASB on HDP and PTB are not conclusive. Preconception exposure to ASB did not show no significant effect on the outcomes.

Funding Sources: None