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

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

Paperzilla title

Diet Soda During Pregnancy May Increase Risk of Gestational Diabetes, But More Research Is Needed

This Australian study suggests that frequently drinking artificially sweetened beverages (ASB) during pregnancy may increase the risk of gestational diabetes. The association was found to be partially mediated by maternal BMI. However, the study relied on self-reported data and did not have information on the type of artificial sweeteners used, limiting the strength of the evidence.

Possible Conflicts of Interest

None identified

Identified Weaknesses

Self-reported data

ASB intake and pregnancy outcomes were self-reported, which can lead to recall bias and misclassification. Information on the types of artificial sweeteners used was not collected, limiting the study's ability to investigate the effects of specific LCS.

Mediation analysis limitations

While the study treated BMI as a mediator, reverse causation is possible, where women with higher weight gain might consume more ASBs due to their non-caloric nature. This confounds the mediation analysis.

Limited ASB assessment

ASB intake was assessed based on consumption of only three types of beverages. Many other food products contain artificial sweeteners, and these were not accounted for, potentially underestimating total LCS exposure.

Small sample size for PTB analysis

The analysis of the association between ASB intake and preterm birth was limited by a small sample size with fewer observed outcomes, especially for higher ASB intake. This resulted in wide confidence intervals, suggesting the estimates are imprecise and further research with larger samples is needed.

Cross-sectional analysis

ASB intake was measured at a single point in time in most surveys, not allowing for assessment of change in intake and making causal inference difficult. Also, the ASB assessment questions in the survey were not validated.

Rating Explanation

This study provides interesting findings, but several limitations related to self-reported data, measurement of ASB intake, the mediation analysis, and limited sample size for PTB outcomes, warrants a cautious interpretation of the results. Hence, the rating of 3 indicating an average study with several limitations.

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Topic Hierarchy

Domain:

Health Sciences

Field:

Medicine

Subfield:

Obstetrics and Gynecology

File Information

Original Title:

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

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September 10, 2025 at 04:15 PM

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