Artificially Sweetened Drinks in Pregnancy Linked to Higher Gestational Diabetes Risk: Study
Australia: Researchers have found in a new study that frequent intake of artificially sweetened beverages during pregnancy was associated with an 88% increased risk of gestational diabetes.
The investigation, published in Diabetes Research and Clinical Practice, was led by Bereket Gebremichael of the School of Agriculture, Food and Wine at the University of Adelaide, Australia. Using data from the Australian Longitudinal Study on Women’s Health (ALSWH), the team explored whether consuming artificially sweetened beverages (ASBs) before conception or during pregnancy influences the risk of complications such as gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and preterm birth (PTB).
Researchers analyzed health information from 3,653 women and applied a generalized linear mixed model, along with an augmented inverse probability weighting estimator, to evaluate both the relative risk and the average treatment effect. They defined frequent consumption as five or more ASB drinks per week.
The study led to the following findings:
- Among women with preconception exposure to artificially sweetened beverages (ASBs), the incidence was 9.1% for gestational diabetes mellitus (GDM), 6.7% for hypertensive disorders of pregnancy (HDP), and 4.3% for preterm birth (PTB).
- For women consuming ASBs during pregnancy, the incidence rates were 8.6% for GDM, 7.5% for HDP, and 4.0% for PTB.
- Frequent ASB intake during pregnancy was associated with an adjusted relative risk of 1.88 for GDM.
- The adjusted relative risk was 1.59 for HDP and 1.22 for PTB.
- The average treatment effect of frequent ASB consumption compared with none was 0.06.
While the relationship between pregnancy, ASB intake, and GDM was clear, the connections to HDP and PTB remained uncertain. Similarly, exposure to these beverages before conception showed no definite association with any of the pregnancy outcomes studied.
The researchers highlighted a potential dose–response trend: the more artificially sweetened drinks consumed during pregnancy, the greater the risk of developing GDM. Importantly, this relationship appeared to be partly mediated by maternal body mass index (BMI). In other words, higher ASB consumption might contribute to weight gain during pregnancy, which in turn elevates the likelihood of gestational diabetes.
These findings carry significant public health implications. They suggest that reducing artificially sweetened beverage intake during pregnancy could help lower GDM risk, especially when combined with efforts to manage maternal weight gain. The authors emphasized that while their data reveal a strong link between ASB intake and GDM, more research—particularly prospective cohort studies and randomized clinical trials—is needed to confirm causality and to guide nutritional recommendations for expectant mothers.
"Frequent consumption of artificially sweetened beverages during pregnancy was strongly associated with an increased risk of gestational diabetes. In contrast, associations with hypertensive disorders of pregnancy and preterm birth remain inconclusive. The study highlights the importance of counseling women on beverage choices and weight management as part of comprehensive prenatal care," the authors concluded.
Reference:
Gebremichael, B., Begum, M., Bianco-Miotto, T., Zhou, S. J., & Lassi, Z. S. (2025). Preconception and pregnancy artificially sweetened beverage consumption and its association with adverse pregnancy outcomes: Findings from the Australian longitudinal study on women’s health. Diabetes Research and Clinical Practice, 227, 112422. https://doi.org/10.1016/j.diabres.2025.112422
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