الفهرس 
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Abstract
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Obesity before and weight gain during pregnancy predispose women to GDM and early onset of T2DM, so prevalence of GDM has increased overtime, along with the increase in the prevalence of obesity.
GDM is associated with an increase in maternal and neonatal complications of pregnancy. A range of factors have been found to increase the risk of developing GDM. Having a low fiber and high glycemic load diet is considered one of the modifiable risk factors for GDM.
Medical nutrition therapy for gestational diabetes should focus on food choices for appropriate weight gain, normoglycemia, and absence of ketones. MNT includes not only the total daily caloric intake and its carbohydrate content, but also the number of meals throughout the day. An evening snack may be needed to prevent accelerated ketosis overnight. Many women need to decrease the amount of carbohydrates ingested at breakfast to 15 to 30g, and then divide the remaining carbohydrates evenly throughout the day.
The general aim of the present study is to assess the effect of dietary intervention in females with gestational diabetes mellitus on maternal and newborn outcomes. The specific objectives are to design and implement dietary intervention for pregnant women with GDM, to assess the effect of intervention on the maternal outcomes: (weight gain, gestational age at delivery and nature of labour) and to determine the effect of intervention on the newborn outcomes: (prematurity, macrosomia, shoulder dystocia and neonatal hypoglycemia).
A quasi experimental study was conducted in karmoz hospital. Both intervention group and the non-intervention group were aged 20 – 40 years, between 28 – 36 gestational weeks, primi or multigravida, singleton pregnancy were included in our study. All cases and controls were randomly selected until the total sample size was achieved.
The study groups were interviewed to answer a pre-designed questionnaire which included socio demographic, family, past and present obstetric history, life style pattern, meal pattern, food habits, frequency of food consumption and dietary intake using 24 hour food recall. The dietary intake was analyzed using the Egyptian food composition tables into energy and macronutrients (protein, carbohydrates and fats). Nutrient adequacy of energy, carbohydrates, proteins and fats was calculated. Physical examination was carried out including blood pressure measurement. Anthropometric measurements were recorded including weight, height and mid upper arm circumference. Record review was taken from files of patients including: haemoglobin level, urine analysis and random blood glucose. The intervention group was given the nutritional advice that emphasized on having total energy intake in range of 1.600 – 1.800 kcal/day, where the consumption of carbohydrates is 40 – 50% of the daily caloric intake and having low glycemic index diet. The control group was maintained on the nutritional advice given by the practicing obstetrician of the hospital. Both cases and controls were followed up regularly till time of delivery.