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Two separate scoring systems, the Mediterranean Diet Index score (MDS) and a customized version, were utilized to assess pre-pregnancy adherence to medical directives. The adjusted odds ratios (aOR) for each score were derived via multiple logistic regression modeling. Out of the 743 women involved, a noteworthy 112 (representing 151 percent) developed gestational diabetes. A statistically significant association was found between a high adherence score (5-9 points) on the MDS index and a lower incidence of gestational diabetes mellitus (GDM) (adjusted
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