Table 4. Multivariable MR analyses of gut microbiota-derived metabolites on GDM after adjusting confounding factors.

Exposure	BMI			Alcohol drinking			Smoking			Hypertension
	OR (95%CI)	P		OR (95%CI)	P		OR (95%CI)	P		OR (95%CI)	P
Serine	5.125(2.142,12.261)	<0.001		3.105(1.443,6.680)	0.004		2.324(1.042,5.184)	0.039		3.348(1.581,7.090)	0.002
Pyruvate	0.424(0.214,0.839)	0.014		0.466(0.294,0.740)	0.001		0.678(0.352,1.309)	0.247		0.492(0.292,0.830)	0.008
Pipecolate	0.542(0.327,0.899)	0.018		0.698(0.423,1.151)	0.159		0.669(0.398,1.123)	0.128		0.648(0.376,1.116)	0.118
Indoleacetate	1.961(0.923,4.164)	0.080		1.684(1.047,2.708)	0.032		1.710(1.029,2.842)	0.039		1.813(1.144,2.875)	0.011
Glycodeoxycholate	0.810(0.551,1.192)	0.285		1.058(0.770,1.454)	0.727		0.893(0.721,1.105)	0.297		0.623(0.556,0.699)	<0.001
Adrenate	2,277(1.686,3.076)	<0.001		1.851(1.270,2.699)	0.001		1.878(1.310,2.692)	0.001		1.829(1.212,2.760)	0.004
Carnitine	0.733(0.320,1.678)	0.462		0.754(0.405,1.405)	0.374		0.725(0.393,1.341)	0.306		0.626(0.331,1.187)	0.152
Phenylacetate	1.184(0.637,2.202)	0.594		1.072(0.647,1.773)	0.778		1,791(1.372,2.339)	0.000		1.596(1.154,2.208)	0.005

OR, odds ratio; CI, confidence interval; P, P value; MR, mendelian randomization; GDM, gestational diabetes mellitus; BMI, body mass index.