Methods	Individual Randomized Controlled Trial in Women and Children Hospital, School of Medicine, Xiamen University, China
Participants	Inclusion criteria: Adult pregnant women aged 18 years or older who had at least one risk factor of GDM were included in this study. The risk factors of GDM were defined as follows: age ≥35 years, pre‐pregnancy body mass index (BMI) ≥25 kg/m2, family history of diabetes mellitus, history of PCOS, and history of GDM in a previous pregnancy. Exclusion criteria: Pregnant women were excluded if they had pre‐existing diabetes mellitus, multiple pregnancies, use of medication that influences glucose metabolism (e.g., steroids, b‐adrenergic agonists, and anti‐psychotic drugs), physical disability, or severe psychiatric disorders. Age [Mean (SD)]—Intervention, Control: 31.4 (4.9), 31.8 (5) Parity [n (%)]—Intervention, Control: 0: 89 (64), 93 (65.5) ≥1: 50 (36.0), 49 (34.5) Education status [n (%)]—Intervention, Control: 0–6 years (primary): 14 (21.6), 9 (13.8) 7–12 years (secondary): 36 (56.9), 43 (67.7) >12 years (college): 14 (21.5), 12 (18.5)
Interventions	Intervention—Lifestyle intervention (counseling and recommended exercise) (n = 152) Description: Participants in the intervention group received structured but individually modified education regarding a balanced dietary pattern, moderate physical activity, and weight control. The intervention included one face‐to‐face education session with an interventionist at the onset of treatment and continuous educational messages delivered via a WeChat public account at a frequency of twice per week. Nutrition counseling messaging: The balanced dietary pattern in the intervention was based on the China diagnosis and therapy guideline of pregnancy with diabetes Mellitus, aimed to achieve or maintain ideal body weight and meet nutritional needs. Pregnant women were encouraged to consume vegetables, fruits, high‐fiber whole‐grain products, low‐fat dairy products, and to avoid foods rich in sugar and saturated fatty acids, among other guidance. Participants in the intervention group were recommended to engage in approximately 30 min of moderate‐intensity physical activity at a frequency of three to four times per week. Bodyweight control during early and mid‐to‐late pregnancy was based on the recommendation of the National Academy of medicine. Intervention adapted to local context: Not reported. Women empowerment approach: Unclear empowerment approach. Control (n = 152) Description: Usual prenatal care was offered.
Outcomes	Gestational weight gain, Hemorrhage, Mode of delivery
Notes	Funding: This research received no specific grant from any funding agency in the public, commercial, or not‐for‐profit sectors.