Ten studies were evaluated to investigate the consumption of macronutrients in pregnant women and women with gestational diabetes mellitus.  Carbohydrate intake affects postprandial blood glucose levels; Increased postprandial blood glucose levels are associated with increased incidence of large-for-gestational age infants and increased rate of Cesarean sections.  Three studies showed improved outcomes at carbohydrate intakes of less than 45% of energy .  Research is limited regarding protein, fat, fiber and glycemic index in women with gestational diabetes mellitus; further research is needed in these areas.   

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.