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This meta-analysis indicates that an increase in dietary cholesterol intake is associated with increased risk of GDM. Detailed cohort studies are essential to gain a better understanding of this association. Key teaching points Studies on animal models have suggested that a cholesterol-rich diet can promote systemic inflammation and insulin resistance, both of which can contribute to T2DM and GDM. Several epidemiological studies have investigated a potential relationship between dietary cholesterol intake and GDM risk, and the results are controversial. Our