Assessment of the Association Between Iron Status and Gestational Diabetes Mellitus: a Hospital-Based Case-Control Study.
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Date
2020-11-25
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Addis Ababa University
Abstract
Background: Gestational diabetes mellitus (GDM) is the glucose intolerance that results in hyperglycemia, which is first recognized during pregnancy. Recently, attention on GDM pathophysiology has been focused on the relation between iron overloads and glucose intolerance. In most developing countries including Ethiopia, pregnant women are exposed to adverse pregnancy outcomes related to iron. However, evidence is lacking regarding the association of iron in the development of gestational diabetes mellitus.
Objective: the objective of the study was to assess the association between iron status of pregnant women and GDM.
Method: Hospital based matched case control study design consisting 100 pregnant women, 50 cases diagnosed with GDM and 50 controls with non-GDM. Both groups were matched for maternal age and gestational week. Following case and control identification, participants in both groups were assessed back in time for the exposure status (haemoglobin and other red blood cell indices) measured at their first antenatal visit. Independent sample t-test and logistic regression analysis were computed to identify significantly associated variables.
Result: During early pregnancy (at first trimester), higher concentrations of multiple indices haemoglobin (Hgb), haematocrit (HCT), and mean cell haemoglobin concentration (MCHC) were shown a significant association with GDM occurrence. Regarding iron status indices measured at third trimester, significantly higher values of HGB and HCT were associated with GDM. Whereas, only higher value of HCT was associated with GDM in the second trimester. The mean Hgb concentrations among cases (13±1 g/dl) and controls (12.5±1.1 g/dl) (p=0.003) were observed at first trimester. Regression analysis of the present study demonstrated that for every unit increase in Hgb concentration, the odds of GDM occurrence nearly doubles (OR = 1.97, 95% CI=1.216 - 3.209, p=0.006). Furthermore, in comparison to those with Hgb concentration of < 13 g/dl, pregnant women with Hgb concentration of > 14 were 4.6 times more likely to develop GDM.
Conclusion: Higher iron status during pregnancy is associated with GDM. Either HGB alone or in combination with HCT concentrations at early pregnancy could be used as an iron status indicator in predicting the potential occurrence of GDM.
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Keywords
Gestational Diabetes Mellitus, Iron Status, Hemoglobin, Pregnancy