Assessment of the Association between Iron Status and Gestational Diabetes Mellitus: A Hospital-based Case-control Study.

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Addis Ababa University


Background: Gestational diabetes mellitus (GDM) is the glucose intolerance that results in hyperglycemia, which is first recogni zed during pregnancy. Recently, attention 011 GDM pathophysiology has been fo cused on the relation between iron overloads and glucose intolerance. In most developing countri es 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: Hospi tal based matched case co ntrol study design consisting 100 pregnant women, 50 cases diagnosed with GDM and 50 controls with non-GDM. Both groups were matched for maternal agc and gestational wcek. Following case and control idcntification, participants in both groups were assessed back in time for the exposure status (haemoglobin and other red blood cell indi ces) measured at their first antenatal vis it. Independent sample t-test and logistic rcgress ion anal ysis were computed to identify signifi cantly associated variables. Result: During early pregnancy (at first trimester), higher concentrations of mul tiple indices haemoglobin (Hgb), haemarocrit (HCT), and mean cell haemoglobin concentration (MCHC) were shown a sign ificant assoc iation with GDM occurrence. Rcgarding iron status indices measured at third trimester, signifi cantly higher values of HGB and !-ICT were associated with GDM. Whereas, only higher value of HCT was assoc iated with GDM in the second trimester. The mean Hgb concentrations among cases ( 13±1 gldl) and controls ( 12.5± l.l gldl) (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 occunence nearly doubles (OR = 1.97,95% CI= 1.2 16 - 3.209 , p=0.006). Furthermore, in comparison to those with Hgb concentration of < 13 gldl, pregnant women wi th Hgb concentration of > 14 were 4.6 times more likely to develop GDM. Conclusion: Higher iron status during pregnancy is assoc iated with GDM. Either HGB alone or in combination with HCT concentrations at early pregnancy cou ld be used as an iron status indicator in predi cting the potential occurrence of GDM. Key-words: Gestational Diabetes Mellitus, iron status, Hem oglobin, pregnancy.



Gestational Diabetes Mellitus, iron status, Hem oglobin, pregnancy