Abstract
BackgroundIron plays a significant role in the pathogenesis of gestational diabetes mellitus. AimTo determine whether elevated haemoglobin levels during the second trimester of pregnancy is associated with the risk of gestational diabetes mellitus. MethodsA nested case-control study was conducted among 216 pregnant women who were in their second trimester. The categorical variables and continuous variables were analysed by using Chi-square and Independent sample T test respectively. The haematological parameters were correlated with blood glucose values at 3 distinct times and oral glucose tolerance test using Pearson's correlation. The outcome prediction analysis was performed by binary logistic regression and ROC curve analysis was done to evaluate the accuracy of the regression model. ResultsThe haematological parameters significantly varied between the groups. The haemoglobin was significantly higher in the gestational diabetic mellitus group (13.96 ± 0.55 vs 11.95 ± 0.86; p = 0.001; 95% CI 1.82 to2.21). The odds of developing gestational diabetes mellitus in pregnant women with haemoglobin greater than 12.6 g/dL was 5 times greater at p = 0.001 (95% CI 5.54, 28.18). The ROC curve analysis was performed and 88.9% sensitivity and 58.3% specificity were found with an AUC of 0.841. The other haematological parameters were moderately and weakly correlated with blood glucose levels and oral glucose tolerance test. ConclusionThe findings suggest when the haemoglobin levels are greater than 12.6 g/dL during early pregnancy play a role in predicting the risk of developing gestational diabetes mellitus. Awareness must be created among clinicians for early diagnosis and treatment.
Highlights
Gestational diabetes mellitus (GDM) is triggered by impaired glucose sensitivity that causes hyperglycaemia of varying intensity and is first seen during pregnancy
The par ticipants were allotted to their respective groups based on the blood glucose values (Gestational Diabetes Mellitus (GDM) group – fasting blood glucose:≥ 92 mg/dl, random blood glucose:≥ 200 mg/dl, postprandial blood glucose:≥ 140 mg/dl, oral glucose tolerance test [75mg Glucose load]: fasting serum glucose ≥92 mg/dl or 1hr serum glucose of ≥180 mg/dl or 2hr serum glucose of ≥153 mg/dl and Non Gestational Diabetes Mellitus (Non- GDM) group – FBS: ≤ 92 mg/dl, RBS: ≤ 200 mg/dl, postprandial blood glucose levels (PPBS): ≤ 140 mg/dl, oral glucose tolerance test levels (OGTT) [75mg Glucose load]: fasting serum glucose ≤92 mg/dl or 1hr serum glucose of ≤180 mg/dl or 2hr serum glucose of ≤153 mg/dl
The data of study participants who were at the gestation period of 13–28th week and visited Government Medical College and Hospital (GMCH), Udhagamandalam for their routine antenatal check-up were collected
Summary
Gestational diabetes mellitus (GDM) is triggered by impaired glucose sensitivity that causes hyperglycaemia of varying intensity and is first seen during pregnancy. Aim: To determine whether elevated haemoglobin levels during the second trimester of pregnancy is associated with the risk of gestational diabetes mellitus. The haematological parameters were correlated with blood glucose values at 3 distinct times and oral glucose tolerance test using Pearson’s correlation. The odds of developing gestational diabetes mellitus in pregnant women with haemoglobin greater than 12.6 g/dL was 5 times greater at p = 0.001 (95% CI 5.54, 28.18). The other haematological parameters were moderately and weakly correlated with blood glucose levels and oral glucose tolerance test. Conclusion: The findings suggest when the haemoglobin levels are greater than 12.6 g/dL during early pregnancy play a role in predicting the risk of developing gestational diabetes mellitus. Awareness must be created among clinicians for early diagnosis and treatment
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