High maternal hemoglobin and ferritin values as risk factors for gestational diabetes

Abstract

A number of studies have linked high maternal serum hemoglobin (Hb) levels in pregnancy with increased incidence of adverse pregnancy outcomes such as low birth weight and small-for-gestational-age newborns pre-term births increased perinatal mortality and pre-eclampsia. Lao et al. Identified high maternal hemoglobin at the initial prenatal visit as a risk factor for gestational diabetes mellitus (GDM). This protective study was conducted on 253 non-diabetic Turkish women with singleton pregnancies whose serum Hb level and mean corpuscular volume (MCV) at the initial visit were > 10 g/dl or > 80 fl respectively. The exclusion criteria were first prenatal visit later than 14 weeks of gestation; pre-existing anemia or hemoglobinopathy chronic disease; such as diabetes mellitus renal or gastrointestinal disorder hypo- or hyper-thyroidism GDM diagnosed before 28 weeks gestation. Values signifying the 50th percentile for Hb (12.2 g/dl) and ferritin (Fe) (19.7 µg/l) were established based on these data and two sets of groups were formed based on the initial-visit-findings (Hb above and below the 50th percentile; Fe above and below the 50th percentile). The pairs of groups were compared with respect to maternal pregnancy and infant characteristics and incidence of GDM. At the first trimester prenatal visit; a blood sample from each subject was analyzed for complete blood count MCV fasting serum glucose level and serum levels of Fe vitamin B12 folic acid and insulin. Insulin sensitivity was calculated using the HOMA index. [(Formula: fasting glucose (mmol/l) X fasting insulin (µunits/ml)/22.5]. All women were screened for GDM between 24 and 28 weeks of gestation with a 50-g oral glucose any subject with serum glucose level > 135 mg is subjected to a 3-h 100-g load OGTT. All the OGTT results at 24-28 weeks gestation were interpreted according to the criteria of Carpenter and Coustan. (excerpt)