Dataset Information

Correlation between high serum ferritin levels and adverse pregnancy outcomes in women with gestational diabetes mellitus.

ABSTRACT:

Aims

To explore the association between higher serum ferritin (SF) levels in mid-pregnancy and adverse pregnancy outcomes in gestational diabetes mellitus (GDM) pregnancies, then develop a predictive cut-off value that might effectively predict the risk of adverse pregnancy outcomes in future clinical.

Methods

The study involved 201 pregnant women with GDM. 201 gestational age and parity matched normoglycemic pregnant women were taken as control group. The differences in clinical data were compared by the Mann-Whitney U test and Chi-square tests. Multivariate logistic regression was used to determine the relationship between SF and GDM-relate adverse pregnancy outcomes. The predicted value of SF level was determined through receiver operating characteristic (ROC) curve analysis.

Results

SF level was significantly higher in women with GDM [16.10 (27.30-9.50) (ng/mL) vs. 12.04 (18.11-7.06) (ng/mL), (p < 0.001)]. Meanwhile, higher levels of SF were also discovered in GDM women with preeclampsia and neonatal hypoglycemia and respiratory distress (all p < 0.05). In the adjusted model, a positive association was shown between SF and preeclampsia [adjusted odds ratio (AOR) = 1.032, 95%CI = 1.004-1.060, p = 0.024], neonatal hypoglycemia [adjusted odds ratio (AOR) = 1.047, 95%CI = 1.022-1.072, p < 0.001] and respiratory distress outcomes (AOR = 1.034, 95%CI = 1.011-1.058, p = 0.004) respectively. The area under ROC curve (AUC) for prediction of preeclampsia by SF combined with serum calcium, age, pre-pregnancy BMI and gestational weight gain (GWG) was 0.658 (95% CI = 50.8-80.8%, p = 0.028) with the cut-off value of 24.45 ng/mL, and the sensitivity and specificity were 58.8.0% and 64.3%, respectively. To predict neonatal hypoglycemia, the clinical point value of SF was 27.43 ng/mL with AUC was 0.800, sensitivity and specificity was 90.5% and 68.0% respectively. Predicting neonatal respiratory distress, the AUC value of the SF level was 0.730, with a cut-off value of 27.37 ng/mL and the sensitivity and specificity were 52.0% and 86.5%, respectively.

Conclusions

Higher level of SF in mid-pregnancy was significantly associated with the risk of GDM and GDM-relate adverse pregnancy outcomes. Moreover, SF levels have moderate clinical value in predicting the adverse outcomes of maternal preeclampsia, neonatal hypoglycemia and respiratory distress.

SUBMITTER: Fan X

PROVIDER: S-EPMC10023919 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Correlation between high serum ferritin levels and adverse pregnancy outcomes in women with gestational diabetes mellitus.

Fan Xizhenzi X Wang Lingli L Jiao Ruifen R Song Wenhui W Liu Yumeng Y Yu Tianxiao T

Heliyon 20230309 3

<h4>Aims</h4>To explore the association between higher serum ferritin (SF) levels in mid-pregnancy and adverse pregnancy outcomes in gestational diabetes mellitus (GDM) pregnancies, then develop a predictive cut-off value that might effectively predict the risk of adverse pregnancy outcomes in future clinical.<h4>Methods</h4>The study involved 201 pregnant women with GDM. 201 gestational age and parity matched normoglycemic pregnant women were taken as control group. The differences in clinical ...[more]

PMID: 36942253

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Project description:AimsGestational diabetes mellitus (GDM) is any degree of glucose intolerance with onset or first detection during pregnancy, with an inconsistent association with serum ferritin (SF). We aimed to ascertain the relationship between SF and the risk of GDM in mid-pregnancy and provide evidence for implementing clinical individualized and reasonable iron supplementation regimens.MethodsA retrospective study was conducted to investigate 1,052 pregnant women at 24-28 weeks of gestation who were examined in the obstetrics department of The Fourth Hospital of Shijiazhuang from January 2019 to December 2021. Questionnaires were used to obtain the general information. The levels of serum ferritin (SF), serum calcium, glycated haemoglobin (HbA1c) and Oral-Glucose-Tolerance-Test (OGTT) were reviewed. The GDM was diagnosed by glucose tests. Multivariate logistic regression was used to determine the relationship between serum ferritin and GDM.ResultsCompared to the non-GDM group, the GDM group had significantly higher level of SF (13.95 (8.59-23.65) ng/mL vs. 12.11 (7.27-19.86) ng/mL, (p = 0.012)). While SF levels positively correlated with 1-hour plasma glucose levels (PG1H) (r = 0.061, p = 0.047), there was a negative correlation between SF and HbA1c levels (r = - 0.078, p = 0.011). The risk of GDM with higher levels of SF was increased (1.010 (95% CI [1.001-1.020], p = 0.025)). In the univariate logistic regression model, the risk of GDM in pregnant women with high ferritin levels was 1.010 (95% CI [1.001-1.020], p = 0.025). After adjustment for age and pre-pregnancy body mass index (BMI), the risk of GDM was significantly increased by 44% and 42% respectively (adjusted odds ratio (AOR) = 1.440, 95% CI [1.025-2.023], p = 0.035), AOR = 1.420 (95% CI [1.011-1.995], p = 0.043). After multivariate adjustment for age and pre-pregnancy BMI, the results were moderately revised (AOR = 1.427, 95%CI [1.013-2.008], p = 0.042).ConclusionsElevated SF levels of mid-pregnancy was associated with risk of GDM, which may guide the implementation of pregnancy-specific supplementation to some extent with the support of further clinical trials.

Project description:BackgroundStudies have shown a strong correlation between excess iron and the development of gestational diabetes mellitus (GDM), though iron is an essential trace element during pregnancy. This study aims to investigate the precise relationship between iron storage levels during late pregnancy and the development of GDM, trying to find out ways to meet pregnant iron storage requirements and reduce GDM risk simultaneously.MethodsA non-anemic population consisting of 9,512 healthy singleton pregnant women were included in this study. Serum ferritin (SF) levels during the second and third trimesters and other clinical information were retrospectively collected. Restricted cubic splines (RCS) were performed to examined the non-linear associations between SF level and the GDM incidence as well as blood glucose related indicators during the second trimester. Moreover, the association between the variation of HbA1c levels and the fluctuation of SF levels throughout the third trimester was also explored with the method of RCS.ResultsOverall, women with GDM had slightly higher median SF level than women without GDM 20.5 (13.3, 32.3) vs. 19.8 (12.9, 30.5), P = 0.017) in the second trimester. A U-shaped relationship between GDM risk and SF levels in the second trimester was established after accounting for other cofounding factors (P < 0.001 for nonlinearity). Both GDM and non-GMD women revealed a significant negative relationship between hemoglobin A1c (HbA1c) and SF levels (P < 0.001 for nonlinearity for both). The 1-hour post-glucose load plasma glucose showed a positive correlation tendency with SF levels (P = 0.748 for nonlinearity) in GDM women, while the relationship between these two variables was not obvious in non-GDM women (P = 0.045 for nonlinearity). Generally, the levels of HbA1c rose in the trimester, however, maintaining a high SF level throughout the third trimester would substantially increase the HbA1c level among GDM women with high SF levels (> 30ng/ml) in the second trimester (P < 0.001 for nonlinearity).ConclusionsGDM might result from high or low SF levels during the second trimester. Iron supplementation during pregnancy should be administered judiciously based on blood glucose level and iron storage capacity to maintain the SF level within an appropriate range.

Project description:ObjectiveTo investigate the association between gestational diabetes mellitus and adverse outcomes of pregnancy after adjustment for at least minimal confounding factors.DesignSystematic review and meta-analysis.Data sourcesWeb of Science, PubMed, Medline, and Cochrane Database of Systematic Reviews, from 1 January 1990 to 1 November 2021.Review methodsCohort studies and control arms of trials reporting complications of pregnancy in women with gestational diabetes mellitus were eligible for inclusion. Based on the use of insulin, studies were divided into three subgroups: no insulin use (patients never used insulin during the course of the disease), insulin use (different proportions of patients were treated with insulin), and insulin use not reported. Subgroup analyses were performed based on the status of the country (developed or developing), quality of the study, diagnostic criteria, and screening method. Meta-regression models were applied based on the proportion of patients who had received insulin.Results156 studies with 7 506 061 pregnancies were included, and 50 (32.1%) showed a low or medium risk of bias. In studies with no insulin use, when adjusted for confounders, women with gestational diabetes mellitus had increased odds of caesarean section (odds ratio 1.16, 95% confidence interval 1.03 to 1.32), preterm delivery (1.51, 1.26 to 1.80), low one minute Apgar score (1.43, 1.01 to 2.03), macrosomia (1.70, 1.23 to 2.36), and infant born large for gestational age (1.57, 1.25 to 1.97). In studies with insulin use, when adjusted for confounders, the odds of having an infant large for gestational age (odds ratio 1.61, 1.09 to 2.37), or with respiratory distress syndrome (1.57, 1.19 to 2.08) or neonatal jaundice (1.28, 1.02 to 1.62), or requiring admission to the neonatal intensive care unit (2.29, 1.59 to 3.31), were higher in women with gestational diabetes mellitus than in those without diabetes. No clear evidence was found for differences in the odds of instrumental delivery, shoulder dystocia, postpartum haemorrhage, stillbirth, neonatal death, low five minute Apgar score, low birth weight, and small for gestational age between women with and without gestational diabetes mellitus after adjusting for confounders. Country status, adjustment for body mass index, and screening methods significantly contributed to heterogeneity between studies for several adverse outcomes of pregnancy.ConclusionsWhen adjusted for confounders, gestational diabetes mellitus was significantly associated with pregnancy complications. The findings contribute to a more comprehensive understanding of the adverse outcomes of pregnancy related to gestational diabetes mellitus. Future primary studies should routinely consider adjusting for a more complete set of prognostic factors.Review registrationPROSPERO CRD42021265837.

Dataset Information

Correlation between high serum ferritin levels and adverse pregnancy outcomes in women with gestational diabetes mellitus.

Aims

Methods

Results

Conclusions

Publications

Correlation between high serum ferritin levels and adverse pregnancy outcomes in women with gestational diabetes mellitus.

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