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孕中期补铁与妊娠期糖尿病

Iron supplementation and gestational diabetes in midpregnancy.

作者信息

Bo Simona, Menato Guido, Villois Paola, Gambino Roberto, Cassader Maurizio, Cotrino Ilenia, Cavallo-Perin Paolo

机构信息

Department of Internal Medicine, University of Turin, Corso Dogliotti 14, Turin 10126, Italy.

出版信息

Am J Obstet Gynecol. 2009 Aug;201(2):158.e1-6. doi: 10.1016/j.ajog.2009.04.049. Epub 2009 Jun 13.

Abstract

OBJECTIVE

Iron supplementation in pregnancy seems beneficial for neonatal/maternal outcomes, but it was associated with diabetes and hypertension in the general population.

STUDY DESIGN

We investigated the association between iron supplementation during midpregnancy and metabolic/hypertensive abnormalities in 500 consecutive gestational diabetes mellitus (GDM) and 500 normoglycemic women.

RESULTS

Iron-supplement users (n = 212/1000) showed significantly higher values of prepregnancy body mass index (BMI), actual BMI, waist circumference, blood pressure, fasting glucose, Homeostasis-Model-Assessment-Insulin-Resistance, and lower high-density lipoprotein-cholesterol than nonusers. The prevalence of GDM (70.8% vs 44.4%), hypertension (25.9% vs 9.8%), metabolic syndrome (25.9% vs 10.4%) was significantly higher in the former with a 2- to 3-fold-increased risk at multiple regression analyses. Most glucose values of the oral glucose tolerance test were significantly higher in iron supplemented women, both in GDM and normoglycemic individuals.

CONCLUSION

Iron supplementation is associated with glucose impairment and hypertension in midpregnancy; its potential harmful effects might be carefully debated regarding its effectiveness.

摘要

目的

孕期补充铁剂似乎对新生儿/母亲结局有益,但在普通人群中它与糖尿病和高血压有关。

研究设计

我们调查了500例连续的妊娠期糖尿病(GDM)女性和500例血糖正常女性在妊娠中期补充铁剂与代谢/高血压异常之间的关联。

结果

与未补充铁剂者相比,补充铁剂者(n = 212/1000)孕前体重指数(BMI)、实际BMI、腰围、血压、空腹血糖、稳态模型评估胰岛素抵抗的值显著更高,高密度脂蛋白胆固醇更低。前者的GDM患病率(70.8%对44.4%)、高血压患病率(25.9%对9.8%)、代谢综合征患病率(25.9%对10.4%)显著更高,在多元回归分析中风险增加2至3倍。在GDM和血糖正常个体中,补充铁剂女性的口服葡萄糖耐量试验的大多数血糖值均显著更高。

结论

妊娠中期补充铁剂与葡萄糖损害和高血压有关;关于其有效性,其潜在有害影响可能需要仔细讨论。

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