Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
Br J Nutr. 2022 Dec 14;128(11):2097-2104. doi: 10.1017/S000711452100502X. Epub 2022 Feb 10.
This study aimed to determine the association between hemoglobin (Hb) concentration and Hb change, during early to mid-pregnancy with the risk of gestational diabetes mellitus (GDM). This was a clinic-based retrospective cohort study of 1951 healthy pregnant women (18-45 years old) with a singleton gestation attending antenatal care at government health clinics. Hb concentration at first prenatal visit and each trimester was extracted from the antenatal cards. Hb changes from first prenatal visit to first and second trimester as well as from second to third trimester were calculated. Multivariate logistic regression was used with adjustment for covariates. Women with GDM had significantly higher Hb concentrations (Hb 1) at first prenatal visit (< 12 weeks) compared with non-GDM women (11·91 g/dl .11·74 g/dl). Hb 1 and Hb changes (Hb change 2) from first prenatal visit to the second trimester (23-27th weeks) were significantly associated with GDM risk, with an adjusted OR of 1·14 (95 % CI 1·01, 1·29) and 1·25 (95 % CI 1·05, 1·49), respectively. The significant associations between Hb 1 and Hb change 2 with the risk of GDM were found among non-Malays, overweight/obese and women aged 35 years and above. Women with higher Hb concentrations in early pregnancy were at higher risk of GDM, and such association was significant among women aged 35 years and above, non-Malays and overweight/obese. This raises a potential concern for elevated Fe status in early pregnancy as a risk factor of GDM among Fe-replete women.
本研究旨在探讨孕早期至中期血红蛋白（Hb）浓度和 Hb 变化与妊娠糖尿病（GDM）风险之间的关联。这是一项基于诊所的回顾性队列研究，纳入了 1951 名在政府诊所接受产前保健的健康孕妇（18-45 岁），单胎妊娠。从产前卡中提取首次产前就诊和每个孕期的 Hb 浓度。计算从首次产前就诊到第一和第二孕期以及从第二孕期到第三孕期的 Hb 变化。采用多变量逻辑回归模型，调整了协变量。与非 GDM 女性相比，患有 GDM 的女性在首次产前就诊（<12 周）时的 Hb 浓度（Hb1）明显更高（11.91g/dl .11.74g/dl）。首次产前就诊至第二孕期（23-27 周）的 Hb1 和 Hb 变化（Hbchange2）与 GDM 风险显著相关，调整后的 OR 分别为 1.14（95%CI 1.01，1.29）和 1.25（95%CI 1.05，1.49）。在非马来人、超重/肥胖和 35 岁及以上的女性中，Hb1 和 Hbchange2 与 GDM 风险之间存在显著关联。在妊娠早期 Hb 浓度较高的女性中，GDM 的风险更高，这种关联在 35 岁及以上、非马来人和超重/肥胖的女性中更为显著。在铁储备充足的女性中，妊娠早期铁水平升高可能是 GDM 的一个潜在危险因素。
