RESUMO
Background: elevated serum ferritin concentration is associated with insulin resistance and diabetes. Recently it has also been described in gestational diabetes mellitus [GDM]
Objective: a prospective study was done to determine whether there was a relationship between serum ferritin concentration in early pregnancy and the risk of GDM
Materials and Methods: a study was performed on 1,384 pregnant women with gestational age of 12-16 weeks. A blood sample was obtained for measurement of ferritin in the first trimester. Diagnosis of GDM was done by 75 gr oral glucose tolerance test between 24-28 wk
Results: women who developed GDM had a higher concentration of serum ferritin than women who did not develop GDM [p=0.01]. A ferritin concentration of 45 ng/ml was calculated to be the 75[th] percentile for healthy pregnant women. Considering this level 32% in the GDM group and 25.2%of normal subjects exhibited high ferritin levels [p=0.01]. The risk of GDM with these high levels of ferritin was 1.4-fold higher than that for subjects with lower concentrations. The Odds Ratio was 1.4 [95% CI= 1-1.87] [p=0.01]. After adjusted for age Odds Ratio was 1.38 [95% CI=1.02-1.86] [p=0.03] and after adjustment for pre-pregnancy Body Mass index, the adjusted odds ratio was 1.31 [CI= 0.96-1.79] [p=0.08]. After multivariable adjustment [age and body mass index], the adjusted odds ratio was 1.3 [0.95-1.8] [p=0.09]
Conclusion: high serum ferritin can be regarded as a significant risk factor for the development of gestational diabetes
RESUMO
Background: Vitamin D supplementation during pregnancy has been supposed to defend against adverse gestational outcomes
Objective: This randomized clinical trial study was conducted to assess the effects of 50,000 IU of vitamin D every two weeks supplementation on the incidence of gestational diabetes [GDM], gestational hypertension, preeclampsia and preterm labor, vitamin D status at term and neonatal outcomes contrasted with pregnant women that received 400 IU vitamin D daily
Materials and Methods: 500 women with gestational age 12-16 weeks and serum 25 hydroxy vitamin D [25 [OH] D] less than 30 ng/ml randomly categorized in two groups. Group A received 400 IU vitamin D daily and group B 50,000 IU vitamin D every 2 weeks orally until delivery. Maternal and Neonatal outcomes were assessed in two groups
Results: The incidence of GDM in group B was significantly lower than group A [6.7% versus 13.4%] and odds ratio [95% Confidence interval] was 0.46 [0.24-0.87] [P=0.01]. The mean +/- SD level of 25 [OH] D at the time of delivery in mothers in group B was significantly higher than A [37.9 +/- 19.8 versus 27.2 +/- 18.8 ng/ml, respectively] [P=0.001]. There were no differences in the incidence of preeclampsia, gestational hypertension, preterm labor, and low birth weight between two groups. The mean level of 25 [OH] D in cord blood of group B was significantly higher than group A [37.9 +/- 18 versus 29.7 +/- 19ng/ml, respectively]. Anthropometric measures between neonates were not significantly different
Conclusion: Our study showed 50,000 IU vitamin D every 2 weeks decreased the incidence of GDM