The relationship between maternal hemoglobin concentration in the first trimester of pregnancy and gestational diabetes

Document Type : Original Article

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, Pregnancy Health Center, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

2 Professor, Department of Epidemiology, Health Promotion Research Center, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

3 General practitioner, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

Abstract

Introduction: Diabetes is the most common endocrine disease in pregnancy and identifying the risk factors for gestational diabetes helps to identify women who are at risk for type 2 diabetes in the future. The present study was performed aimed to determine the relationship between maternal hemoglobin concentration in the first trimester of pregnancy and gestational diabetes in pregnant women.
Methods: This retrospective study was performed on 300 cases of pregnant women who referred to medical centers of Zahedan in 2017-2019. The information checklist was used to collect demographic characteristics of research samples such as age, height, weight and number of pregnancies and deliveries, maternal hemoglobin and FBS concentrations at the first visit to the relevant centers and GCT levels in 24 to 28 weeks of pregnancy. Data were analyzed by SPSS statistical software (version 25) and Independent t-test and ANOVA tests. P<0.05 was considered statistically significant.
Results: Out of 300 women in the statistical population, 113 (37.7%) had gestational diabetes and 187 (62.3%) were healthy in terms of diabetes. Of the subjects, 103 (34.3%) had hemoglobin concentrations greater than 13, 42 (14%) had hemoglobin concentrations 12.4 to 13, 79 (26.3%) had hemoglobin concentrations between 11.6 to 12.3, and 76 (25.3%) had hemoglobin concentrations less than 11.5. The mean hemoglobin level in diabetic pregnant women was 13.71 ± 0.61 g/dl and in healthy women was 11.80 ± 0.52 g/dl, and the difference was statistically significant (P <0.001). There was also a positive and significant correlation between hemoglobin and fasting blood sugar levels (P <0.001).
Conclusion: High hemoglobin level (more than 13 g/dl) in the first trimester of pregnancy is significantly and directly related to gestational diabetes, therefore it can be considered as a risk factor for gestational diabetes.

Keywords

References

  1. Jung J, Rahman MM, Rahman MS, Swe KT, Islam MR, Rahman MO, et al. Effects of hemoglobin levels during pregnancy on adverse maternal and infant outcomes: a systematic review and meta‐analysis. Annals of the New York Academy of Sciences 2019; 1450(1):69-82.
  2. Si S, Shen Y, Xin X, Mo M, Shao B, Wang S, et al. Hemoglobin concentration and iron supplement during pregnancy were associated with an increased risk of gestational diabetes mellitus. Journal of Diabetes 2021; 13(3):211-21.
  3. Abbasi Z, Khodabandeh F, Yahyavi Kouchaksarayie F, Nazari S. The effect of anabolic androgenic steroid abuse on male fertility: Review Study. Iran J Obstet Gynecol Infertil 2021; 24(3):71-84.
  4. Lee KW, Ching SM, Ramachandran V, Yee A, Hoo FK, Chia YC, et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC pregnancy and childbirth 2018; 18(1):1-20.
  5. Hamel MS, Werner EF. Interventions to improve rate of diabetes testing postpartum in women with gestational diabetes mellitus. Current Diabetes Reports 2017; 17(2):1-7.
  6. Benhalima K, Van Crombrugge P, Moyson C, Verhaeghe J, Vandeginste S, Verlaenen H, et al. The sensitivity and specificity of the glucose challenge test in a universal two-step screening strategy for gestational diabetes mellitus using the 2013 World Health Organization criteria. Diabetes care 2018; 41(7):e111-2.
  7. Akhlaghi F, Moeindarbari S, Najaf Najafi M. The Relationship between Number of Pregnancy Cares with Maternal and Neonatal Complications in Mothers with Gestational Diabetes. Iran J Obstet Gynecol Infertil 2021; 24(4):10-15.
  8. Zhang C, Rawal S, Chong YS. Risk factors for gestational diabetes: is prevention possible?. Diabetologia 2016; 59(7):1385-90.
  9. Jafari-Shobeiri M, Ghojazadeh M, Azami-Aghdash S, Naghavi-Behzad M, Reza PI, Pourali-Akbar Y, et al. Prevalence and risk factors of gestational diabetes in Iran: a systematic review and meta-analysis. Iranian journal of public health 2015; 44(8):1036.
  10. Tasneem S, Kashif S. Gestational Diabetes Mellitus (GDM) Related Common Risk Factors and Recurrence among Pregnant Patients: A Multifactorial Cross-Sectional Study. Life and Science 2021; 2(2):5-.
  11. Feizollahi N, Zayeri ZD, Moradi N, Zargar M, Rezaeeyan H. The effect of coagulation factors polymorphisms on abortion. Frontiers in Biology 2018; 13(3):190-6.
  12. Moyer VA, US Preventive Services Task Force*. Screening for gestational diabetes mellitus: US Preventive Services Task Force recommendation statement. Annals of internal medicine 2014; 160(6):414-20.
  13. Rajaei E, Shahbazian N, Rezaeeyan H, Mohammadi AK, Hesam S, Zayeri ZD. The effect of lupus disease on the pregnant women and embryos: a retrospective study from 2010 to 2014. Clinical rheumatology 2019; 38(11):3211-5.
  14. Lemaitre M, Ternynck C, Bourry J, Baudoux F, Subtil D, Vambergue A. Association Between HbA1c Levels on Adverse Pregnancy Outcomes During Pregnancy in Patients With Type 1 Diabetes. The Journal of Clinical Endocrinology & Metabolism 2022; 107(3):e1117-25.
  15. Hinkle SN, Tsai MY, Rawal S, Albert PS, Zhang C. HbA1c measured in the first trimester of pregnancy and the association with gestational diabetes. Scientific reports 2018; 8(1):1-8.
  16. Shobeiri F, Begum K, Nazari M. A prospective study of maternal hemoglobin status of Indian women during pregnancy and pregnancy outcome. Nutrition Research 2006; 26(5):209-13.
  17. Gungor ES, Danisman N, Mollamahmutoglu L. Maternal serum ferritin and hemoglobin values in patients with gestational diabetes mellitus. Saudi medical journal 2007; 28(3):478-80.
  18. Bodnar LM, Siega-Riz AM, Arab L, Chantala K, McDonald T. Predictors of pregnancy and postpartum haemoglobin concentrations in low-income women. Public health nutrition 2004; 7(6):701-11.
  19. Lao TT, Ho LF. Impact of iron deficiency anemia on prevalence of gestational diabetes mellitus. Diabetes Care 2004; 27(3):650-6.
  20. Lao TT, Chan LY, Tam KF, Ho LF. Maternal hemoglobin and risk of gestational diabetes mellitus in Chinese women. Obstetrics & Gynecology 2002; 99(5):807-12.
  21. Nielsen GL, Møller M, Sørensen HT. HbA1c in early diabetic pregnancy and pregnancy outcomes: a Danish population-based cohort study of 573 pregnancies in women with type 1 diabetes. Diabetes care 2006; 29(12):2612-6.
  22. Rayis DA, Musa IR, Al-Shafei AI, Moheldein AH, El-Gendy OA, Adam I. High haemoglobin levels in early pregnancy and gestational diabetes mellitus among Sudanese women. Journal of Obstetrics and Gynaecology 2021; 41(3):385-9.
  23. Özgen G, Aydın GA, Özgen L. The effects of first-trimester hemoglobin on adverse pregnancy outcomes. mortality 2020; 5:10.
  24. Wang C, Lin L, Su R, Zhu W, Wei Y, Yan J, et al. Hemoglobin levels during the first trimester of pregnancy are associated with the risk of gestational diabetes mellitus, pre-eclampsia and preterm birth in Chinese women: a retrospective study. BMC pregnancy and childbirth 2018; 18(1):1-11.
  25. MJ V. Shapiro JL. Preconception care of women with diabetes. Diabetes Care 2004; 27:S78-80.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 25, Issue 7
September 2022
Pages 39-44

Files

Share

How to cite

Statistics