Association of increased maternal ferritin levels with gestational diabetes and intra-uterine growth retardation.
ABSTRACT The objectives of the present study were to determine whether or not increased serum ferritin in women with premature labour is associated with gestational diabetes mellitus (GDM) and intra-uterine growth retardation (IUGR) and, if so, whether or not such increased levels reflect excess maternal iron stores, and have an effect on neonatal iron status and outcome.
This prospective, single-hospital, observational study involved 63 mothers and their 90 preterm neonates. Full blood counts as well as serum ferritin, soluble transferrin receptor (sTfR) and erythropoietin concentrations were compared across the three study groups based on maternal ferritin levels at the time of delivery. Perinatal history, neonatal morbidity and early outcomes were also assessed.
High maternal ferritin levels were significantly associated with higher rates of GDM and IUGR. However, there was no correlation between maternal ferritin and sTfR levels or between maternal and neonatal iron status.
Elevated maternal ferritin is not a reflection of excess iron stores, but is related to an increased risk of GDM or IUGR. Also, maternal ferritin levels are not associated with either neonatal iron status or neonatal outcomes.
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ABSTRACT: The assessment of fetal growth is an essential component of good antenatal care, especially for twins. The aims of this study are to develop twin-specific intrauterine 'growth' charts, based on cross-sectional birthweight data, for monochorionic and dichorionic twins according to sex and parity, and to detect twins at risk for neonatal death by comparing the use of twin-specific and singleton charts. The study sample consisted of 76,471 singletons and 8454 twins (4227 pairs) born in East Flanders (Belgium). Birthweights were analyzed using a nonlinear Gaussian regression. After 33 weeks of gestation, the birthweights of twins started to deviate from singletons (difference of 900 grams at 42 weeks). Birthweights of dichorionic twins continued to increase, whereas those of monochorionic twins decreased after week 40 (difference of more than 300 g at 42 weeks). After 31 weeks of gestation, neonatal mortality increased as centile decreased, and was especially high if birthweight was below the twin-specific third centile: .032 (below) versus .007 (above). Using singleton centiles, this was less obvious. In conclusion, twin-specific growth charts, taking chorionicity into account, are more accurate to detect twins at risk for neonatal death. Therefore the presented charts, based on cross-sectional birthweight data, enable an improved assessment of twin growth.Twin Research and Human Genetics 05/2008; 11(2):224-35. · 1.64 Impact Factor
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ABSTRACT: To examine the relationship between high maternal hemoglobin concentration at the initial antenatal visit and occurrence of gestational diabetes mellitus (GDM) in the third trimester in nonanemic women. In a prospective observational study, 762 nondiabetic Chinese women with singleton pregnancies, whose initial visit hemoglobin concentration and mean cell volume were 10 g/dL or more and 80 fL or more, respectively, recruited at 28-30 weeks, had blood drawn for repeat measurement of hemoglobin concentration and iron parameters. These women were categorized by their initial visit hemoglobin concentration into quartiles, and the incidence of GDM was analyzed together with the maternal characteristics and iron status. The final study sample comprised 730 women. Compared with the rest, the group in the highest hemoglobin quartile (more than 13 g/dL) had a significantly higher incidence of GDM (18.7% versus 10.9%, P =.007), as well as greater age, weight, and serum ferritin and iron concentrations. Logistic regression was used to examine the effects of high body mass index (more than 25 kg/m(2)), advanced age (older than 34 years), parity of 1 or more, and hemoglobin in the highest quartile, on the incidence of GDM. Only advanced age (odds ratio 3.79, 95% confidence interval 2.33, 6.17) and hemoglobin in the highest quartile (odds ratio 1.73, 95% confidence interval 1.08, 2.78) emerged to be significant factors. A high maternal hemoglobin (more than 13 g/dL) at the initial prenatal visit in Chinese women is an independent risk factor for GDM. This may reflect a better nutritional status in these women, as suggested by the increased iron status.Obstetrics and Gynecology 06/2002; 99(5 Pt 1):807-12. · 4.80 Impact Factor
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ABSTRACT: of GDM that are based on perinatal out- comes. Thus, for the interim, the partic- ipants o f t he F ifth I nternational Workshop-Conference on GDM en- dorsed a motion to continue use of the definition, classification criteria, and strategies for detection and diagnosis of GDM that were recommended at the Fourth Workshop-Conference. Those guidelines are reproduced (with minor modifications) in this article in APPENDIX Tables 1 and 2.Diabetes care 08/2007; 30 Suppl 2:S251-60. · 7.74 Impact Factor