A study to investigate the elevated maternal haemoglobin value as a risk biomarker for gestational diabetes: A nested case control study

Abstract

Background: Iron plays a significant role in the pathogenesis of gestational diabetes mellitus. Aim: To determine whether elevated haemoglobin levels during the second trimester of pregnancy is associated with the risk of gestational diabetes mellitus. Methods: A nested case-control study was conducted among 216 pregnant women who were in their second trimester. The categorical variables and continuous variables were analysed by using Chi-square and Independent sample T test respectively. The haematological parameters were correlated with blood glucose values at 3 distinct times and oral glucose tolerance test using Pearson's correlation. The outcome prediction analysis was performed by binary logistic regression and ROC curve analysis was done to evaluate the accuracy of the regression model. Results: The haematological parameters significantly varied between the groups. The haemoglobin was significantly higher in the gestational diabetic mellitus group (13.96 ± 0.55 vs 11.95 ± 0.86; p = 0.001; 95% CI 1.82 to2.21). The odds of developing gestational diabetes mellitus in pregnant women with haemoglobin greater than 12.6 g/dL was 5 times greater at p = 0.001 (95% CI 5.54, 28.18). The ROC curve analysis was performed and 88.9% sensitivity and 58.3% specificity were found with an AUC of 0.841. The other haematological parameters were moderately and weakly correlated with blood glucose levels and oral glucose tolerance test. Conclusion: The findings suggest when the haemoglobin levels are greater than 12.6 g/dL during early pregnancy play a role in predicting the risk of developing gestational diabetes mellitus. Awareness must be created among clinicians for early diagnosis and treatment.

Keywords

• Insulin resistance
• Iron
• Oral glucose tolerance test
• Pregnant women
• Second trimester