Associations of maternal hemoglobin and its changes with gestational diabetes mellitus: a prospective cohort study.

IF 5.7 2区医学 Q1 NUTRITION & DIETETICS

Nutrition Journal Pub Date : 2026-03-13 DOI:10.1186/s12937-026-01306-w

Danmeng Liu, Doudou Zhao, Fuyang Zhao, Li Shan, Xinru Gao, Yang Mi, Pengfei Qu

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引用次数: 0

Abstract

BACKGROUND: Higher iron status during pregnancy may increase gestational diabetes mellitus (GDM) risk via iron-induced oxidative stress, leading to insulin resistance and impairing pancreatic β-cell function through lipid peroxidation and/or DNA damage. However, associations between maternal iron status and GDM remain controversial. Hemoglobin is a clinically routine iron status indicator measured across pregnancy. This study aims to explore whether hemoglobin levels (and changes) in early and mid-pregnancy are associated with GDM risk. METHODS: This study employed longitudinal data from a prospective cohort study conducted from December 2018 to September 2021. Pregnancy women at early pregnancy were recruited in the birth cohort, and 6420 eligible women were included in the final analysis of the present study. Data collected at early and mid-pregnancy was used. Generalized linear models were applied to evaluated the associations between hemoglobin and GDM. RESULTS: 49.6% (3184 of 6420) and 7.1% (458 of 6420) of women had high hemoglobin in early and mid-pregnancy, respectively. 92.6% (5946 of 6420) of women had decreased hemoglobin concentrations from early to mid-pregnancy. The overall incidence of GDM was 23.1% (1484 of 6420). Higher hemoglobin concentrations (for every 10 g/L increase) were associated with increased risk of GDM (early pregnancy: RR: 1.09, 95%CI: 1.04, 1.14; mid-pregnancy: RR: 1.07, 95%CI: 1.01, 1.13). High hemoglobin in early or/and mid-pregnancy significantly increased GDM risk (early pregnancy: RR: 1.11, 95%CI: 1.01, 1.21; mid-pregnancy: RR: 1.19, 95%CI: 1.03, 1.39; both periods: RR: 1.36, 95%CI: 1.15, 1.61). Significantly reduced risk of GDM was observed with every 10 g/L decrease in hemoglobin from early to mid-pregnancy (RR: 0.87, 95%CI: 0.81, 0.93), especially in women with the High-Decrease change pattern (RR: 0.87, 95%CI: 0.80, 0.95). CONCLUSIONS: Maternal high hemoglobin levels in early and/or mid-pregnancy are associated with increased GDM risk, and a decline in hemoglobin levels from early to mid-pregnancy is associated with reduced GDM risk. CLINICAL TRIAL NUMBER: Not applicable.

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母体血红蛋白及其变化与妊娠糖尿病的关系：一项前瞻性队列研究。

背景：妊娠期高铁水平可能通过铁诱导的氧化应激增加妊娠期糖尿病（GDM）的风险，导致胰岛素抵抗，并通过脂质过氧化和/或DNA损伤损害胰腺β细胞功能。然而，母体铁含量与GDM之间的关系仍存在争议。血红蛋白是妊娠期临床常规铁状态指标。本研究旨在探讨妊娠早期和中期血红蛋白水平（及其变化）是否与GDM风险相关。方法：本研究采用了2018年12月至2021年9月进行的前瞻性队列研究的纵向数据。在出生队列中招募了早期妊娠妇女，并将6420名符合条件的妇女纳入本研究的最终分析。数据收集于妊娠早期和中期。应用广义线性模型评估血红蛋白与GDM之间的关系。结果：49.6%（3184 / 6420）和7.1%（458 / 6420）的女性在妊娠早期和中期分别出现高血红蛋白。92.6%（5946 / 6420）的妇女在妊娠早期至中期血红蛋白浓度下降。GDM的总发病率为23.1%（1484 / 6420）。较高的血红蛋白浓度（每增加10 g/L）与GDM风险增加相关（妊娠早期：RR: 1.09, 95%CI: 1.04, 1.14；妊娠中期：RR: 1.07, 95%CI: 1.01, 1.13）。妊娠早期或/和妊娠中期的高血红蛋白显著增加GDM风险（妊娠早期：RR: 1.11, 95%CI: 1.01, 1.21；妊娠中期：RR: 1.19, 95%CI: 1.03, 1.39；两个时期：RR: 1.36, 95%CI: 1.15, 1.61）。妊娠早期至妊娠中期血红蛋白每降低10 g/L，发生GDM的风险显著降低（RR: 0.87, 95%CI: 0.81, 0.93），特别是高-低变化模式的妇女（RR: 0.87, 95%CI: 0.80, 0.95）。结论：孕妇妊娠早期和/或中期血红蛋白水平高与GDM风险增加相关，妊娠早期至中期血红蛋白水平下降与GDM风险降低相关。临床试验编号：不适用。

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来源期刊

Nutrition Journal NUTRITION & DIETETICS-

CiteScore

9.80

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.