High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review: a prospective study and systematic review

Amina Z. Khambalia; Ashley Mariko Aimone; P. Nagubandi; Christine L. Roberts; Aidan McElduff; Jonathan M Morris; Katie L. Powell; Vitomir Tasevski; Natasha M.M Nassar

doi:10.1111/dme.13056

High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review: a prospective study and systematic review

Amina Z. Khambalia^*, Ashley Mariko Aimone, P. Nagubandi, Christine L. Roberts, Aidan McElduff, Jonathan M Morris, Katie L. Powell, Vitomir Tasevski, Natasha M.M Nassar

^*Corresponding author for this work

Research output: Contribution to journal › Review article › Research › peer-review

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Abstract

AIM: High iron measured using dietary intake and biomarkers is associated with Type 2 diabetes. It is uncertain whether a similar association exists for gestational diabetes mellitus. The aim of this systematic review was to conduct a cohort study examining first trimester body iron stores and subsequent risk of gestational diabetes, and to include these findings in a systematic review of all studies examining the association between maternal iron status, iron intake (dietary and supplemental) and the risk of gestational diabetes.

METHODS: Serum samples from women with first trimester screening were linked to birth and hospital records for data on maternal characteristics and gestational diabetes diagnosis. Blood was analysed for ferritin, soluble transferrin receptor and C-reactive protein. Associations between iron biomarkers and gestational diabetes were assessed using multivariate logistic regression. A systematic review and meta-analysis, registered with PROSPERO (CRD42014013663) included studies of all designs published in English from January 1995 to July 2015 that examined the association between iron and gestational diabetes and included an appropriate comparison group.

RESULTS: Of 3776 women, 3.4% subsequently developed gestational diabetes. Adjusted analyses found increased odds of gestational diabetes for ferritin (OR 1.41; 95% CI 1.11, 1.78), but not for soluble transferrin receptor (OR 1.00; 95% CI 0.97, 1.03) per unit increase of the biomarker. Two trials of iron supplementation found no association with gestational diabetes. Increased risk of gestational diabetes was associated with higher levels of ferritin and serum iron and dietary haem iron intakes.

CONCLUSIONS: Increased risk of gestational diabetes among women with high serum ferritin and iron levels and dietary haem iron intakes warrants further investigation.

Original language	English
Pages (from-to)	1211-1221
Number of pages	11
Journal	Diabetic Medicine
Volume	33
Issue number	9
DOIs	https://doi.org/10.1111/dme.13056
Publication status	Published - Sept 2016
Externally published	Yes

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Khambalia, A. Z., Aimone, A. M., Nagubandi, P., Roberts, C. L., McElduff, A., Morris, J. M., Powell, K. L., Tasevski, V., & Nassar, N. M. M. (2016). High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review: a prospective study and systematic review. Diabetic Medicine, 33(9), 1211-1221. https://doi.org/10.1111/dme.13056

@article{37046572e8af4046b8485433e7eaf850,

title = "High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review: a prospective study and systematic review",

abstract = "AIM: High iron measured using dietary intake and biomarkers is associated with Type 2 diabetes. It is uncertain whether a similar association exists for gestational diabetes mellitus. The aim of this systematic review was to conduct a cohort study examining first trimester body iron stores and subsequent risk of gestational diabetes, and to include these findings in a systematic review of all studies examining the association between maternal iron status, iron intake (dietary and supplemental) and the risk of gestational diabetes.METHODS: Serum samples from women with first trimester screening were linked to birth and hospital records for data on maternal characteristics and gestational diabetes diagnosis. Blood was analysed for ferritin, soluble transferrin receptor and C-reactive protein. Associations between iron biomarkers and gestational diabetes were assessed using multivariate logistic regression. A systematic review and meta-analysis, registered with PROSPERO (CRD42014013663) included studies of all designs published in English from January 1995 to July 2015 that examined the association between iron and gestational diabetes and included an appropriate comparison group.RESULTS: Of 3776 women, 3.4% subsequently developed gestational diabetes. Adjusted analyses found increased odds of gestational diabetes for ferritin (OR 1.41; 95% CI 1.11, 1.78), but not for soluble transferrin receptor (OR 1.00; 95% CI 0.97, 1.03) per unit increase of the biomarker. Two trials of iron supplementation found no association with gestational diabetes. Increased risk of gestational diabetes was associated with higher levels of ferritin and serum iron and dietary haem iron intakes.CONCLUSIONS: Increased risk of gestational diabetes among women with high serum ferritin and iron levels and dietary haem iron intakes warrants further investigation.",

author = "Khambalia, {Amina Z.} and Aimone, {Ashley Mariko} and P. Nagubandi and Roberts, {Christine L.} and Aidan McElduff and Morris, {Jonathan M} and Powell, {Katie L.} and Vitomir Tasevski and Nassar, {Natasha M.M}",

note = "{\textcopyright} 2015 Diabetes UK.",

year = "2016",

month = sep,

doi = "10.1111/dme.13056",

language = "English",

volume = "33",

pages = "1211--1221",

journal = "Diabetic Medicine",

issn = "0742-3071",

publisher = "Wiley-Blackwell",

number = "9",

}

Khambalia, AZ, Aimone, AM, Nagubandi, P, Roberts, CL, McElduff, A, Morris, JM, Powell, KL, Tasevski, V & Nassar, NMM 2016, 'High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review: a prospective study and systematic review', Diabetic Medicine, vol. 33, no. 9, pp. 1211-1221. https://doi.org/10.1111/dme.13056

High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review: a prospective study and systematic review. / Khambalia, Amina Z.; Aimone, Ashley Mariko; Nagubandi, P. et al.
In: Diabetic Medicine, Vol. 33, No. 9, 09.2016, p. 1211-1221.

Research output: Contribution to journal › Review article › Research › peer-review

TY - JOUR

T1 - High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review: a prospective study and systematic review

AU - Khambalia, Amina Z.

AU - Aimone, Ashley Mariko

AU - Nagubandi, P.

AU - Roberts, Christine L.

AU - McElduff, Aidan

AU - Morris, Jonathan M

AU - Powell, Katie L.

AU - Tasevski, Vitomir

AU - Nassar, Natasha M.M

PY - 2016/9

Y1 - 2016/9

N2 - AIM: High iron measured using dietary intake and biomarkers is associated with Type 2 diabetes. It is uncertain whether a similar association exists for gestational diabetes mellitus. The aim of this systematic review was to conduct a cohort study examining first trimester body iron stores and subsequent risk of gestational diabetes, and to include these findings in a systematic review of all studies examining the association between maternal iron status, iron intake (dietary and supplemental) and the risk of gestational diabetes.METHODS: Serum samples from women with first trimester screening were linked to birth and hospital records for data on maternal characteristics and gestational diabetes diagnosis. Blood was analysed for ferritin, soluble transferrin receptor and C-reactive protein. Associations between iron biomarkers and gestational diabetes were assessed using multivariate logistic regression. A systematic review and meta-analysis, registered with PROSPERO (CRD42014013663) included studies of all designs published in English from January 1995 to July 2015 that examined the association between iron and gestational diabetes and included an appropriate comparison group.RESULTS: Of 3776 women, 3.4% subsequently developed gestational diabetes. Adjusted analyses found increased odds of gestational diabetes for ferritin (OR 1.41; 95% CI 1.11, 1.78), but not for soluble transferrin receptor (OR 1.00; 95% CI 0.97, 1.03) per unit increase of the biomarker. Two trials of iron supplementation found no association with gestational diabetes. Increased risk of gestational diabetes was associated with higher levels of ferritin and serum iron and dietary haem iron intakes.CONCLUSIONS: Increased risk of gestational diabetes among women with high serum ferritin and iron levels and dietary haem iron intakes warrants further investigation.

AB - AIM: High iron measured using dietary intake and biomarkers is associated with Type 2 diabetes. It is uncertain whether a similar association exists for gestational diabetes mellitus. The aim of this systematic review was to conduct a cohort study examining first trimester body iron stores and subsequent risk of gestational diabetes, and to include these findings in a systematic review of all studies examining the association between maternal iron status, iron intake (dietary and supplemental) and the risk of gestational diabetes.METHODS: Serum samples from women with first trimester screening were linked to birth and hospital records for data on maternal characteristics and gestational diabetes diagnosis. Blood was analysed for ferritin, soluble transferrin receptor and C-reactive protein. Associations between iron biomarkers and gestational diabetes were assessed using multivariate logistic regression. A systematic review and meta-analysis, registered with PROSPERO (CRD42014013663) included studies of all designs published in English from January 1995 to July 2015 that examined the association between iron and gestational diabetes and included an appropriate comparison group.RESULTS: Of 3776 women, 3.4% subsequently developed gestational diabetes. Adjusted analyses found increased odds of gestational diabetes for ferritin (OR 1.41; 95% CI 1.11, 1.78), but not for soluble transferrin receptor (OR 1.00; 95% CI 0.97, 1.03) per unit increase of the biomarker. Two trials of iron supplementation found no association with gestational diabetes. Increased risk of gestational diabetes was associated with higher levels of ferritin and serum iron and dietary haem iron intakes.CONCLUSIONS: Increased risk of gestational diabetes among women with high serum ferritin and iron levels and dietary haem iron intakes warrants further investigation.

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U2 - 10.1111/dme.13056

DO - 10.1111/dme.13056

M3 - Review article

C2 - 26670627

SN - 0742-3071

VL - 33

SP - 1211

EP - 1221

JO - Diabetic Medicine

JF - Diabetic Medicine

IS - 9

ER -

High maternal iron status, dietary iron intake and iron supplement use in pregnancy and risk of gestational diabetes mellitus: a prospective study and systematic review: a prospective study and systematic review

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