Association of elevated serum ferritin levels in mid-pregnancy and the risk of gestational diabetes mellitus
Dr. V Sumathy, Dr. T Rajatharangini and S Padmanaban
Gestational Diabetes Mellitus is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy, according to WHO guidelines. serum ferritin, is a major storage protein of iron. It is also a acute phase reactant which increases in inflammatory conditions. Studies have shown a positive relation between insulin resistance and serum ferritin levels.
The role of serum ferritin as an inflammatory marker is used in this study and its levels are measured in mid pregnancy to predict the risk of developing GDM, thereby making it as a tool for early diagnosis and prevention.
Aim: To determine the association between moderately elevated Serum Ferritin levels in mid-pregnancy and risk of onset of Gestational Diabetes Mellitus.
To investigate the effect of a higher level of maternal serum Ferritin and thereafter describe a generic framework for combining this screening information with designing a prophylactic intervention in the future.
Materials and methods
Study Centre: Department of Obstetrics and Gynecology, Madras Medical College, Chennai
Duration of: One year
Study Design: Prospective study
Sample Size: 100
Results: Among th 100 pregnant women in this study, only 37 had GDM diagnosed at some point of time in the current pregnancy. In that 37 women, 22 were started on insulin and 15 were on medical nutrition therapy out of 37 who developed GDM, about 18 had ferritin values between 60-90 ng/ml, and 6 had values above 90 ng/ml. and in this 6 women women with serum ferritin >90, 5 were started on insulin
Conclusion: Serum ferritin levels, apart from iron store action, is a good predictor of developing GDM. Elevated serum ferritin concentrations, at early gestational weeks, is associated with increased risk of developing GDM. This association is mediated by fat mass of the mother and obesity, at least in part.