These results suggested that rates of vitamin D deficiency are higher among women with IGT/GDM, and the relationship between vitamin D status and glucose tolerance in pregnancy needs further study.

Low serum vitamin D levels are correlated with insulin resistance during pregnancy. We have assessed the effects of different doses of vitamin D on insulin resistance during pregnancy. A randomized clinical trial was done on 120 women with a gestational age of less than 12 weeks. The women were divided into three groups randomly. Group A received 200 IU vitamin D daily, group B 50,000 IU vitamin D monthly and group C 50,000 IU vitamin D every 2 weeks from 12 weeks of pregnancy until delivery. The serum levels of fasting blood sugar (FBS), insulin, calcium and 25-hydroxyvitamin D were measured before and after intervention. We used the homeostatic model assessment of insulin resistance (HOMA-IR) as a surrogate measure of insulin resistance. The mean ± standard deviation of serum 25-hydroxyvitamin D increased in group C from 7.3 ± 5.9 to 34.1 ± 11.5 ng/ml and in group B it increased from 7.3 ± 5.3 to 27.23 ± 10.7 ng/ml, but the level of vitamin D in group A increased from 8.3 ± 7.8 to 17.7 ± 9.3 ng/ml (p < 0.001). The mean differences of insulin and HOMA-IR before and after intervention in groups A and C were significant (p = 0.01, p = 0.02). This study has shown that supplementation of pregnant women with 50 000 IU vitamin D every 2 weeks improved insulin resistance significantly.

Our data showed that serum leptin level was higher in GDM and had a positive correlation with insulin resistance. Our findings suggest that high leptin levels might be a risk factor for GDM and IGT in pregnant women.

Quince (Cydonia oblonga Mill) is a popular medicinal herb in different traditional medicines. Concentrated quince fruit extract, also known as quince sauce (QS), is traditionally used for the treatment of a variety of gastrointestinal disorders. The aim of this study was to compare the efficacy of QS versus ranitidine on gastroesophageal reflux disease (GERD) in pregnant women. We compared the efficacy of 4 weeks of ranitidine (150 mg, twice daily) with the efficacy of QS (10 mg, after meals) on 137 pregnant women with GERD. Their General Symptom Score (GSS) and Major Symptom Score (MSS) were compared at the baseline, 2 weeks and 4 weeks after intervention. After 2 weeks of the study, the mean GSS score of the QS group was significantly lower compared with the ranitidine group (p = .036). Although, the GSS value at the end of the study had no difference between groups (p = .074). However, the MSS of the different symptoms of the two groups at 2 weeks and 4 weeks had no significant differences. It seems that the efficacy of QS for the management of pregnancy-related GERD is similar to ranitidine. Impact statement What is already known on this subject? Quince is a traditional gastric tonic, an appetiser, and a remedy for nausea/vomiting and epigastric pain. Also, there are several previous positive experiences about quince products for GERD treatment. What do the results of this study add? It seems that the efficacy of QS for the management of pregnancy-related GERD is similar to ranitidine. What are the implications of these findings for clinical practice and/or further research? QS can be suggested as an alternative medicine for pregnant patients with GERD.

Background: Elevated serum ferritin concentration is associated with insulin resistance and diabetes. Recently it has also been described in gestational diabetes mellitus (GDM). Objective: A prospective study was done to determine whether there was a relationship between serum ferritin concentration in early pregnancy and the risk of GDM. Materials and Methods: A study was performed on 1,384 pregnant women with gestational age of 12-16 weeks. A blood sample was obtained for measurement of ferritin in the first trimester. Diagnosis of GDM was done by 75 gr oral glucose tolerance test between 24-28 wk. Results: Women who developed GDM had a higher concentration of serum ferritin than women who did not develop GDM (p=0.01). A ferritin concentration of 45 ng/ml was calculated to be the 75 th percentile for healthy pregnant women. Considering this level 32% in the GDM group and 25.2%of normal subjects exhibited high ferritin levels (p=0.01). The risk of GDM with these high levels of ferritin was 1.4-fold higher than that for subjects with lower concentrations. The Odds Ratio was 1.4 (95% CI= 1-1.87) (p=0.01). After adjusted for age Odds Ratio was 1.38 (95% CI=1.02-1.86) (p=0.03) and after adjustment for pre-pregnancy Body Mass index, the adjusted odds ratio was 1.31 (CI= 0.96-1.79) (p=0.08). After multivariable adjustment (age and body mass index), the adjusted odds ratio was 1.3 (0.95-1.8) (p=0.09). Conclusion: High serum ferritin can be regarded as a significant risk factor for the development of gestational diabetes.