Maternal and neonatal outcomes related to iron supplementation or iron status: a summary of meta-analyses

Iqbal, Sehar; Ekmekçioğlu, Cem

doi:10.1080/14767058.2017.1406915

Cited by 55 publications

(40 citation statements)

References 48 publications

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“…Even after the adjustment for several reasonable confounding factors, such impact was still existed. Our result was consistent with several previous epidemiological studies that have reported an association between body iron status and GDM [6,7,15,16]. They found that high maternal hemoglobin level and/or high serum ferritin levels were the risk factor for GDM [15].…”

Section: Discussionsupporting

confidence: 93%

“…There were some studies showing that pregnant women without antenatal iron supplement had adverse obstetric outcomes including maternal anemia, preterm delivery and low birth weight infant [11,16,19]. However, in the present study, the early (before 16 weeks gestation) and the later (after 16 weeks gestation) iron supplementation had comparable infants' birth weight, length of gestational period, and incidence of maternal anemia at delivery.…”

Section: Discussioncontrasting

confidence: 69%

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Iron Supplementation in Non-Anemic Pregnancy and Risk of Developing Gestational Diabetes Mellitus

et al. 2018

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Background: Routine iron supplementation for all pregnant women in order to reduce adverse neonatal outcomes has been a standard practice in developing countries, including Thailand. However, there is evidence that excess iron can affect glucose metabolism and may increase risk of gestational diabetes mellitus (GDM). This study aims to investigate the association of iron supplementation starting from early gestation and the risk of GDM in non-anemic women. Methods: This retrospective cohort study included non-anemic pregnant Thai women who received their first antenatal care and delivered at Vajira Hospital (Bangkok, Thailand) during January 2008 to December 2009. All pregnant women underwent oral glucose tolerance test during gestational weeks 24-28. The proportions of ongoing GDM and birth outcomes were compared between the early oral iron supplementation group (before 16 completed weeks) and the control group (after 16 weeks). Results: There were 1,935 non-anemic pregnant women, 966 in the early supplement group and 969 in the control group. The early supplement group had significantly higher prevalence of GDM than the control group did (9.7% vs. 5.6%, RR: 1.83; 95% CI: 1.29-2.59). No significant differences in maternal anemia, gestational age at birth, or neonatal birth weight were observed between groups. Conclusions: Early antenatal iron supplementation in non-anemic pregnant women was found to be associated with significantly increased risk of GDM.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 69%

Iron Supplementation in Non-Anemic Pregnancy and Risk of Developing Gestational Diabetes Mellitus

et al. 2018

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“…Various other factors that could have effects on the HbA1c and GDM such as or ferritin, iron levels, and hepcidin were not assessed in our study 36,37 . We failed to follow‐up these women so as to access the maternal and perinatal outcomes in relation to HbA1c.…”

Section: Resultsmentioning

confidence: 99%

Reliability of glycosylated hemoglobin in the diagnosis of gestational diabetes mellitus

Rayis

Ahmed

Sharif

et al. 2020

Clinical Laboratory Analysis

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Background Oral glucose tolerance test (OGTT) performed at 24‐28 weeks gestation is the current recommended method to the diagnosis of gestational diabetes mellitus (GDM). Many recent studies investigating HbA1c in detecting GDM yield different results. There are no published data on HbA1c in the diagnosis of GDM in Sub‐Saharan countries including Sudan. Methods A cross‐sectional study was carried out at the antenatal care of Saad Abuelela Maternity Hospital, Khartoum, Sudan during the period from February to November 2018 to assess the reliability of HbA1c in the diagnosis of GDM. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups using a 75‐g oral glucose tolerance test. Results Three hundred and forty‐eight women were enrolled. The mean (SD) of the age, gravidity, and gestational age of the enrolled women were 27.8 (5.6) years, 2.36 (2.2) and 26.26 (2.43) weeks, respectively. Sixty‐eight women (19.5%) had GDM. A poor productively for HbA1c in diagnosis GDM was shown (AUC = 0.62, 95% CI = 0.55‐0.69). At HbA1c level of 4.150%, the sensitivity and specificity of the diagnosis for GDM were 76.51% and 37.85%, respectively. At HbA1c level of 5.850%, the sensitivity and specificity of the diagnosis for GDM were 13.24% and 91.43%, respectively. While there was no significant (Spearman) correlation between fasting blood glucose and HbA1c, there were significant correlations between HbA1c and OGTT 1 and 2 hours of OGTT. Conclusion In this study, HbA1c has a poor reliability, insufficient sensitivity or specificity for use to diagnose GDM.

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“…Fe deficiency is a common cause of anaemia, and daily Fe supplementation may result in an increase in Hb values in 11 % of pregnant women ( 32 ) . A recent meta-analysis indicated that both Fe deficiency and Fe excess would increase the risk of gestational disease and pregnancy outcomes ( 33 ) . In China, free prenatal Fe supplements were not provided by the government.…”

Section: Discussionmentioning

confidence: 99%

Preconception Hb concentration and risk of preterm birth in over 2·7 million Chinese women aged 20–49 years: a population-based cohort study

Zhang

Yang

et al. 2018

Br J Nutr

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Evidence on the association between maternal Hb concentration and preterm birth (PTB) risk is inconclusive. This paper aimed to explore whether women with anaemia or high Hb level before pregnancy would be at higher risk of PTB. We conducted a population-based cohort study with 2 722 274 women aged 20-49 years, who participated in National Free Pre-Pregnancy Checkups Project between 2013 and 2015 and delivered a singleton before 2016 in rural China. Logistic models were used to estimate OR and 95 % CI after adjusting for confounding variables. Restricted cubic spline models were applied to evaluate the dose-response relationships. A total of 192 819 (7·08 %) women had preterm deliveries. Compared with women with Hb of 110-149 g/l, the multivariable-adjusted OR for PTB was 1·19 (95 % CI 0·98, 1·44) for women with Hb<70 g/l, 1·01 (95 % CI 0·97, 1·03) for 70-99 g/l, 0·96 (95 % CI 0·95, 0·98) for 100-109 g/l, 1·04 (95 % CI 1·01, 1·06) for 150-159 g/l, 1·11 (95 % CI 1·05, 1·17) for 160-169 g/l and 1·19 (95 % CI 1·11, 1·27) for ≥170 g/l, respectively. The multivariable-adjusted OR for very PTB (VPTB) was 1·07 (95 % CI 1·03, 1·12) and 1·06 (95 % CI 1·01, 1·12) for women with Hb <110 and ≥150 g/l, compared with those with Hb of 110-149 g/l, respectively. Our study identified a U-shaped relationship between maternal preconception Hb concentration and PTB risk. Both preconception anaemia and high Hb level can significantly increase VPTB risk. Appropriate intervention for women with abnormal Hb levels before pregnancy is very necessary.

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Maternal and neonatal outcomes related to iron supplementation or iron status: a summary of meta-analyses

Abstract: Our summary of meta-analyses showed that multimicronutrient supplementation had beneficial effects on some neonatal outcomes. Furthermore, higher ferritin levels seem to increase the risk for GDM whereas maternal anemia was associated with adverse birth/neonatal outcomes.

Cited by 55 publications

References 48 publications

Iron Supplementation in Non-Anemic Pregnancy and Risk of Developing Gestational Diabetes Mellitus

Iron Supplementation in Non-Anemic Pregnancy and Risk of Developing Gestational Diabetes Mellitus

Reliability of glycosylated hemoglobin in the diagnosis of gestational diabetes mellitus

Preconception Hb concentration and risk of preterm birth in over 2·7 million Chinese women aged 20–49 years: a population-based cohort study

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