Iron-Related Factors in Early Pregnancy and Subsequent Risk of Gestational Diabetes Mellitus: the Ma’anshan Birth Cohort (MABC) Study

  • Beibei Zhu
  • Chunmei Liang
  • Xun Xia
  • Kun Huang
  • Shuangqin Yan
  • Jiahu Hao
  • Peng Zhu
  • Hui Gao
  • Fangbiao TaoEmail author


Iron is an essential micronutrient while its excessive load has been related to the etiology of diabetes. We used data of 3289 pregnant women from the Ma’anshan birth cohort (MABC) study in China to examine the associations of three iron-related factors (i.e., serum iron (SI) concentration, hemoglobin level, and use of iron supplements) with risk of gestational diabetes mellitus (GDM). Emphatically explore the potential non-linear relationship between SI concentration and risk of GDM. SI concentration was measured in fasting blood using inductively coupled plasma mass spectrometry (ICP-MS). GDM diagnosis was determined by 75 g oral glucose tolerance test at 24~28 weeks. Restricted cubic splines with three knots were used to examine potential non-linear relationship between SI concentration and GDM risk. We observed a U-shape relation between SI concentration in the first trimester and risk of GDM. In the multivariate-adjusted model, compared with the middle level (ln(SI), 7.1–7.7 μg/L), both the lowest level (ln(SI) ≤ 7.1 μg/L) (odds ratio (OR) = 1.35, 95% confidence interval (CI) = 1.04–1.76) and the highest level (ln(SI) > 7.7 μg/L) (OR = 1.63, 95%CI = 1.16–2.28) increased risk of GDM. Associations of hemoglobin level in the first trimester and risk of GDM attenuated to non-significance after adjustment for pre-pregnancy body mass index (BMI) and blood pressure. Pre-pregnancy iron supplement use was associated with an increased risk of GDM (OR = 1.57, 95%CI = 1.06–2.32). In conclusion, the three iron-related factors are all related to GDM risk on some level.


Serum iron concentration Hemoglobin Iron supplements Gestational diabetes mellitus Non-linear relationship 


Source of Funding

This work is supported by the National Natural Science Foundation of China (NSCF-81330068) and National Natural Science Foundation of China (NSCF-81573168). The funder did not involve in study design, data collection, data analysis, and manuscript preparation and/or publication decisions.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

12011_2018_1595_MOESM1_ESM.docx (17 kb)
ESM 1 (DOCX 16 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Maternal, Child and Adolescent HealthAnhui Medical UniversityHefeiChina
  2. 2.Anhui Provincial Key Laboratory of Population Health and AristogenicsAnhui Medical UniversityHefeiChina
  3. 3.Ma’anshan Maternal and Child Health Care CenterMa’anshanChina

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