| Objective: The study based on a maternal-child-adolescent cohort to collect samples of pregnant woman.This cross-sectional study was conducted to explore the association between serum ferritin level in the second trimester and gestational diabetes mellitus.Methods: The study population came from the maternal-child-adolescent cohort of the National Key R&D Program of China-“China Northeast Cohort Study”.The data of pregnant women were collected by Shengjing Hospital of China Medical University from December 2018 to January 2020.The corrective information of 2424 pregnant women included the concentration of serum ferritin,the results of the OGTT experiment,and the data of height,weight,general statistical indicators,pregnancy history,disease history,family disease history,lifestyle,sleep and exercise during pregnancy.GDM was diagnosed according to WHO standard.All participants participated in the research project voluntarily and signed informed consent.Through inclusion and exclusion criteria,a total of 967 participants were finally included.After the serum ferritin was divided into two groups(ferritin deficiency group and non-ferritin deficiency group),t test and chi square test were used to deal with the difference of continuity and classification variables.At the same time,t-test and chi square test were used to deal with the characteristics of GDM group and non GDM group.We used multivariate logistic regression to estimate the value of odds ratio(OR)and 95% confidence interval(95% CI)with GDM as the dependent variable and serum ferritin as the independent variable.At the same time,we also use the restrictive cubic spline model to fit the trend of the outcome and exposure to test the accuracy of logistic regression resuts.Finally,we used age factors(?35 years old and < 35 years old)as subgroups for subgroup analysis.The analysis methods of subgroups were consisted with above-mentioned.Results: The study found that the prevalence of GDM was 21.7% in this population.Through the analysis of t-test and chi square test,we found that there were statistical differences in age,education,whether the first pregnancy,BMI during pregnancy and passive smoking during pregnancy between GDM group and non-GDM group.After grouping by the serum ferritin,we found that there were significant differences between the two groups in occupation,nationality,education,BMI during pregnancy,family history of GDM and whether the first pregnancy.After adjustment for potential confounding factors,such as age,body mass index,nationality,occupation,BMI during pregnancy,first pregnancy or not,family history of diabetes mellitus,and passive smoking during pregnancy,the final adjusted model showed that no correlation between serum ferritin level and GDM(OR(95% CI)= 1.25(0.90,1.72),P = 0.17).In this study,the inflexion points are fitted by the restricted cubic spline model,and the results show that there is no statistical correlation between GDM and serum ferritin.At the same time,subgroup analysis showed that there was a significant correlation between serum ferritin level and GDM in the senile(?35 years old)pregnant women(OR(95% CI)= 3.23(1.24,8.44),P = 0.02).Conclusion: The results showed that there was no correlation between serum ferritin and GDM.In the future,more research and larger sample size are needed to test and verify the association between ferritin and GDM.However,senile pregnant women are more likely to have GDM risk.To strengthen the screening of GDM,the senile pregnant women can be described as dietary guidance and iron supplement during pregnancy to provide reasonable suggestions to reduce the incidence of adverse pregnancy outcomes. |
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