Prothrombotic state and calcium deficiency in early pregnancy are risk factors for gestational diabetes mellitus: a retrospective cohort study

Abstract

Objectives

To investigate whether the prothrombotic state (PTS), calcium deficiency and iron deficiency anemia (IDA) in early pregnancy is associated with the risk of gestational diabetes mellitus (GDM).

Methods

We conducted a retrospective cohort study, including consecutive pregnant women tested for PTS, calcium deficiency and IDA before 20 weeks' gestation between September 1, 2017 and March 21, 2021. For routine prenatal care, pregnant women underwent a 75-g oral glucose tolerance test (OGTT) to make a GDM diagnosis during 24–28 weeks of gestation. Testing data and relevant clinical information were obtained from Shenzhen Baoan Women's and Children's Hospital. To estimate GDM risk of exposures (PTS, calcium deficiency and IDA) in early pregnancy, we used logistic regression to obtain odds ratio (OR) adjusted for maternal age, parity, family history of diabetes and pre-pregnancy body mass index.

Results

The cohort included 8396 pregnant women with complete data of exposures and GDM outcomes. Baseline characteristics were not comparable between exposure and control groups. PTS (adjusted OR 2.38, 95% CI 1.61–3.52) or calcium deficiency (adjusted OR 1.23, 95% CI 1.02–1.49) in early pregnancy was independently associated with increased GDM risk after adjusting covariates. There was no significant association between IDA status and GDM risk (adjusted OR 0.86, 95% CI 0.63–1.18).

Conclusions

PTS and calcium deficiency in early pregnancy may be independent risk factors of GDM. These findings need further validation in well-designed prospective cohorts.

摘要

目的：探讨妊娠早期血栓前状态（PTS）、缺钙和缺铁性贫血（IDA）是否与妊娠期糖尿病（GDM）风险相关。方法：我们进行了一项回顾性队列研究, 包括2017年9月1日至2021年3月21日期间连续20周妊娠前对孕妇进行PTS、缺钙和IDA检测。对于常规产前护理, 孕妇在妊娠24-28周期间接受75克口服葡萄糖耐量试验（OGTT）以诊断GDM。检测数据和相关临床信息来自深圳市宝安区妇幼保健院。为了估计早孕期暴露（PTS、缺钙和IDA）的GDM风险, 我们使用logistic回归获得优势比（OR）, 根据母亲年龄、产次、糖尿病家族史和孕前体重指数进行调整。结果：该队列包括8396名孕妇, 她们有完整的暴露和GDM结果数据。暴露组和对照组之间的基线特征不具有可比性。在调整协变量后, 妊娠早期的PTS（调整后的OR 2.38, 95%可信区间1.61–3.52）或缺钙（调整后的OR 1.23, 95%可信区间1.02–1.49）与GDM风险增加独立相关。IDA状态与GDM风险之间没有显著相关性（调整后的OR值为0.86, 95%可信区间为0.63–1.18）。结论：PTS和妊娠早期缺钙可能是GDM的独立危险因素。这些发现需要在严密设计的前瞻性队列中进一步验证。

Keywords:

• Gestational diabetes mellitus
• prothrombotic state
• calcium deficiency
• iron deficiency anemia
• cohort

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by Shenzhen Municipal Government of China (JCYJ20180703093402288), China Postdoctoral Science Foundation (2020M683201), and Guangdong Basic and Applied Basic Research Foundation (2020A1515110116).