Iron Salts, High Levels of Hemoglobin and Ferritin in Pregnancy, and Development of Gestational Diabetes: A Systematic Review

The aim of this study was to systematically review literature on the use of iron supplements (not including iron derived from diet), increased levels of hemoglobin and/or ferritin, and the risk of developing gestational diabetes mellitus (GDM).  The following databases were searched, from the study&...

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Bibliographic Details
Published in:Revista Brasileira de ginecologia e obstetrícia 2022-11, Vol.44 (11), p.1059-1069
Main Authors: Miranda, Vanessa Iribarrem Avena, Pizzol, Tatiane da Silva Dal, Jesus, Patricia Romualdo de, Silveira, Marysabel Pinto Telis, Bertoldi, Andréa Dâmaso
Format: Article
Language:English
Subjects:
Diabetes, Gestational - epidemiology
Female
ferritin
Ferritins
gestational diabetes
hemoglobin
Hemoglobins
Humans
Iron
iron supplement
OBSTETRICS & GYNECOLOGY
Pregnancy
Review
Salts
United States
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Summary:The aim of this study was to systematically review literature on the use of iron supplements (not including iron derived from diet), increased levels of hemoglobin and/or ferritin, and the risk of developing gestational diabetes mellitus (GDM).  The following databases were searched, from the study's inception to April 2021: PUBMED, Cochrane, Web of Science, Scopus, Embase, Cinahl and Lilacs.  A total of 6,956 titles and abstracts were reviewed, 9 of which met the final inclusion criteria, with 7,560 women in total.  Data extraction was performed by two independent reviewers and disagreements were resolved by a third researcher.  Methodological quality in controlled trials were assessed according to the Cochrane Collaboration tools (ROB-2 and ROBINS-1) and for the observational studies, the National Institutes of Health's (NIH) quality assessment tool was used. Among the 5 observational studies, women with a higher hemoglobin or ferritin level were more likely to develop GDM when compared with those with lower levels of these parameters. Among the 3 randomized clinical trials, none found a significant difference in the incidence of GDM among women in the intervention and control groups. However, we identified many risks of bias and great methodological differences among them.  Based on the studies included in this review, and due to the important methodological problems pointed out, more studies of good methodological quality are needed to better establish the association between iron supplementation and GDM.
ISSN:0100-7203
1806-9339
1806-9339
DOI:10.1055/s-0042-1755460