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BJOG. 2009 May;116(6):789-97; discussion 797-8. doi: 10.1111/j.1471-0528.2008.02014.x.

Iron supplement in pregnancy and development of gestational diabetes--a randomised placebo-controlled trial.

Author information

1
Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong SAR, China. kklchan@hkucc.hku.hk

Abstract

OBJECTIVE:

To test the hypothesis that iron supplement from early pregnancy would increase the risk of gestational diabetes mellitus (GDM).

DESIGN:

Randomised placebo-controlled trial.

SETTING:

A university teaching hospital in Hong Kong.

POPULATION:

One thousand one hundred sixty-four women with singleton pregnancy at less than 16 weeks of gestation with haemoglobin (Hb) level between 8 and 14 g/dl and no pre-existing diabetes or haemoglobinopathies.

METHODS:

Women were randomly allocated to receive 60 mg of iron supplement daily (n= 565) or placebo (n= 599). Oral glucose tolerance tests (OGTTs) were performed at 28 and 36 weeks. Women were followed up until delivery.

OUTCOME MEASURES:

The primary outcome was development of GDM at 28 weeks. The secondary outcomes were 2-hour post-OGTT glucose levels, development of GDM at 36 weeks and delivery and infant outcomes.

RESULTS:

There was no significant difference in the incidence of GDM in the iron supplement and placebo groups at 28 weeks (OR: 1.04, 95% confidence interval [CI]: 0.7-1.53 at 90% power) or 36 weeks. Maternal Hb and ferritin levels were higher in the iron supplement group at delivery (P < 0.001 and P= 0.003, respectively). Elective caesarean section rate was lower in the iron supplement group (OR: 0.58, 95% CI: 0.37-0.89). Infant birthweight was heavier (P= 0.001), and there were fewer small-for-gestational-age babies in the iron supplement group (OR: 0.46, 95% CI: 0.24-0.85).

CONCLUSION:

Iron supplement from early pregnancy does not increase the risk of GDM. It may have benefits in terms of pregnancy outcomes.

[Indexed for MEDLINE]
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