Maternal and Foetal Blood Analysis in Term Pregnancies with and without Gestational Diabetes Mellitus: A Prospective Cohort Study

Abstract

Introduction: Gestational Diabetes Mellitus (GDM) is the development of carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Iron is essential for the beta cell functioning of the pancreas and glucose homeostasis in adequate quantities. However, excess iron levels can lead to the generation of an increased amount of free radicals, which can cause toxicity to the pancreatic beta cells, leading to insulin resistance by impairing glucose metabolism. Aim: To compare maternal and foetal blood analysis in term pregnancies with and without GDM. Materials and Methods: This prospective cohort study was conducted at the Department of Obstetrics and Gynaecology, JSS Medical College and Hospital Research Centre, Mysuru, Karnataka, India, on 120 term pregnant women, with 60 cases of GDM and 60 non GDM controls. Maternal blood and cord blood samples were used to measure Haemoglobin (Hb), Packed Cell Volume (PCV), serum iron, and serum ferritin in the mother and newborn at the time of delivery. Foetal blood analysis was performed in terms of foetal haemoglobin, iron, and ferritin. Birth weight was also measured. Statistical analysis was performed using the Chi-square test and Independent t-test, with a p-value <0.05 considered significant. Results: The serum ferritin level of the mother was higher in GDM cases (mean value 89.47 ng/mL) than in non GDM controls (mean value 47.62 ng/mL), and this difference was statistically significant. Serum ferritin levels in newborns were significantly lower in the GDM group (85.43) compared to the non GDM group (102.71). Mean values of haemoglobin, PCV, and iron levels were not significantly higher in newborns of GDM mothers compared to non GDM mothers. Conclusion: In GDM, serum ferritin was increased, indicating a marker of inflammation or iron overload, which increases oxidative stress that might affect placental iron transfer and haemoglobin synthesis in the foetus.