Association Between Serum Ferritin Concentration and Risk of Adverse Maternal and Fetal Pregnancy Outcomes: A Retrospective Cohort Study

Lanyao Yang; Lanlan Wu; Yao Liu; Hengying Chen; Yuanhuan Wei; Ruifang Sun; Siwen Shen; Bowen Zhan; Jianjun Yang; Guifang Deng

doi:10.2147/DMSO.S380408

Association Between Serum Ferritin Concentration and Risk of Adverse Maternal and Fetal Pregnancy Outcomes: A Retrospective Cohort Study

Diabetes Metab Syndr Obes. 2022 Sep 19:15:2867-2876. doi: 10.2147/DMSO.S380408. eCollection 2022.

Authors

Lanyao Yang^#^{1

2}, Lanlan Wu^#³, Yao Liu³, Hengying Chen⁴, Yuanhuan Wei³, Ruifang Sun³, Siwen Shen³, Bowen Zhan^{1

2}, Jianjun Yang^{1

2}, Guifang Deng³

Affiliations

¹ Department of Nutrition and Food Hygiene, School of Public Health and Management, Ningxia Medical University, Yinchuan, People's Republic of China.
² Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health and Management, Ningxia Medical University, Yinchuan, People's Republic of China.
³ Department of Clinical Nutrition, Union Shenzhen Hospital of Huazhong University of Science and Technology, Shenzhen, People's Republic of China.
⁴ Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

^# Contributed equally.

Abstract

Objective: This study evaluated the associations of serum ferritin (SF) concentration during pregnancy with the risk of adverse maternal and fetal pregnancy outcomes.

Methods: We conducted a retrospective study of 2327 pregnant women from 2015 to 2020 in Guangdong, China. SF concentrations were measured at 16-18th and 28-32th week of gestation. Logistic regression models were applied to estimate the association between SF concentration and the risk of adverse pregnancy outcomes.

Results: After multivariable adjustment, the odds ratio (OR) of the highest quartile of SF concentration at 16-18th week of gestation was 1.43 (95% confidence interval [CI]: 1.09, 1.89) for gestational diabetes mellitus (GDM) and 1.79 (95% CI: 1.15, 2.79) for small for gestational age (SGA) when compared with the lowest quartile. At 28-32th week of gestation compared with the lowest quartile, women with SF in the highest quartile had an increased risk of SGA (OR: 1.62; 95% CI: 1.01, 2.62). Moreover, the lowest quartile of SF concentration decreased risk of SGA by 90% (95% CI: 0.01, 0.80) when compared with the highest quartile among pregnancy women with GDM.

Conclusion: Elevated SF concentrations increased the risk of GDM and SGA during pregnancy. Maintaining an appropriately low level of maternal SF at 28-32th week of gestation in women with GDM could reduce the risk of SGA.

Keywords: adverse pregnancy outcomes; ferritin; gestational diabetes mellitus; small for gestational age.

Grants and funding

This study was supported by the National Natural Science Foundation of China [grant number 82103821], the Shenzhen Science and Technology Innovation Committee [grant number JCYJ20190809102203602; JCYJ20210324112400002] and the Guangdong Basic and Applied Basic Project [grant number 2019A1515110456].