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Objective: To determine the frequency of gestational diabetes mellitus (GDM) in non-anaemic women with and without iron supplementation.
Methods: This comparative cross-sectional study was conducted at the Department of Obstetrics and Gynecology, Holy Family Hospital, Rawalpindi, from January to June 2025. A total of 110 non-anaemic pregnant women (20–24 weeks’ gestation) were enrolled: 55 using iron supplements and 55 not using them. Haemoglobin (Hb) and serum ferritin levels were measured. All participants were screened using a 75 g oral glucose tolerance test (OGTT) at 28 weeks of gestation to assess GDM. Data were analysed using chi-square tests and multivariable logistic regression; adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated (p ≤ 0.05).
Results: GDM occurred in 28 (25.5%) participants and was more frequent in supplement users than in non-users (36.4% vs. 14.5%; p = 0.01). The mean serum ferritin level was higher in users (85.4 ± 17.8 ng/mL) than in non-users (51.1 ± 14.9 ng/mL). In the unadjusted analysis, iron supplementation was associated with higher odds of GDM (OR 3.36, 95% CI: 1.33–8.49). After adjusting for confounders, iron supplementation remained significantly associated with GDM (aOR = 3.12, 95% CI: 1.21–8.03; p = 0.018). Ferritin levels >100 ng/mL were also associated with an increased risk of GDM (aOR = 3.70, 95% CI: 1.13–12.11; p = 0.030). No differences were observed in terms of parity, education, or diet.
Conclusion: Iron supplementation in non-anaemic pregnant women is associated with an increased risk of GDM, particularly at high ferritin levels. Careful assessment and individualised supplementation are recommended.
Keywords: Gestational diabetes mellitus, Iron supplementation, Pregnancy, Non-anaemic women, Maternal health
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