SF

This prospective study investigated the association between elevated serum ferritin levels at entry to care and the risk of gestational diabetes mellitus (GDM), as well as the potential role of increased iron stores versus inflammation. Among 1,456 pregnant women, those who developed GDM had significantly higher serum ferritin levels compared to those who did not (p < 0.001). Women in the highest quintile of serum ferritin had a twofold increased risk of developing GDM after adjusting for known risk factors (adjusted OR: 2.02, 95% CI: 1.04–3.92, p < 0.05). Similarly, a nested case-control analysis showed that women in the highest tertile of serum ferritin or C-reactive protein (CRP) levels also had a greater than twofold increased GDM risk. However, these associations became non-significant after adjusting for pre-pregnancy BMI, suggesting that the relationship is partly mediated by maternal fat mass and obesity. The findings point to a potential link between elevated ferritin levels, low-grade inflammation, and GDM risk.