Association of Iron Deficiency with Gestational Diabetes Mellitus Among Tribal Pregnant Women in Rangamati: A Cross-Sectional Study

Open Access

Abstract

Background: Gestational diabetes mellitus (GDM) is a common metabolic disorder associated with adverse maternal and neonatal outcomes. Iron deficiency is prevalent among pregnant women, particularly in low-resource and indigenous communities. Emerging evidence suggests that maternal iron status may influence glucose metabolism and insulin sensitivity. However, evidence regarding the association between iron deficiency and GDM among tribal pregnant women in Bangladesh remains limited. Objective: To determine the association between iron deficiency and GDM among tribal pregnant women receiving antenatal care in Rangamati, Bangladesh. Methods & Materials: A hospital-based cross-sectional study was conducted among 100 tribal pregnant women at 24-36 weeks of gestation attending the Department of Gynaecology and Obstetrics, Rangamati General Hospital, Chattogram, Bangladesh, from January to December 2025. Participants were recruited consecutively. Sociodemographic, obstetric, dietary, and clinical information was collected using structured interviews and medical records. Hemoglobin and serum ferritin were measured to assess iron status. GDM was diagnosed using a 75-g oral glucose tolerance test according to WHO criteria. Results: The mean age was 26.8±4.9 years. Iron deficiency was present in 42.0% and GDM in 18.0% of participants. GDM occurred in 9.5% of women with iron deficiency compared with 24.1% of those with normal iron status (p=0.041). After adjustment for relevant confounders, iron deficiency remained independently associated with lower odds of GDM (AOR=0.34; 95% CI: 0.12-0.93; p=0.036). Maternal age ≥30 years, BMI ≥25 kg/m² and family history of diabetes were independently associated with increased odds of GDM. Conclusion: Iron deficiency was common among tribal pregnant women, while GDM affected nearly one-fifth. An inverse association between iron deficiency and GDM persisted after adjustment. Larger prospective multicenter studies are warranted to clarify causality and guide antenatal nutritional interventions.