Association between First-Trimester Maternal Serum Manganese Concentrations and the Subsequent Risk of Gestational Diabetes Mellitus

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 1035–1046

DOI: 10.46882/2026/IJOG/000567

Original Research Article

Title: Association between First-Trimester Maternal Serum Manganese Concentrations and the Subsequent Risk of Gestational Diabetes Mellitus

Names of Authors: Elizabeth Johnson¹, Greta Fischer²

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, Harvard Medical School, Boston, Massachusetts, USA
² Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria

Abstract:
Manganese functions as an essential trace element cofactor for key metabolic enzymes involved in gluconeogenesis and antioxidant defenses, yet its relationship with maternal carbohydrate kinetics remains poorly defined. This prospective cohort study examined the relationship between early-pregnancy maternal serum manganese levels and the subsequent risk of developing Gestational Diabetes Mellitus (GDM). Serum samples were collected from 500 normotensive nulliparous women between 11 and 13⁺⁶ weeks of gestation, and absolute manganese concentrations were quantified via inductively coupled plasma mass spectrometry. All participants underwent standard 2-hour, 75 g oral glucose tolerance testing (OGTT) at 24 to 28 weeks to diagnose GDM. Sixty women (12.0%) developed GDM. First-trimester maternal serum manganese levels were significantly lower in the cohort that subsequently developed GDM compared to those who maintained normal metabolic profiles (1.12 ± 0.32 μg/L vs. 1.64 ± 0.45 μg/L, p < 0.001). Adjusting for baseline maternal age, body mass index, and family history of type 2 diabetes, multivariable logistic regression modeling confirmed that a first-trimester serum manganese level < 1.25 μg/L was associated with a threefold increase in the risk of GDM (Odds Ratio [OR] = 3.14; 95% CI, 1.62 to 6.08, p < 0.001). Early maternal serum manganese deficiency during the first trimester is independently associated with an elevated risk of subsequent gestational diabetes mellitus, highlighting a potential role for early micronutrient risk stratification.

Keywords: Gestational Diabetes Mellitus; Manganese Deficiency; Trace Elements; Insulin Resistance; First-Trimester Screening; Metabolic Biomarkers.

Manuscript Timeline: Received: July 08, 2026; Revised: September 04, 2026; Accepted: September 18, 2026; Published: September 29, 2026.

Citation: Johnson E, Fischer G. Association between First-Trimester Maternal Serum Manganese Concentrations and the Subsequent Risk of Gestational Diabetes Mellitus. International Journal of Obstetrics and Gynecology. 2026; 14(9): 1035–1046.

Subscribe to read the full article: https://mail.internationalscholarsjournals.org/subscribe-to-read