Obstet Gynecol Sci.  2022 Mar;65(2):156-165. 10.5468/ogs.21250.

A model for predicting gestational diabetes mellitus in early pregnancy: a prospective study in Thailand

• Lappharat S
• Rothmanee P
• Jandee K
• Suksai M
• Liabsuetrakul T

• KMID: 2527267
• DOI: http://doi.org/10.5468/ogs.21250

Abstract

Objective
To develop a predictive model using the risk factors of gestational diabetes mellitus (GDM) and construct a predictive nomogram for GDM risk in women during early pregnancy.
Methods
A prospective study was conducted in two tertiary hospitals among pregnant women with gestational age ≤14 weeks. Early GDM was diagnosed if an abnormal 100 g oral glucose tolerance test was detected using the Carpenter and Coustan criteria after an abnormal 50 g glucose challenge test. The factors included in the model were ACOG risk factors; maternal age; family history of hypertensive disorder in pregnancy; family history of dyslipidemia; gravida; parity; histories of preterm birth, early fetal death, abortion, stillbirth, and low birth weight; and glycated hemoglobin (HbA1c) levels. The predictive models for early GDM were analyzed using multiple logistic regression analyses. The nomograms were constructed, and their discrimination ability and predictive accuracy were tested.
Results
Of the 553 pregnant women, 54 (9.8%) were diagnosed with early GDM. In the integrated model, there was a history of GDM (adjusted odds ratio [aOR], 5.15; 95% confidence interval [CI], 1.82-14.63; P=0.004), HbA1c threshold ≥5.3% (aOR, 2.61; 95% CI, 1.44-4.74; P=0.002), and family history of dyslipidemia (aOR, 2.68; 95% CI, 1.37-5.21; P=0.005). The integrated nomogram model showed that a history of GDM had a high impact on the risk of early GDM. Its discrimination and mean absolute error were 0.76 and 0.009, respectively.
Conclusion
Application of the predictive model and nomogram will help healthcare providers investigate the probability of early GDM, especially in resource-limited countries.

Keyword

Diabetes, gestational; Pregnancy trimester, first; Nomograms; Diagnostic screening programs

Figure

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  Fig. 1 Flow chart of the study. HbA1c, glycated hemoglobin; OGTT, oral glucose tolerance test; GDM, gestational diabetes mellitus.

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  Fig. 2 Nomogram and calibration curve of the integrated model: (A) nomogram and (B) calibration plot. DLP, dyslipidemia; DM, diabetes mellitus; GDM, gestational diabetes mellitus; HbA1c, glycated hemoglobin; B, bootstrapping.

Reference

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