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      A simple model to predict risk of gestational diabetes mellitus from 8 to 20 weeks of gestation in Chinese women

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          Abstract

          Background

          Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes. Screening for GDM and applying adequate interventions may reduce the risk of adverse outcomes. However, the diagnosis of GDM depends largely on tests performed in late second trimester. The aim of the present study was to bulid a simple model to predict GDM in early pregnancy in Chinese women using biochemical markers and machine learning algorithm.

          Methods

          Data on a total of 4771 pregnant women in early gestation were used to fit the GDM risk-prediction model. Predictive maternal factors were selected through Bayesian adaptive sampling. Selected maternal factors were incorporated into a multivariate Bayesian logistic regression using Markov Chain Monte Carlo simulation. The area under receiver operating characteristic curve (AUC) was used to assess discrimination.

          Results

          The prevalence of GDM was 12.8%. From 8th to 20th week of gestation fasting plasma glucose (FPG) levels decreased slightly and triglyceride (TG) levels increased slightly. These levels were correlated with those of other lipid metabolites. The risk of GDM could be predicted with maternal age, prepregnancy body mass index (BMI), FPG and TG with a predictive accuracy of 0.64 and an AUC of 0.766 (95% CI 0.731, 0.801).

          Conclusions

          This GDM prediction model is simple and potentially applicable in Chinese women. Further validation is necessary.

          Electronic supplementary material

          The online version of this article (10.1186/s12884-019-2374-8) contains supplementary material, which is available to authorized users.

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          Most cited references37

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          International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy: Response to Weinert

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            The Hyperglycemia and Adverse Pregnancy Outcome Study

            OBJECTIVE To determine associations of gestational diabetes mellitus (GDM) and obesity with adverse pregnancy outcomes in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. RESEARCH DESIGN AND METHODS Participants underwent a 75-g oral glucose tolerance test (OGTT) between 24 and 32 weeks. GDM was diagnosed post hoc using International Association of Diabetes and Pregnancy Study Groups criteria. Neonatal anthropometrics and cord serum C-peptide were measured. Adverse pregnancy outcomes included birth weight, newborn percent body fat, and cord C-peptide >90th percentiles, primary cesarean delivery, preeclampsia, and shoulder dystocia/birth injury. BMI was determined at the OGTT. Multiple logistic regression was used to examine associations of GDM and obesity with outcomes. RESULTS Mean maternal BMI was 27.7, 13.7% were obese (BMI ≥33.0 kg/m2), and GDM was diagnosed in 16.1%. Relative to non-GDM and nonobese women, odds ratio for birth weight >90th percentile for GDM alone was 2.19 (1.93–2.47), for obesity alone 1.73 (1.50–2.00), and for both GDM and obesity 3.62 (3.04–4.32). Results for primary cesarean delivery and preeclampsia and for cord C-peptide and newborn percent body fat >90th percentiles were similar. Odds for birth weight >90th percentile were progressively greater with both higher OGTT glucose and higher maternal BMI. There was a 339-g difference in birth weight for babies of obese GDM women, compared with babies of normal/underweight women (64.2% of all women) with normal glucose based on a composite OGTT measure of fasting plasma glucose and 1- and 2-h plasma glucose values (61.8% of all women). CONCLUSIONS Both maternal GDM and obesity are independently associated with adverse pregnancy outcomes. Their combination has a greater impact than either one alone.
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              Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline.

              (2014)
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                Author and article information

                Contributors
                rizi55@sina.com
                hhfsh@126.com
                xipengwang@hotmail.com
                lixiaoyong0055@126.com
                jlittle@uottawa.ca
                jlittle@uottawa.ca
                10121577104@qq.com
                +8602125078255 , zhanglin01@xinhuamed.com.cn
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                19 July 2019
                19 July 2019
                2019
                : 19
                : 252
                Affiliations
                [1 ]ISNI 0000 0004 0368 8293, GRID grid.16821.3c, Obstetric and Gynecology Department, Xinhua Hospital, , Shanghai Jiao Tong University School of Medicine, ; Shanghai, China
                [2 ]ISNI 0000 0004 0368 8293, GRID grid.16821.3c, Endocrinology Department, Xinhua Hospital, , Shanghai Jiao Tong University School of Medicine, ; Shanghai, China
                [3 ]ISNI 0000 0004 0368 8293, GRID grid.16821.3c, MOE-Shanghai Key Lab of Children’s Environmental Health, Xinhua Hospital, , Shanghai Jiao Tong University School of Medicine, ; Shanghai, China
                [4 ]ISNI 0000 0001 2182 2255, GRID grid.28046.38, School of Epidemiology and Public Health, Faculty of Medicine, , University of Ottawa, ; Ottawa, Canada
                Author information
                http://orcid.org/0000-0002-2728-4715
                Article
                2374
                10.1186/s12884-019-2374-8
                6642502
                31324151
                c0838aa8-e18e-42c8-8149-a5dd5715a663
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 24 September 2018
                : 24 June 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100008750, Shanghai Hospital Development Center;
                Award ID: SHDC12016204
                Award Recipient :
                Funded by: School of Medicine, Shanghai Jiao Tong University (CN)
                Award ID: 15QT12
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100003399, Science and Technology Commission of Shanghai Municipality;
                Award ID: 15411953200
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Obstetrics & Gynecology
                gestational diabetes mellitus,risk prediction,maternal factors
                Obstetrics & Gynecology
                gestational diabetes mellitus, risk prediction, maternal factors

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