Estimating the risk of gestational diabetes mellitus based on the 2013 WHO criteria: a prediction model based on clinical and biochemical variables in early pregnancy

Acta Diabetol. 2020 Jun;57(6):661-671. doi: 10.1007/s00592-019-01469-5. Epub 2020 Jan 8.

Abstract

Aims: We aimed to develop a prediction model based on clinical and biochemical variables for gestational diabetes mellitus (GDM) based on the 2013 World Health Organization (WHO) criteria.

Methods: A total of 1843 women from a Belgian multi-centric prospective cohort study underwent universal screening for GDM. Using multivariable logistic regression analysis, a model to predict GDM was developed based on variables from early pregnancy. The performance of the model was assessed by receiver-operating characteristic (AUC) analysis. To account for over-optimism, an eightfold cross-validation was performed. The accuracy was compared with two validated models (van Leeuwen and Teede).

Results: A history with a first degree relative with diabetes, a history of smoking before pregnancy, a history of GDM, Asian origin, age, height and BMI were independent predictors for GDM with an AUC of 0.72 [95% confidence interval (CI) 0.69-0.76)]; after cross-validation, the AUC was 0.68 (95% CI 0.64-0.72). Adding biochemical variables, a history of a first degree relative with diabetes, a history of GDM, non-Caucasian origin, age, height, weight, fasting plasma glucose, triglycerides and HbA1c were independent predictors for GDM, with an AUC of the model of 0.76 (95% CI 0.72-0.79); after cross-validation, the AUC was 0.72 (95% CI 0.66-0.78), compared to an AUC of 0.67 (95% CI 0.63-0.71) using the van Leeuwen model and an AUC of 0.66 (95% CI 0.62-0.70) using the Teede model.

Conclusions: A model based on easy to use variables in early pregnancy has a moderate accuracy to predict GDM based on the 2013 WHO criteria.

Keywords: 2013 WHO criteria; Gestational diabetes mellitus; Prediction; Risk factors.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Belgium / epidemiology
  • Biomarkers / analysis*
  • Biomarkers / blood
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Body Mass Index
  • Cohort Studies
  • Diabetes, Gestational / blood
  • Diabetes, Gestational / diagnosis*
  • Diabetes, Gestational / epidemiology
  • Diabetes, Gestational / etiology*
  • Female
  • Gestational Age
  • Glucose Tolerance Test
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / metabolism
  • Humans
  • Models, Statistical*
  • Pregnancy
  • Pregnancy Trimester, First / blood
  • Prenatal Diagnosis / methods*
  • Prenatal Diagnosis / standards
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Triglycerides / blood
  • World Health Organization
  • Young Adult

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Triglycerides
  • hemoglobin A1c protein, human