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- Title
A Novel Early Pregnancy Risk Prediction Model for Gestational Diabetes Mellitus.
- Authors
Sweeting, Arianne N.; Wong, Jencia; Appelblom, Heidi; Ross, Glynis P.; Kouru, Heikki; Williams, Paul F.; Sairanen, Mikko; Hyett, Jon A.; Sweeting, Arianne N; Ross, Glynis P; Williams, Paul F; Hyett, Jon A
- Abstract
<bold>Introduction: </bold>Accurate early risk prediction for gestational diabetes mellitus (GDM) would target intervention and prevention in women at the highest risk. We evaluated novel biomarker predictors to develop a first-trimester risk prediction model in a large multiethnic cohort.<bold>Methods: </bold>Maternal clinical, aneuploidy and pre-eclampsia screening markers (PAPP-A, free hCGβ, mean arterial pressure, uterine artery pulsatility index) were measured prospectively at 11-13+6 weeks' gestation in 980 women (248 with GDM; 732 controls). Nonfasting glucose, lipids, adiponectin, leptin, lipocalin-2, and plasminogen activator inhibitor-2 were measured on banked serum. The relationship between marker multiples-of-the-median and GDM was examined with multivariate regression. Model predictive performance for early (< 24 weeks' gestation) and overall GDM diagnosis was evaluated by receiver operating characteristic curves.<bold>Results: </bold>Glucose, triglycerides, leptin, and lipocalin-2 were higher, while adiponectin was lower, in GDM (p < 0.05). Lipocalin-2 performed best in Caucasians, and triglycerides in South Asians with GDM. Family history of diabetes, previous GDM, South/East Asian ethnicity, parity, BMI, PAPP-A, triglycerides, and lipocalin-2 were significant independent GDM predictors (all p < 0.01), achieving an area under the curve of 0.91 (95% confidence interval [CI] 0.89-0.94) overall, and 0.93 (95% CI 0.89-0.96) for early GDM, in a combined multivariate prediction model.<bold>Conclusions: </bold>A first-trimester risk prediction model, which incorporates novel maternal lipid markers, accurately identifies women at high risk of GDM, including early GDM.
- Subjects
GESTATIONAL diabetes; PREGNANCY complications; DIAGNOSIS of diabetes; FIRST trimester of pregnancy; ANEUPLOIDY; PREECLAMPSIA; LIPOCALIN-1
- Publication
Fetal Diagnosis & Therapy, 2019, Vol 45, Issue 2, p76
- ISSN
1015-3837
- Publication type
journal article
- DOI
10.1159/000486853