Fasting plasma glucose and body mass index during the first trimester of pregnancy as predictors of gestational diabetes mellitus in a Chinese population

Abstract

This retrospective study assessed fasting plasma glucose (FPG) and body mass index (BMI) during the first trimester of pregnancy as potential screening indicators of later gestational diabetes mellitus (GDM). The study population included 820 pregnant women who delivered in our hospital between 17 September 2013 and 3 March 2014. Demographics and baseline characteristics were collected at the first antenatal visit; FPG levels were measured at 8 or 9 weeks. All participants underwent a 75-g oral glucose tolerance test at 24-28 weeks gestation. Multivariate logistic regression and receiver operating characteristic curve analysis were performed to determine the diagnostic power of risk factors. GDM was diagnosed in 20.3% of the women. There was an increased prevalence of GDM with advancing age, parity, high FPG, and obesity, but not in women with family predisposition. FPG (OR: 3.984; 95% CI: 2.397-6.62) and BMI (OR: 1.144; 95% CI: 1.083-1.208) were independent risk factors for later development of GDM (p<0.01). FPG level ≥4.6 mmol/L was the best threshold for predicting GDM with a sensitivity of 53.89 and specificity of 70.90%. BMI ≥23.5 kg/m yielded a sensitivity of 48.5% and a specificity of 73.1% for predicting GDM. FPG and BMI combined markedly enhanced the predictive capability for GDM (OR, 3.861; 95% CI: 2.701-5.520). High FPG or BMI in the first trimester, especially in combination, may predict later GDM with limited accuracy and specificity in Chinese women.

Risk Factors for the Prediction of Hyperglycemia during Pregnancy – A Cohort Study from a Brazilian Public Primary Care Center

“…The results of other studies in diverse populations do not differ from ours 11,13,14,16,42,43 . Also in agreement with other reports, we observed that the higher Sp shown by FG, HbA1c and HOMA-IR indicate them as the best predictors for ruling out GDM risk and the need for a diagnostic test 10,13,42,44,45 . universal screening are not available 16,17,46 .…”

The first-trimester of pregnancy – A window of opportunity for prediction and prevention of pregnancy complications and future life

“…The adiponectin association was further validated by two other groups [66,67]; in one of the studies, assessment at a fixed screen positive rate of 25% gave 80% sensitivity [67]. Whilst fasting plasma glucose is associated with GDM, this is a difficult test to include in a one-stop screening clinic that may give appointments late in the day [68]. Glycosylation and/or glycation of proteins such as fibronectin and CD59 (respectively) have recently been shown to have high ROC AUC scores and further work is needed to see if these can be combined with other maternal characteristics and investigational tools [69,70].…”

Effects of Vitamin D Deficiency on Incidence Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-analysis

“…Gestational diabetes mellitus (GDM), a frequent disorder in pregnancy, is defined as any degree of glucose intolerance that first develops or is first recognized during pregnancy ( 1 , 2 ). The incidence of GDM is rapidly increasing worldwide, and it affects 1–25% of all pregnancies depending on patient demographics, screening strategies, and diagnostic thresholds ( 2 , 3 ). According to the Hyperglycemia and Adverse Pregnancy Outcome Study Cooperative, GDM increases the number of maternal and fetal complications ( 4 – 6 ).…”