Risk stratification in early pregnancy for women at increased risk of gestational diabetes

Harrison, C. L., Lombard, C. B., East, C., Boyle, J. and Teede, H. J. (2015) Risk stratification in early pregnancy for women at increased risk of gestational diabetes. Diabetes Research and Clinical Practice, 107 1: 61-68. doi:10.1016/j.diabres.2014.09.006


Author Harrison, C. L.
Lombard, C. B.
East, C.
Boyle, J.
Teede, H. J.
Title Risk stratification in early pregnancy for women at increased risk of gestational diabetes
Journal name Diabetes Research and Clinical Practice   Check publisher's open access policy
ISSN 1872-8227
0168-8227
Publication date 2015-01
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.diabres.2014.09.006
Open Access Status Not Open Access
Volume 107
Issue 1
Start page 61
End page 68
Total pages 8
Place of publication Shannon, Clare Ireland
Publisher Elsevier
Collection year 2016
Language eng
Formatted abstract
Aim: To evaluate the addition of fasting glucose and lipids to a simple, validated risk prediction tool for gestational diabetes (GDM) applied in early pregnancy.

Methods: Women at risk of developing GDM on a validated risk prediction tool were recruited in early pregnancy into a large randomised controlled trial. Outcome measures included fasting biochemical markers (glucose, lipids) at 12–15 weeks gestation and GDM diagnosis (28 weeks gestation). Multivariable logistic regression was used to identify additional predictive biochemical variables for GDM, with corresponding receiver operator characteristic (ROC) curves generated. Unadjusted and adjusted models were derived for both the Australasian Diabetes in Pregnancy (ADIPS) and the International Association for Diabetes in Pregnancy Study Group (IADPSG) GDM diagnostic criteria.

Results: 51 (23%) Women were diagnosed with GDM based on ADIPS criteria, with 60 (30%) diagnosed based on IADPSG criteria. In all four regression models, fasting glucose was the strongest predictor for GDM development with an odds ratio range of 4.7–6.3 (ADIPS) and 8.8–10 (IADPSG). ROC curves revealed an area under the curve of 0.79 (95% CI: 0.72–0.86) for ADIPS criteria and 0.83 (95% CI: 0.77–0.90) for IADPSG criteria for adjusted models.

Conclusions: In a two-step approach, when applied with a validated risk prediction tool, fasting glucose in early pregnancy was predictive of GDM and incrementally improved risk identification, presenting potential for an early pregnancy, GDM risk screening strategy for streamlining of pregnancy care and opportunity for preventive intervention.
Keyword Pregnancy
Gestational diabetes
Screening
Risk stratification
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Nursing, Midwifery and Social Work Publications
 
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Created: Mon, 28 Sep 2015, 14:09:37 EST by Natalie Cowley on behalf of School of Nursing, Midwifery and Social Work