Prediction of gestational diabetes mellitus in the Born in Guangzhou Cohort Study, China.
Schaefer KK., Xiao W., Chen Q., He J., Lu J., Chan F., Chen N., Yuan M., Xia H., Lam KBH., Hirst JE., Qiu X.
OBJECTIVE: To assess potential risk factors in identifying women at risk for gestational diabetes mellitus (GDM). METHODS: The present study included data collected as part of a prospective cohort study, and included women with singleton pregnancies who underwent initial prenatal examination at a tertiary women and children's hospital in Guangzhou, China between February 1, 2012, and December 31, 2015. Maternal characteristics and medical history were investigated to evaluate associations with GDM. A risk factor scoring system for the prediction of GDM was generated using logistic regression. RESULTS: Overall, 1129 (13.5%) of 8381 women were diagnosed with GDM. Women older than 35 years had a 3.95-fold increased risk of GDM (95% confidence interval 2.80-5.58) compared with women aged 16-25 years; obese women had a 6.54-fold higher risk (95% confidence interval 3.50-12.23) compared with underweight women. A risk scoring system was established based on age, body mass index, family history of diabetes, weight gain, and history of GDM. Screening for women with a score of 12 or more would have reduced the number undergoing oral glucose tolerance testing by 2131 (25.4%) patients with a sensitivity of 87% for GDM detection. CONCLUSION: The assessment of risk factors for GDM could provide a foundation for improving risk-based screening strategies in this and similar populations.