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Gestational diabetes: Development of an early risk prediction tool to facilitate opportunities for prevention
Author(s) -
TEEDE Helena J.,
HARRISON Cheryce L.,
TEH Wan T.,
PAUL Eldho,
ALLAN Carolyn A.
Publication year - 2011
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2011.01356.x
Subject(s) - gestational diabetes , medicine , diabetes mellitus , computer science , obstetrics , pregnancy , gestation , endocrinology , biology , genetics
Background and aim: In the setting of advancing maternal age, escalating obesity and increasing Gestational Diabetes Mellitus (GDM) rates, we aimed to develop a novel risk prediction tool to identify high‐risk women in early pregnancy, specifically to facilitate targeted antenatal prevention of GDM. Methods: In this retrospective, observational study, first‐trimester data collected routinely by midwifery staff in 4276 women attending a large tertiary hospital in 2007/2008 was analysed to examine predictive factors for GDM. GDM was diagnosed with a 28‐week oral glucose tolerance test. The data set included a derivation group ( n = 2880, from 2007 deliveries) and a validation group ( n = 1396, from 2008). Multivariate analysis generated a scoring system. Results: GDM was significantly correlated with a number of factors: past history of GDM, increasing maternal age and body mass index, Asian descent and family history of diabetes. Validation group clinical scores achieved a sensitivity of 61.3% and specificity of 71.4% for differentiating women according to their risk of developing GDM. Conclusions: Risk factors for GDM are easily identified at the first‐trimester midwifery hospital booking visit. A risk prediction tool, derived from risk factors in early pregnancy, identifies women at high risk of GDM. This represents a novel approach to facilitate targeted early intervention with the potential to prevent development of or ameliorate, GDM.