Estimating the risk of gestational diabetes mellitus: a clinical prediction model based on patient characteristics and medical history

M. van Leeuwen*, B. C. Opmeer, E. J. K. Zweers, E. van Ballegooie, H. G. ter Brugge, H. W. de Valk, G. H. A. Visser, B. W. J. Mol

*Corresponding author for this work

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    Abstract

    Objective

    To develop a clinical prediction rule that can help the clinician to identify women at high and low risk for gestational diabetes mellitus (GDM) early in pregnancy in order to improve the efficiency of GDM screening.

    Design

    We used data from a prospective cohort study to develop the clinical prediction rule.

    Setting

    The original cohort study was conducted in a university hospital in the Netherlands.

    Population

    Nine hundred and ninety-five consecutive pregnant women underwent screening for GDM.

    Methods

    Using multiple logistic regression analysis, we constructed a model to estimate the probability of development of GDM from the medical history and patient characteristics. Receiver operating characteristics analysis and calibration were used to assess the accuracy of the model.

    Main outcome measure

    The development of a clinical prediction rule for GDM. We also evaluated the potential of the prediction rule to improve the efficiency of GDM screening.

    Results

    The probability of the development of GDM could be predicted from the ethnicity, family history, history of GDM and body mass index. The model had an area under the receiver operating characteristic curve of 0.77 (95% CI 0.69-0.85) and calibration was good (Hosmer and Lemeshow test statistic, P = 0.25). If an oral glucose tolerance test was performed in all women with a predicted probability of 2% or more, 43% of all women would be tested and 75% of the women with GDM would be identified.

    Conclusions

    The use of a clinical prediction model is an accurate method to identify women at increased risk for GDM, and could be used to select women for additional testing for GDM.

    Original languageEnglish
    Pages (from-to)69-75
    Number of pages7
    JournalBJOG-an International Journal Of Obstetrics And Gynaecology
    Volume117
    Issue number1
    DOIs
    Publication statusPublished - Jan-2010

    Keywords

    • Gestational diabetes mellitus
    • prediction model
    • screening
    • PREGNANCY OUTCOMES
    • DIAGNOSIS
    • TESTS
    • WOMEN

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