Diagnostic accuracy of first and early second trimester multiple biomarkers for prediction of gestational diabetes mellitus: a multivariate longitudinal approach

Elham Shaarbaf Eidgahi,Malihe Nasiri,Nourossadat Kariman,Maryam Kazemi,Farid Zayeri,Masoud Salehi,Nastaran Safavi Ardebili

doi:10.1186/s12884-021-04348-6

Abstract

BackgroundGestational Diabetes Mellitus (GDM) is an underlying cause of maternal and newborn morbidity and mortality all around the world. Timely diagnosis of GDM plays an important role in reducing its adverse consequences and burden. This study aimed to determine diagnostic accuracy of multiple indicators in complete blood count (CBC) test for early prediction of GDM.MethodsIn this prospective cohort study, the data from 600 pregnant women was analyzed. In the study sample, the two-step approach was utilized for the diagnosis of GDM at 24–28 weeks of gestation. We also used the repeated measures of hemoglobin (Hb), hematocrit (Hct), fasting blood sugar (FBS) and red blood cell count (RBC) in the first and early second trimesters of pregnancy as the longitudinal multiple indicators for early diagnosis of GDM. The classification of pregnant women to GDM and non-GDM groups was performed using a statistical technique based on the random-effects modeling framework.ResultsAmong the sample, 49 women (8.2%) were diagnosed with GDM. In the first and early second trimester of pregnancy, the mean HcT, Hb and FBS of women with GDM was significantly higher than non-GDMs (P < 0.001). The concurrent use of multiple longitudinal data from HcT, Hb, RBC and FBS in the first and early second trimester of pregnancy resulted in a sensitivity, specificity and area under the curve (AUC) of 87%, 70% and 83%, respectively, for early prediction of GDM.ConclusionsIn general, our findings showed that the concurrent use of repeated measures data on Hct, Hb, FBS and RBC in the first and early second trimester of pregnancy might be utilized as an acceptable tool to predict GDM earlier in pregnancy.

Highlights

Gestational Diabetes Mellitus (GDM) is one of the most common medical complications of pregnancy with considerable increasing prevalence in some parts of the world within the previous decades, especially in developing countries [1,2,3]
The inclusion criteria were singleton pregnancy, gestational age of 13 weeks or less, maternal age between 18 and 35 years, parity of 3 or less, lack of any diagnosed systemic diseases, lack of any history of smoking, alcohol use, non-routine drugs use during the present pregnancy, and any history of preeclampsia in previous pregnancy
The results revealed that the mean levels of these four biomarkers were higher in women with GDM than non-GDM

Summary

Introduction

Gestational Diabetes Mellitus (GDM) is one of the most common medical complications of pregnancy with considerable increasing prevalence in some parts of the world within the previous decades, especially in developing countries [1,2,3]. GDM is mostly symptom-free, it might be an underlying cause of acute or long-term consequences both in mothers and babies. Babies born from GDM women are at risk of being overweight or obese and developing type II diabetes [5, 9, 10]. Gestational Diabetes Mellitus (GDM) is an underlying cause of maternal and newborn morbidity and mortality all around the world. Diagnosis of GDM plays an important role in reducing its adverse consequences and burden. This study aimed to determine diagnostic accuracy of multiple indicators in complete blood count (CBC) test for early prediction of GDM

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