Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population

Abstract Gestational diabetes mellitus (GDM) has aroused wide public concern, as it affects approximately 1.8–25.1% of pregnancies worldwide. This study aimed to examine the association of pre-pregnancy demographic parameters and early-pregnancy laboratory biomarkers with later GDM risk, and further...

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Autores principales:	Min Zhao, Shuyu Yang, Tzu Chieh Hung, Wenjie Zheng, Xiaojie Su
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0a27a81da4334b7095dc27d018a960d7
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spelling	oai:doaj.org-article:0a27a81da4334b7095dc27d018a960d72021-12-02T14:25:21ZAssociation of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population10.1038/s41598-021-86818-72045-2322https://doaj.org/article/0a27a81da4334b7095dc27d018a960d72021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86818-7https://doaj.org/toc/2045-2322Abstract Gestational diabetes mellitus (GDM) has aroused wide public concern, as it affects approximately 1.8–25.1% of pregnancies worldwide. This study aimed to examine the association of pre-pregnancy demographic parameters and early-pregnancy laboratory biomarkers with later GDM risk, and further to establish a nomogram prediction model. This study is based on the big obstetric data from 10 “AAA” hospitals in Xiamen. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. Data are analyzed using Stata (v14.1) and R (v3.5.2). Total 187,432 gestational women free of pre-pregnancy diabetes mellitus were eligible for analysis, including 49,611 women with GDM and 137,821 women without GDM. Irrespective of confounding adjustment, eight independent factors were consistently and significantly associated with GDM, including pre-pregnancy body mass index (BMI), pre-pregnancy intake of folic acid, white cell count, platelet count, alanine transaminase, albumin, direct bilirubin, and creatinine (p < 0.001). Notably, per 3 kg/m2 increment in pre-pregnancy BMI was associated with 22% increased risk [adjusted odds ratio (OR) 1.22, 95% confidence interval (CI) 1.21–1.24, p < 0.001], and pre-pregnancy intake of folic acid can reduce GDM risk by 27% (adjusted OR 0.73, 95% CI 0.69–0.79, p < 0.001). The eight significant factors exhibited decent prediction performance as reflected by calibration and discrimination statistics and decision curve analysis. To enhance clinical application, a nomogram model was established by incorporating age and above eight factors, and importantly this model had a prediction accuracy of 87%. Taken together, eight independent pre-/early-pregnancy predictors were identified in significant association with later GDM risk, and importantly a nomogram modeling these predictors has over 85% accuracy in early detecting pregnant women who will progress to GDM later.Min ZhaoShuyu YangTzu Chieh HungWenjie ZhengXiaojie SuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Min Zhao Shuyu Yang Tzu Chieh Hung Wenjie Zheng Xiaojie Su Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population
description	Abstract Gestational diabetes mellitus (GDM) has aroused wide public concern, as it affects approximately 1.8–25.1% of pregnancies worldwide. This study aimed to examine the association of pre-pregnancy demographic parameters and early-pregnancy laboratory biomarkers with later GDM risk, and further to establish a nomogram prediction model. This study is based on the big obstetric data from 10 “AAA” hospitals in Xiamen. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. Data are analyzed using Stata (v14.1) and R (v3.5.2). Total 187,432 gestational women free of pre-pregnancy diabetes mellitus were eligible for analysis, including 49,611 women with GDM and 137,821 women without GDM. Irrespective of confounding adjustment, eight independent factors were consistently and significantly associated with GDM, including pre-pregnancy body mass index (BMI), pre-pregnancy intake of folic acid, white cell count, platelet count, alanine transaminase, albumin, direct bilirubin, and creatinine (p < 0.001). Notably, per 3 kg/m2 increment in pre-pregnancy BMI was associated with 22% increased risk [adjusted odds ratio (OR) 1.22, 95% confidence interval (CI) 1.21–1.24, p < 0.001], and pre-pregnancy intake of folic acid can reduce GDM risk by 27% (adjusted OR 0.73, 95% CI 0.69–0.79, p < 0.001). The eight significant factors exhibited decent prediction performance as reflected by calibration and discrimination statistics and decision curve analysis. To enhance clinical application, a nomogram model was established by incorporating age and above eight factors, and importantly this model had a prediction accuracy of 87%. Taken together, eight independent pre-/early-pregnancy predictors were identified in significant association with later GDM risk, and importantly a nomogram modeling these predictors has over 85% accuracy in early detecting pregnant women who will progress to GDM later.
format	article
author	Min Zhao Shuyu Yang Tzu Chieh Hung Wenjie Zheng Xiaojie Su
author_facet	Min Zhao Shuyu Yang Tzu Chieh Hung Wenjie Zheng Xiaojie Su
author_sort	Min Zhao
title	Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population
title_short	Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population
title_full	Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population
title_fullStr	Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population
title_full_unstemmed	Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population
title_sort	association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large chinese population
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/0a27a81da4334b7095dc27d018a960d7
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Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population

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