期刊
JOURNAL OF DIABETES RESEARCH
卷 2017, 期 -, 页码 -出版社
HINDAWI LTD
DOI: 10.1155/2017/2849346
关键词
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资金
- Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA)
- South African Sugar Association (SASA)
- Roche
- SASA grant
- SEMDSA grant
Aim. We aimed to develop a prediction model for the diagnosis of gestational diabetes and to evaluate the performance of published prediction tools on our population. Methods. We conducted a cohort study on nondiabetic women < 26 weeks gestation at a level 1 clinic in Johannesburg, South Africa. At recruitment, participants completed a questionnaire and random basal glucose and HbA1c were evaluated. A 75 g 2-hour OGTT was scheduled between 24-28 weeks gestation, as per FIGO guidelines. A score was derived using multivariate logistic regression. Published scoring systems were tested by deriving ROC curves. Results. In 554 women, RBG, BMI, and previous baby >= 4000 g were significant risk factors included for GDM, which were used to derive a nomogram-based score. The logistic regression model for prediction of GDM had R-2 0.143, Somer's Dxy rank correlation 0.407, and Harrell's c-score 0.703. HbA1c did not improve predictive value of the nomogram at any threshold (e.g,. at probability > 10%, 25.6% of cases were detected without the HbA1c, and 25.8% of cases would have been detected with the HbA1c). The 9 published scoring systems performed poorly. Conclusion. We propose a nomogram-based score that can be used at first antenatal visit to identify women at high risk of GDM.
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