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Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population
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 estab...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016847/ https://www.ncbi.nlm.nih.gov/pubmed/33795771 http://dx.doi.org/10.1038/s41598-021-86818-7 |
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author | Zhao, Min Yang, Shuyu Hung, Tzu Chieh Zheng, Wenjie Su, Xiaojie |
author_facet | Zhao, Min Yang, Shuyu Hung, Tzu Chieh Zheng, Wenjie Su, Xiaojie |
author_sort | Zhao, Min |
collection | PubMed |
description | 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/m(2) 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 | Online Article Text |
id | pubmed-8016847 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-80168472021-04-05 Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population Zhao, Min Yang, Shuyu Hung, Tzu Chieh Zheng, Wenjie Su, Xiaojie Sci Rep Article 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/m(2) 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. Nature Publishing Group UK 2021-04-01 /pmc/articles/PMC8016847/ /pubmed/33795771 http://dx.doi.org/10.1038/s41598-021-86818-7 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Zhao, Min Yang, Shuyu Hung, Tzu Chieh Zheng, Wenjie Su, Xiaojie Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population |
title | 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_short | 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 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016847/ https://www.ncbi.nlm.nih.gov/pubmed/33795771 http://dx.doi.org/10.1038/s41598-021-86818-7 |
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