Cooray et al reported the PeRSonal GDM model for predicting adverse pregnancy outcomes for a woman with gestational diabetes mellitus. The authors are from Monash University in Australia, University of Birmingham, CIBER Epidemiology and Public Health, and Birmingham Women's and Children's NHS Foundation Trust.
Patient selection: gestational diabetes mellitus
Adverse pregnancy outcomes: hypertensive disorder of pregnancy (eclampsia, pre-eclampsia), large for gestational age, neonatal hypoglycemia, shoulder dystocia, fetal death, neonatal death, bone fracture, nerve palsy
Parameters:
(1) maternal age in years
(2) pre-pregnancy body mass index in kg per square meter
(3) fasting glucose at baseline before OGTT in mmol/L
(4) blood glucose in mmol/L at 1 hour afer 75 g glucose load OGTT
(5) week of gestation at diagnosis of gestational diabetes
(6) ethnicity
(7) nulliparity
(8) previous large for gestational age (LGA) baby
(9) previous pre-eclampsia
(10) gestational weight gain per week to the diagnosis of gestational diabetes
(11) family history of diabetes
|
Parameter
|
Finding
|
Points
|
|
maternal age
|
|
0.01 * (age)
|
|
pre-pregnancy BMI
|
|
0.04 * (BMI)
|
|
fasting glucose OGTT
|
|
0.32 * (glucose)
|
|
1-hour glucose OGTT
|
|
0.06 * (glucose)
|
|
gestational age at GDM dx
|
|
-0.02 * (week)
|
|
ethnicity
|
East Asian
|
-0.14
|
|
|
Southern or Central Asian
|
-0.65
|
|
|
other
|
0
|
|
nuliparity
|
no
|
0
|
|
|
yes
|
0.17
|
|
previous LGA baby
|
no
|
0
|
|
|
yes
|
0.53
|
|
previous pre-eclampsia
|
no
|
0
|
|
|
yes
|
0.93
|
|
gestational weight gain
|
|
0.54 * (weight gain)
|
|
family history of diabetes
|
no
|
0
|
|
|
yes
|
-0.07
|
where:
• If a woman is nulliparous then the questions about previous pregnancies are not relevant.
value of X =
= SUM(points for all of the parameters) - 4.11
probability of adverse pregnancy outcome =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.68 which suboptimal.
