Patient selection: pregnant woman in Thailand
Parameters:
(1) age in years
(2) first visit body mass index (BMI) in kilograms per square meter
(3) family history of type 2 diabetes (first degree relatives)
(4) previous history of macrosomia in an infant (>= 4,000 g)
(5) history of >= 2 abortions (miscarriages, stillbirth or congenital malformations, adverse obstetrical events)
risk score =
= (6 * (age in years)) + (11 * (BMI)) + (109 * (points for family history)) + (42 * (points for macrosomia)) + (49 * (points for history of abortions))
Interpretation:
• minimum score: < 294 (score for a 16 year old with BMI 18)
• maximum score: > 760
• The higher the score the greater the need to screen for gestational diabetes.
Performance:
• The cutoff of >= 380 had the greatest sensitivity (87% in derivation cohort, 84% in validation cohort and 98% in Table 4) but low specificity. The negative predictive value (NPV) was 88-90%.
• The Youden score (20%) and AUC (0.60) are low.
• The performance would be affected by the population.
• For women 20 years old, a BMI < 23.6 kg per sq m and no risk factors is required to not trigger testing.
Other information - The clinical criteria for high-risk pregnancy without the score was any of the following:
(1) age >= 35 years of age
(2) BMI > 27 kg per square meter
(3) any first-degree relatives with type 2 diabetes
(4) personal history of gestational diabetes
(5) prior delivery of infant with macrosomia (>= 4,000 g)
(6) history of adverse obstetric event (as listed above)
(7) glucosuria
