Prediction of Gestational Diabetes Mellitus Risk in Early Pregnancy Using Antenatal Screening Biomarkers
Abstract
Aim: In this study, we aimed to compare their success in predicting the risk of Gestational Diabetes Mellitus (GDM) using demographic (age, gravidity, parity), body mass index (BMI), first-trimester fasting blood glucose (FBG), thyroid-stimulating hormone (TSH), and antenatal screening biomarkers (dual and quadruple tests).
Materials and Methods: In this study, 800 pregnant women who underwent a one-step 75 g Oral Glucose Tolerance Test (OGTT) and antenatal screening tests at a tertiary hospital between January 2017 and June 2020 were retrospectively investigated. After patients were divided into two groups based on their GDM screening test results, the examined parameters were compared between the GDM-Positive and GDM-Negative groups. Once the parameters significantly associated with GDM were determined, their clinical utility in the early diagnosis of GDM was investigated.
Results: GDM was diagnosed in 159 (19.8%) of 800 patients. The GDM-Positive group had a higher age, gravidity, parity, BMI, and first-trimester serum FBG levels, as well as lower serum PAPP-A MoM levels than the GDM-Negative group (P <0.05). There were no significant differences between the groups based on serum TSH and f-βhCG, NT, AFP, uE3, ßhCG, and Inhibin-A MoM levels. Binary logistic regression analysis revealed that increased age (P=0.02, CI=1.007-1.096, OR=1.050), BMI (P<0.01, CI=1.452-3.213, OR=1.107), and first-trimester serum FBG levels were independently associated with GDM.
Conclusion: The use of first- and second-trimester antenatal screening tests for predicting GDM risk does not appear meaningful. Further studies are needed to determine the usability of these tests for early diagnosis of GDM in the Turkish population.
References
- 1. Sweeting A, Wong J, Murphy HR, Ross GP. A Clinical Update on Gestational Diabetes Mellitus. Endocr Rev. 2022;43(5):763-93. 2. Zehravi M, Maqbool M, Ara I. Correlation between obesity, gestational diabetes mellitus, and pregnancy outcomes: an overview. Int J Adolesc Med Health. 2021;33(6):339-45. 3. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline. Diabetes Res Clin Pract. 2014;103(3):341-63.
Antenatal Tarama Biyobelirteçleri Kullanılarak Erken Gebelikte Gestasyonel Diabetes Mellitus Riskinin Tahmin Edilmesi
Abstract
Amaç: Bu çalışmada demografik veriler (yasş, gravida, parite), vücut kitle indeksi (VKİ), ilk-trimester açlık kan şekeri (AKŞ), tiroid uyarıcı hormon (TSH) ve antenatal tarama test biyobelirteçlerinin (ikili ve dörtlü tarama) Gestasyonel Diabetes Mellitus (GDM) riskini öngörmedeki başarılarını karşılaştırması amaçlanmıştır.
Gereç ve Yöntemler: Bu çalışmada Ocak 2017 – Haziran 2020 tarihleri arasında üçüncü basamak bir hastanede tek-basamak 75 gr Oral Glukoz Tolerans Testi (OGTT) ve antenatal tarama testleri yapılan 800 gebe retrospektif olarak incelendi. Olgular GDM tarama sonuçlarına göre iki gruba ayrıldıktan sonra GDM-Pozitif ve GDM-Negatif gruplar incelenen parametreler açısından karşılaştırıldı. GDM ile anlamlı derecede ilişkili parametreler belirlendikten sonra bunların GDM'nin erken tanısındaki klinik faydaları araştırıldı.
Bulgular: Sekiz yüz hastanın 159'una (% 19,8) GDM tanısı konuldu. GDM-Pozitif grup, GDM-Negatif gruba göre daha yüksek yaş, gravida, parite, VKİ ve ilk-trimester serum AKŞ düzeylerinin yanı sıra daha düşük serum PAPP-A MoM düzeylerine sahipti (P <0.05). Serum TSH ve f-βhCG, NT, AFP, uE3, ßhCG ve İnhibin-A MoM düzeyleri açısından gruplar arasında anlamlı fark yoktu. Lojistik regresyon analizinde, artan yaş (P=0.02, CI=1.007-1.096, OR=1.050), VKİ (P<0.01, CI=1.452-3.213, OR=1.107) ve ilk-trimester serum AKŞ düzeyleri GDM ile ilişkili bağımsız değişkenler olarak tespit edildi.
Sonuç: Birinci ve ikinci trimester antenatal tarama testlerinin GDM riskini öngörmede kullanılması anlamlı görünmemektedir. Bu testlerin Türk toplumunda GDM'nin erken tanısında kullanılabilirliğinin belirlenmesi için daha ileri çalışmalara ihtiyaç vardır.
References
- 1. Sweeting A, Wong J, Murphy HR, Ross GP. A Clinical Update on Gestational Diabetes Mellitus. Endocr Rev. 2022;43(5):763-93. 2. Zehravi M, Maqbool M, Ara I. Correlation between obesity, gestational diabetes mellitus, and pregnancy outcomes: an overview. Int J Adolesc Med Health. 2021;33(6):339-45. 3. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline. Diabetes Res Clin Pract. 2014;103(3):341-63.
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | September 30, 2024 |
| Submission Date | July 21, 2024 |
| Acceptance Date | August 21, 2024 |
| Published in Issue | Year 2024 Volume: 21 Issue: 3 |
