OGTT-based model predicts GDM in pregnant women

The current diagnostic criteria being used to predict gestational diabetes mellitus (GDM) is not fully reliable, but adding oral glucose tolerance test (OGTT) to the model may improve early prediction of GDM, according to a study.

Some 721 women from Women’s Hospital, Zheijiang University School of Medicine in Hangzhou, China, participated in this prospective cohort study between 30 May 2021 and 13 August 2022. Participants completed an OGTT during gestational weeks 7 through 14 for early prediction of GDM and at weeks 24 through 28 for GDM diagnosis.

The investigators constructed a new prediction model incorporating OGTT results and baseline characteristics using logistic regression analysis. To assess and visualize the performance of the model, they used the receiver operating characteristic (ROC) curve, Hosmer-Lemeshow test, decision clinical analysis, and a nomogram. Internal and external validations were done to confirm model stability.

The mean ages of participants were 30.5 years in the low-risk group and 31.0 years in the high-risk group, according to the International Association of Diabetes and Pregnancy Study Groups criteria in early OGTT.

At weeks 7 through 14, the area under ROC curve (AUC) of the existing criteria ranged from 0.705 to 0.724. The AUC of the new prediction model, based on maternal age, prepregnancy body mass index, and results of early OGTT, was 0.8720. This result was validated by both internal (AUC, 0.8541) and external (AUC, 0.8241) confirmation.