Selective Screening Strategies for Gestational Diabetes: A Prospective Cohort Observational Study
Aim. We aimed to develop a prediction model for the diagnosis of gestational diabetes and to evaluate the performance of published prediction tools on our population. Methods. We conducted a cohort study on nondiabetic women < 26 weeks gestation at a level 1 clinic in Johannesburg, South Africa....
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2017/2849346 |
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| _version_ | 1832567030697426944 |
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| author | Sumaiya Adam Paul Rheeder |
| author_facet | Sumaiya Adam Paul Rheeder |
| author_sort | Sumaiya Adam |
| collection | DOAJ |
| description | Aim. We aimed to develop a prediction model for the diagnosis of gestational diabetes and to evaluate the performance of published prediction tools on our population. Methods. We conducted a cohort study on nondiabetic women < 26 weeks gestation at a level 1 clinic in Johannesburg, South Africa. At recruitment, participants completed a questionnaire and random basal glucose and HbA1c were evaluated. A 75 g 2-hour OGTT was scheduled between 24–28 weeks gestation, as per FIGO guidelines. A score was derived using multivariate logistic regression. Published scoring systems were tested by deriving ROC curves. Results. In 554 women, RBG, BMI, and previous baby ≥ 4000 g were significant risk factors included for GDM, which were used to derive a nomogram-based score. The logistic regression model for prediction of GDM had R2 0.143, Somer’s Dxy rank correlation 0.407, and Harrell’s c-score 0.703. HbA1c did not improve predictive value of the nomogram at any threshold (e.g,. at probability > 10%, 25.6% of cases were detected without the HbA1c, and 25.8% of cases would have been detected with the HbA1c). The 9 published scoring systems performed poorly. Conclusion. We propose a nomogram-based score that can be used at first antenatal visit to identify women at high risk of GDM. |
| format | Article |
| id | doaj-art-4652cfc0be6a4a32909392f865023b55 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-4652cfc0be6a4a32909392f865023b552025-02-03T01:02:30ZengWileyJournal of Diabetes Research2314-67452314-67532017-01-01201710.1155/2017/28493462849346Selective Screening Strategies for Gestational Diabetes: A Prospective Cohort Observational StudySumaiya Adam0Paul Rheeder1Department of Obstetrics and Gynecology, University of Pretoria, Pretoria, South AfricaDepartment of Internal Medicine, University of Pretoria, Pretoria, South AfricaAim. We aimed to develop a prediction model for the diagnosis of gestational diabetes and to evaluate the performance of published prediction tools on our population. Methods. We conducted a cohort study on nondiabetic women < 26 weeks gestation at a level 1 clinic in Johannesburg, South Africa. At recruitment, participants completed a questionnaire and random basal glucose and HbA1c were evaluated. A 75 g 2-hour OGTT was scheduled between 24–28 weeks gestation, as per FIGO guidelines. A score was derived using multivariate logistic regression. Published scoring systems were tested by deriving ROC curves. Results. In 554 women, RBG, BMI, and previous baby ≥ 4000 g were significant risk factors included for GDM, which were used to derive a nomogram-based score. The logistic regression model for prediction of GDM had R2 0.143, Somer’s Dxy rank correlation 0.407, and Harrell’s c-score 0.703. HbA1c did not improve predictive value of the nomogram at any threshold (e.g,. at probability > 10%, 25.6% of cases were detected without the HbA1c, and 25.8% of cases would have been detected with the HbA1c). The 9 published scoring systems performed poorly. Conclusion. We propose a nomogram-based score that can be used at first antenatal visit to identify women at high risk of GDM.http://dx.doi.org/10.1155/2017/2849346 |
| spellingShingle | Sumaiya Adam Paul Rheeder Selective Screening Strategies for Gestational Diabetes: A Prospective Cohort Observational Study Journal of Diabetes Research |
| title | Selective Screening Strategies for Gestational Diabetes: A Prospective Cohort Observational Study |
| title_full | Selective Screening Strategies for Gestational Diabetes: A Prospective Cohort Observational Study |
| title_fullStr | Selective Screening Strategies for Gestational Diabetes: A Prospective Cohort Observational Study |
| title_full_unstemmed | Selective Screening Strategies for Gestational Diabetes: A Prospective Cohort Observational Study |
| title_short | Selective Screening Strategies for Gestational Diabetes: A Prospective Cohort Observational Study |
| title_sort | selective screening strategies for gestational diabetes a prospective cohort observational study |
| url | http://dx.doi.org/10.1155/2017/2849346 |
| work_keys_str_mv | AT sumaiyaadam selectivescreeningstrategiesforgestationaldiabetesaprospectivecohortobservationalstudy AT paulrheeder selectivescreeningstrategiesforgestationaldiabetesaprospectivecohortobservationalstudy |