Performance of Variables in Screening for Gestational Diabetes

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Public Health

Background:

• Gestational diabetes mellitus (GDM) is linked to adverse pregnancy outcomes.
• Current GDM screening strategies lack international standardization.
• Effective prediction of GDM is crucial for maternal and fetal health.

Purpose of the Study:

• To evaluate the predictive performance of capillary random plasma glucose (RPG), maternal body mass index (BMI), and maternal age for GDM.
• To assess the combined predictive power of these factors in identifying GDM.

Main Methods:

• Retrospective cohort study of 4,698 pregnancies in Sweden (2015-2016).
• Analysis of RPG levels (gestational weeks 23-28), maternal BMI, and maternal age.
• Receiver-operating characteristic (ROC) curve analysis to determine predictive accuracy.

Main Results:

• RPG showed fair predictive ability (AUC 0.73).
• Maternal BMI demonstrated slightly better performance (AUC 0.75).
• Maternal age had poor predictive value (AUC 0.61).
• Combining RPG (≥7) and BMI (≥27.9) achieved the best performance (AUC 0.75, sensitivity 75.4%, specificity 70.1%).

Conclusions:

• Capillary RPG alone offers fair sensitivity for GDM prediction.
• Combining RPG with maternal BMI or age enhances predictive sensitivity.
• No single or combined screening factor demonstrated sufficient accuracy for reliable GDM prediction.