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Updated: Sep 27, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Prediction of gestational diabetes mellitus by different obesity indices
Zhimin Song1, Yan Cheng2, Tingting Li2
1Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310006, People's Republic of China.
Insights
Increased abdominal circumference (AC) and abdominal circumference/height ratio (ACHtR) in early pregnancy are independent risk factors for gestational diabetes mellitus (GDM). These measures, along with prepregnancy body mass index (preBMI), may help predict GDM, though each has limited individual predictive power.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Rising rates of obesity and gestational diabetes mellitus (GDM) necessitate investigation into predictive factors.
- Early pregnancy obesity indices may offer insights into GDM risk.
Purpose of the Study:
- To evaluate the relationship between prepregnancy body mass index (preBMI), first-trimester abdominal circumference (AC), and abdominal circumference/height ratio (ACHtR) and GDM.
- To assess the predictive efficacy of these obesity indices for GDM.
Main Methods:
- A cohort of 15,472 pregnant women was studied.
- Prepregnancy weight, height, and first-trimester AC were measured.
- GDM diagnosis utilized a 75-g oral glucose tolerance test; receiver operator characteristic (ROC) curve analysis assessed predictive values.
Main Results:
- 12.4% of women were diagnosed with GDM.
- AC, ACHtR, and preBMI were independent risk factors for GDM (P < 0.001).
- Optimal cut-off values were identified for AC (≥80.3 cm), ACHtR (≥0.49), and preBMI (≥22.7) with varying sensitivity and specificity.
Conclusions:
- Elevated first-trimester AC and ACHtR are independent risk factors for GDM, even in normal BMI individuals.
- AC, ACHtR, and preBMI show potential as anthropometric predictors of GDM.
- No single index demonstrated high predictive value for GDM on its own.
Background:
The incidence rates of obesity and gestational diabetes mellitus (GDM) are increasing in parallel. This study aimed to evaluate the relationship between different obesity indices, including prepregnancy body mass index (preBMI), the first-trimester abdominal circumference (AC), and first-trimester abdominal circumference/height ratio (ACHtR), and GDM, and the efficacy of these three indices in predicting GDM was assessed.
Methods:
A total of 15,472 pregnant women gave birth to a singleton at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. Prepregnancy weight was self-reported by study participants, body height and AC were measured by nurses at the first prenatal visit during weeks 11 to 13+6 of pregnancy. GDM was diagnosed through a 75-g oral glucose tolerance test at 24-28 gestational weeks. Using receiver operator characteristic (ROC) curve analysis, we evaluated the association between obesity indices and GDM.
Results:
A total of 1912 women (12.4%) were diagnosed with GDM. Logistic regression analysis showed that AC, ACHtR, and preBMI (P < 0.001) were all independent risk factors for the development of GDM. In the normal BMI population, the higher the AC or ACHtR was, the more likely the pregnant woman was to develop GDM. The area under the ROC curve (AUC) was 0.63 (95% CI: 0.62-0.64) for the AC, 0.64 (95% CI: 0.62-0.65) for the ACHtR and 0.63 (95% CI: 0.62-0.64) for the preBMI. An AC ≥ 80.3 cm (sensitivity: 61.6%; specificity: 57.9%), an ACHtR of ≥ 0.49 (sensitivity: 67.3%; specificity: 54.0%), and a preBMI ≥ 22.7 (sensitivity: 48.4%; specificity: 71.8%) were determined to be the best cut-off levels for identifying subjects with GDM.
Conclusions:
An increase in ACHtR may be an independent risk factor for GDM in the first trimester of pregnancy. Even in the normal BMI population, the higher the AC and ACHtR are, the more likely a pregnant woman is to develop GDM. AC, ACHtR in the first trimester and preBMI might be anthropometric indices for predicting GDM, but a single obesity index had limited predictive value for GDM.
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