Risk assessment for preeclampsia in women with gestational diabetes mellitus.
OBJECTIVE
To develop a clinical model to assess the risk of preeclampsia in women with gestational diabetes mellitus (GDM).


METHODS
We studied clinical characteristics of 813 consecutive women who had GDM between January 2003 and February 2008 at our institution. The clinical features which were significantly associated with preeclampsia by multiple logistic regression analysis were integrated into a risk model. The diagnostic performance of this model was then evaluated from a receiver-operating characteristic (ROC) curve analysis.


RESULTS
A total of 78 women with GDM (9.6%) developed preeclampsia. In a multivariable analysis, first-trimester BMI > or =27 kg/m(2) (P<0.001), GDM diagnosed within 20 weeks of gestation (P<0.001), and poor glycemic control (P<0.001) were associated with preeclampsia. These three factors were incorporated into a risk-scoring model which ranged from 0 to 3 points. At the optimal cut-off score of > or =2, the sensitivity, specificity, and area under the curve (AUC) for preeclampsia were high at 76.9% [95% confidence interval (CI) 69.0-85.2], 92.8% (95% CI 85.9-98.1), and 0.849 (95% CI 0.792-0.905), respectively.


CONCLUSIONS
A model based on clinical data yielded predicted the development of preeclampsia in women with GDM.
Phaloprakarn
Chadakarn
C
Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok, Thailand. chadakarn_pt@yahoo.com
Tangjitgamol
Siriwan
S
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000097:blood* / Q000473:pathology; D005260:Female; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D008954:Models, Biological; D011225:Pre-Eclampsia / Q000097:blood* / Q000209:etiology* / Q000473:pathology; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors; D013785:Thailand
D001786:Blood Glucose