Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks.
OBJECTIVE
To develop a model for the prediction of gestational diabetes mellitus (GDM) from maternal characteristics and biochemical markers at 11 to 13 weeks' gestation.


METHODS
A prospective screening study on early prediction of pregnancy complications (n = 11, 464), including 297 (2.6%) cases of GDM was used to create the predictive model of GDM based on maternal characteristics. Maternal serum concentrations of adiponectin, follistatin-like-3 (FSTL3) and sex hormone-binding globulin (SHBG) were measured in a case-control study of 80 women who developed GDM and 300 controls.


RESULTS
In the screening study, maternal age, body mass index, racial origin, previous history of GDM and macrosomic neonate were significant independent predictors of future GDM. In the GDM group, compared to controls, the median multiple of the normal median adiponectin (0.66; IQR: 0.5-0.9 vs 1.02; IQR: 0.7-1.29) and SHBG (0.81; IQR: 0.6-1.04 vs 1.02; IQR: 0.8-1.2) was lower (p < 0.05), but FSTL3 was not significantly different. In screening for GDM by maternal characteristics, the detection rate was 61.6% at a false-positive rate of 20% and the detection increased to 74.1% by the addition of adiponectin and SHBG.


CONCLUSIONS
First-trimester screening for GDM can be provided by a combination of maternal characteristics and biomarkers.
Harris Birthright Research Centre for Fetal Medicine, Kings College Hospital, London, UK.
Surabhi
S
Nanda
Mina
M
Savvidou
Argyro
A
Syngelaki
Ranjit
R
Akolekar
Kypros H
KH
Nicolaides
D052242:Adiponectin / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000097:blood* / Q000175:diagnosis; D005260:Female; D038702:Follistatin-Related Proteins / Q000097:blood; D006801:Humans; D008403:Mass Screening; D008954:Models, Biological; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
D052242:Adiponectin; D015415:Biomarkers; D038702:Follistatin-Related Proteins; D012738:Sex Hormone-Binding Globulin