Predictive value of changes in body mass index and blood glucose indicators in early pregnancy for gestational diabetes mellitus
10.3760/cma.j.cn341190-20240915-01191
- VernacularTitle:孕早期BMI变化及孕期血糖指标对妊娠期糖尿病的预测价值
- Author:
Yu WANG
1
;
Weiying ZHU
1
;
Haiyan YUAN
1
Author Information
1. 嘉兴市妇幼保健院产科，嘉兴 314000
- Publication Type:Journal Article
- Keywords:
Diabetes, gestational;
Body mass index;
Blood glucose;
Hemoglobin A,glycosylated;
Pregnancy outcome;
Forecasting
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(6):829-834
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of changes in body mass index (BMI) and blood glucose indicators in early pregnancy for gestational diabetes mellitus (GDM).Methods:A total of 126 pregnant women with GDM who were admitted to the Department of Obstetrics at Jiaxing Maternity and Child Health Care Hospital from January 2022 to December 2023 were retrospectively analyzed and included in the GDM group. Additionally, 140 healthy pregnant women were included in the non-GDM group. Changes in BMI and levels of blood glucose indicators [fasting blood glucose (FBG), 1-hour postprandial blood glucose, 2-hour postprandial blood glucose (2hPG), and glycated hemoglobin during early pregnancy were compared between the two groups. Influential factors for GDM were analyzed using a multivariate logistic regression model. The predictive value of changes in BMI and blood glucose indicators during early pregnancy for GDM was assessed using receiver operating characteristic curves.Results:The BMI at 10 [(24.60 ± 0.82) kg/m2] and 14 weeks of pregnancy [(23.50 ± 0.85) kg/m2] in the GDM group was significantly higher compared with the non-GDM group (both P < 0.05). The levels of FBG [(5.98 ± 0.36) mmol/L], 1-hour postprandial blood glucose [(10.95 ± 0.83) mmol/L], and 2hPG [(8.60 ± 0.82) mmol/L] in the GDM group were also significantly higher than those in the non-GDM group ( t = 12.25, 23.90, 5.98, all P < 0.001). The levels of total cholesterol [(6.35 ± 1.10) mmol/L] and triglycerides [(3.23 ± 0.60) mmol/L] in the GDM group were significantly higher compared with the non-GDM group ( t = 6.45, 7.45, both P < 0.001). The number of cesarean sections ( n = 69 cases) and the incidence of adverse delivery outcomes [26.98% (34/126)] in the GDM group were significantly higher than those in the non-GDM group ( χ2 = 16.72, 12.71, both P < 0.001). Multivariate logistic regression analysis indicated that BMI at 10 weeks of pregnancy, BMI at 14 weeks of pregnancy, FBG, and 2hPG were independent risk factors for GDM ( OR = 1.292, 6.514, 2.601, 1.784, all P < 0.05). According to Receiver Operating Characteristic curve analysis, the area under the curve (AUC) (95% CI) for BMI at 10 and 14 weeks of pregnancy were 0.717 (0.630-0.795) and 0.719 (0.631-0.796), respectively. The AUC (95% CI) for FBG and 2hPG levels were 0.731 (0.635-0.813) and 0.802 (0.712-0.873), respectively. The AUC (95% CI) for the combined evaluation of these indicators was 0.911 (0.839-0.958), indicating that the combined evaluation had a higher predictive value for GDM than the use of a single indicator ( P < 0.05). Conclusions:The changes in BMI and blood glucose indicators during early pregnancy are closely related to the occurrence of GDM. The combination of these measurements has a high predictive value for GDM and is of significant importance for its prevention.
