Obstetric and Gynecology Department, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Endocrinology Department, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
BMC Pregnancy Childbirth. 2019 Jul 19;19(1):252. doi: 10.1186/s12884-019-2374-8.
Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes. Screening for GDM and applying adequate interventions may reduce the risk of adverse outcomes. However, the diagnosis of GDM depends largely on tests performed in late second trimester. The aim of the present study was to bulid a simple model to predict GDM in early pregnancy in Chinese women using biochemical markers and machine learning algorithm.
Data on a total of 4771 pregnant women in early gestation were used to fit the GDM risk-prediction model. Predictive maternal factors were selected through Bayesian adaptive sampling. Selected maternal factors were incorporated into a multivariate Bayesian logistic regression using Markov Chain Monte Carlo simulation. The area under receiver operating characteristic curve (AUC) was used to assess discrimination.
The prevalence of GDM was 12.8%. From 8th to 20th week of gestation fasting plasma glucose (FPG) levels decreased slightly and triglyceride (TG) levels increased slightly. These levels were correlated with those of other lipid metabolites. The risk of GDM could be predicted with maternal age, prepregnancy body mass index (BMI), FPG and TG with a predictive accuracy of 0.64 and an AUC of 0.766 (95% CI 0.731, 0.801).
This GDM prediction model is simple and potentially applicable in Chinese women. Further validation is necessary.
妊娠期糖尿病(GDM)与围产期不良结局相关。对 GDM 进行筛查并采取适当干预措施可能降低不良结局的发生风险。然而,GDM 的诊断在很大程度上依赖于孕中期晚期的检查。本研究旨在利用生化标志物和机器学习算法,建立一种预测中国妇女早孕期 GDM 的简单模型。
本研究使用了共 4771 名早孕期孕妇的数据来拟合 GDM 风险预测模型。通过贝叶斯自适应抽样选择预测性母体因素。选择的母体因素被纳入使用马尔可夫链蒙特卡罗模拟的多变量贝叶斯逻辑回归。接收者操作特征曲线(AUC)下的面积用于评估判别能力。
GDM 的患病率为 12.8%。从妊娠第 8 周到第 20 周,空腹血糖(FPG)水平略有下降,甘油三酯(TG)水平略有升高。这些水平与其他脂质代谢物的水平相关。GDM 的风险可以通过母体年龄、孕前体重指数(BMI)、FPG 和 TG 进行预测,预测准确性为 0.64,AUC 为 0.766(95%CI 0.731,0.801)。
该 GDM 预测模型简单,可能适用于中国妇女。需要进一步验证。