Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Basic Sciences, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Pregnancy Childbirth. 2022 Jan 4;22(1):13. doi: 10.1186/s12884-021-04348-6.
Gestational Diabetes Mellitus (GDM) is an underlying cause of maternal and newborn morbidity and mortality all around the world. Timely diagnosis of GDM plays an important role in reducing its adverse consequences and burden. This study aimed to determine diagnostic accuracy of multiple indicators in complete blood count (CBC) test for early prediction of GDM.
In this prospective cohort study, the data from 600 pregnant women was analyzed. In the study sample, the two-step approach was utilized for the diagnosis of GDM at 24-28 weeks of gestation. We also used the repeated measures of hemoglobin (Hb), hematocrit (Hct), fasting blood sugar (FBS) and red blood cell count (RBC) in the first and early second trimesters of pregnancy as the longitudinal multiple indicators for early diagnosis of GDM. The classification of pregnant women to GDM and non-GDM groups was performed using a statistical technique based on the random-effects modeling framework.
Among the sample, 49 women (8.2%) were diagnosed with GDM. In the first and early second trimester of pregnancy, the mean HcT, Hb and FBS of women with GDM was significantly higher than non-GDMs (P < 0.001). The concurrent use of multiple longitudinal data from HcT, Hb, RBC and FBS in the first and early second trimester of pregnancy resulted in a sensitivity, specificity and area under the curve (AUC) of 87%, 70% and 83%, respectively, for early prediction of GDM.
In general, our findings showed that the concurrent use of repeated measures data on Hct, Hb, FBS and RBC in the first and early second trimester of pregnancy might be utilized as an acceptable tool to predict GDM earlier in pregnancy.
妊娠期糖尿病（GDM）是全球孕产妇和新生儿发病率和死亡率的一个潜在原因。及时诊断 GDM 对于降低其不良后果和负担起着重要作用。本研究旨在确定全血细胞计数（CBC）检测中多个指标在 GDM 早期预测中的诊断准确性。
在这项前瞻性队列研究中，分析了 600 名孕妇的数据。在研究样本中，采用两步法在 24-28 周妊娠时诊断 GDM。我们还使用血红蛋白（Hb）、红细胞压积（Hct）、空腹血糖（FBS）和红细胞计数（RBC）在妊娠第一和早期第二阶段的重复测量值作为 GDM 早期诊断的纵向多指标。使用基于随机效应建模框架的统计技术对孕妇进行 GDM 和非 GDM 分组。
在样本中，有 49 名女性（8.2%）被诊断为 GDM。在妊娠第一和早期第二阶段，患有 GDM 的女性的平均 Hct、Hb 和 FBS 显著高于非 GDM 组（P<0.001）。同时使用 Hct、Hb、RBC 和 FBS 在妊娠第一和早期第二阶段的多个纵向数据，可早期预测 GDM 的灵敏度、特异性和曲线下面积（AUC）分别为 87%、70%和 83%。
总体而言，我们的研究结果表明，在妊娠第一和早期第二阶段同时使用 Hct、Hb、FBS 和 RBC 的重复测量数据可能作为一种可接受的工具，用于更早地预测 GDM。
