Evaluation of First Trimester Fasting Blood Glucose, HOMA-IR and HbA1c in Prediction of Gestational Diabetes Mellitus in Non-Obese Pregnant Women: A Retrospective Study

Kirlangic, Mehmet Mete; Halıcı, Belfin Nur Arıcı

doi:10.25048/tudod.1198697

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…In other studies, the sensitivity of HOMA-IR for predicting GDM is much lower. In the study by Kirlangiç et al and our study, the sensitivity of HOMA-IR was found to be 63.6% and 61.1%, respectively (22).…”

Section: Discussionsupporting

confidence: 49%

“…The predictive value of the HOMA-IR index in early pregnancy for predicting GDM development has been examined in several studies. In some of these studies, the HOMA-IR has been a strong predictor, while in other studies, its predictive value was moderate (19)(20)(21)(22). In the studies by Ozcimen et al and Alptekin et al, the sensitivity of HOMA-IR for GDM occurrence was reported as 100% and 90%, respectively.…”

Section: Discussionmentioning

confidence: 95%

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The yield of early-pregnancy HOMA-IR index for predicting gestational diabetes mellitus in different BMI and age groups

Hashemipour,

Zohal,

Modarresnia

et al. 2023

Preprint

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Background: Gestational diabetes (GDM) is a highly prevalent disorder with maternal and neonatal complications. Early prediction of GDM can be beneficial for lifestyle modifications to prevent GDM. Method: This study is part of the Qazvin Maternal and Neonatal Metabolic Study (QMNMS) in Iran in which pregnant women with gestational age ≤14 weeks were enrolled and followed until delivery to investigate the risk factors for maternal and neonatal complications. The predictive value and best cut-off of early-pregnancy Homeostasis of Model Assessment -Insulin Resistance (HOMA-IR) to predict GDM in BMI and age categories were evaluated using logistic regression analysis and receiver operating characteristic analysis, respectively. Results: GDM was developed in 16.7% of 772 participants who completed the study. In the logistic regression analysis, the third HOMA-IR tertile was independently associated with 3.7 times higher GDM development (95% CI:1.9-7.3, P<0.001). Despite the high prevalence of GDM in advanced maternal age (GDM rate=30.9%), HOMA-IR had no association with GDM occurrence in this high-risk group. In both normal BMI and overweight/obese groups, HOMA-IR was a moderate predictor of GDM development (AUC=0.638, P=0.005 and AUC=0.622, P=0.008, respectively). However, the best cut-off for predicting GDM was 2.06 (sensitivity 67.5%, specificity 61.1%) in normal BMI and 3.13 (sensitivity 64.6%, specificity61.8%) in overweight/obese BMI. Conclusion: The present study revealed the necessity of considering the baseline GDM risk group when using the HOMA-IR index to predict GDM. Using lower cut-offs is more accurate for women with a normal BMI. In the advanced maternal age, there is no yield of HOMA-IR for predicting GDM.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 95%

The yield of early-pregnancy HOMA-IR index for predicting gestational diabetes mellitus in different BMI and age groups

Hashemipour,

Zohal,

Modarresnia

et al. 2023

Preprint

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show abstract

“…The results of this study also emphasize the importance of early diagnosis and good management of GDM, which could also reduce the risk of preterm birth. Additional use of some markers from the first trimester can also facilitate GDM diagnosis and could also reduce the risk of preterm birth and its related adverse outcomes [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Rate of Spontaneous Preterm Delivery Between Pregnant Women With and Without Gestational Diabetes

Boriboonhirunsarn¹,

Tanpong²

2023

Cureus

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The aim of this study is to compare the rate of spontaneous preterm delivery between gestational diabetes mellitus (GDM) and normal pregnancy. Pregnancy outcomes and associated risk factors for spontaneous preterm delivery were evaluated. MethodsA retrospective cohort study was conducted on 120 GDM and 480 normal pregnant women. All women received GDM screening with 50-g glucose challenge test and 100-g oral glucose tolerance test at the first visit and repeated at 24-28 weeks. Data were retrieved from medical records and included baseline and obstetric characteristics, preterm risks, GDM risks, and pregnancy outcomes. Spontaneous preterm birth was defined as delivery before 37 completed weeks of gestation that had been preceded by spontaneous labor. ResultsGDM women were more likely to be ≥30 years (p=0.032) and have previous GDM (p=0.013). Incidence of overall preterm delivery was significantly higher in GDM women (17.5% vs. 8.5%, p=0.004), as well as the incidence of spontaneous preterm delivery (15.8% vs. 7.1%, p=0.004). GDM women had less gestational weight gain (p<0.001) and were less likely to have excessive weight gain (p=0.002). GDM women were more likely to deliver large for gestational age (LGA) (p=0.02) and macrosomic infants (p=0.027). Neonatal hypoglycemia was significantly more common among GDM women (p=0.013). Multivariate analysis showed that previous preterm birth and GDM independently increased the risk of spontaneous preterm delivery

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The yield of early-pregnancy homeostasis of model assessment -insulin resistance (HOMA-IR) for predicting gestational diabetes mellitus in different body mass index and age groups

Hashemipour,

Zohal,

Modarresnia

et al. 2023

BMC Pregnancy Childbirth

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Background Early prediction of gestational diabetes mellitus(GDM) can be beneficial for lifestyle modifications to prevent GDM. The aim of this study was to investigate the predictive values of Homeostasis of Model Assessment -Insulin Resistance (HOMA-IR) in early pregnancy to predict GDM development in different body mass index (BMI) and age risk categories. Materials and methods This study is part of the Qazvin Maternal and Neonatal Metabolic Study (QMNMS) in Iran (2018–2021). In this prospective longitudinal study, pregnant women with a gestational age ≤ 14 weeks were enrolled in the study using convenience sampling method and were followed up until delivery to investigate risk factors for maternal and neonatal complications. Data collection was done using questionnaires. Serum sampling was done at a gestational age ≤ 14 weeks and sera were frozen until the end of study. GDM was diagnosed at 24–28 weeks of pregnancy using 75gr oral glucose tolerance test. Fasting blood glucose and insulin were measured in sera taken during early pregnancy in 583 participants. The Mann-Whitney U test, independent t-test, and Chi-square test were used for comparing variables between groups. The logistic regression analysis was used to examine the independent association of HOMA-IR with GDM development and receiver operating characteristic analysis was used for finding the best cut-off of HOMA-IR for predicting GDM. Results GDM was developed in 90 (15.4%) of the participants. The third HOMA-IR tertile was independently associated with 3.2 times higher GDM occurrence (95% CI:1.6–6.2, P = 0.001). Despite the high prevalence of GDM in advanced maternal age (GDM rate = 28.4%), HOMA-IR had no association with GDM occurrence in this high-risk group. In both normal BMI and overweight/obese groups, HOMA-IR was a moderate predictor of GDM development (AUC = 0.638, P = 0.005 and AUC = 0.622, P = 0.008, respectively). However, the best cut-off for predicting GDM was 2.06 (sensitivity 67.5%, specificity 61.1%) in normal BMI and 3.13 (sensitivity 64.6%, specificity61.8%) in overweight/obese BMI. Conclusion The present study revealed the necessity of considering the BMI and age risk groups when using the HOMA-IR index to predict GDM. Using lower cut-offs is more accurate for women with a normal BMI. In the advanced maternal age, there is no yield of HOMA-IR for predicting GDM.

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Evaluation of First Trimester Fasting Blood Glucose, HOMA-IR and HbA1c in Prediction of Gestational Diabetes Mellitus in Non-Obese Pregnant Women: A Retrospective Study

Cited by 4 publications

References 25 publications

The yield of early-pregnancy HOMA-IR index for predicting gestational diabetes mellitus in different BMI and age groups

The yield of early-pregnancy HOMA-IR index for predicting gestational diabetes mellitus in different BMI and age groups

Rate of Spontaneous Preterm Delivery Between Pregnant Women With and Without Gestational Diabetes

The yield of early-pregnancy homeostasis of model assessment -insulin resistance (HOMA-IR) for predicting gestational diabetes mellitus in different body mass index and age groups

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