Epidemiology

You have full text access to this OnlineOpen article

Estimating the risk of gestational diabetes mellitus: a clinical prediction model based on patient characteristics and medical history

  1. M van Leeuwen1,
  2. BC Opmeer2,
  3. EJK Zweers3,4,
  4. E van Ballegooie5,†,
  5. HG ter Brugge6,
  6. HW de Valk4,
  7. GHA Visser7,
  8. BWJ Mol1,7

Article first published online: 10 DEC 2009

DOI: 10.1111/j.1471-0528.2009.02425.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 117, Issue 1, pages 69–75, January 2010

Additional Information

How to Cite

van Leeuwen, M., Opmeer, B., Zweers, E., van Ballegooie, E., ter Brugge, H., de Valk, H., Visser, G. and Mol, B. (2010), Estimating the risk of gestational diabetes mellitus: a clinical prediction model based on patient characteristics and medical history. BJOG: An International Journal of Obstetrics & Gynaecology, 117: 69–75. doi: 10.1111/j.1471-0528.2009.02425.x

Author Information

  1. 1

    Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, the Netherlands

  2. 2

    Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, the Netherlands

  3. 3

    Department of Internal Medicine, Bronovo Hospital, The Hague, the Netherlands

  4. 4

    Department of Internal Medicine, University Medical Center, Utrecht, the Netherlands

  5. 5

    Department of Internal Medicine, Bethesda Hospital, Hoogeveen, the Netherlands

  6. 6

    Department of Obstetrics and Gynaecology, Isala Clinics, Zwolle, the Netherlands

  7. 7

    Department of Obstetrics, University Medical Center, Utrecht, the Netherlands

  1. †

    Deceased.

*Dr M van Leeuwen, Academic Medical Centre, Department of Obstetrics and Gynaecology, H4-255, Meibergdreef 9, PO Box 22700, 1105 DE Amsterdam, the Netherlands. Email marsha.vanleeuwen@amc.uva.nl

Publication History

  1. Issue published online: 10 DEC 2009
  2. Article first published online: 10 DEC 2009
  3. Accepted 23 September 2009.

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article with Supporting Information (HTML) Get PDF (104K)

Keywords:

  • Gestational diabetes mellitus;
  • prediction model;
  • screening

Objective  To develop a clinical prediction rule that can help the clinician to identify women at high and low risk for gestational diabetes mellitus (GDM) early in pregnancy in order to improve the efficiency of GDM screening.

Design  We used data from a prospective cohort study to develop the clinical prediction rule.

Setting  The original cohort study was conducted in a university hospital in the Netherlands.

Population  Nine hundred and ninety-five consecutive pregnant women underwent screening for GDM.

Methods  Using multiple logistic regression analysis, we constructed a model to estimate the probability of development of GDM from the medical history and patient characteristics. Receiver operating characteristics analysis and calibration were used to assess the accuracy of the model.

Main outcome measure  The development of a clinical prediction rule for GDM. We also evaluated the potential of the prediction rule to improve the efficiency of GDM screening.

Results  The probability of the development of GDM could be predicted from the ethnicity, family history, history of GDM and body mass index. The model had an area under the receiver operating characteristic curve of 0.77 (95% CI 0.69–0.85) and calibration was good (Hosmer and Lemeshow test statistic, P = 0.25). If an oral glucose tolerance test was performed in all women with a predicted probability of 2% or more, 43% of all women would be tested and 75% of the women with GDM would be identified.

Conclusions  The use of a clinical prediction model is an accurate method to identify women at increased risk for GDM, and could be used to select women for additional testing for GDM.

View Full Article with Supporting Information (HTML) Get PDF (104K)