Selective screening strategies for gestational diabetes : a prospective cohort observational study

dc.contributor.authorAdam, Sumaiya
dc.contributor.authorRheeder, Paul
dc.contributor.emailsumaiya.adam@up.ac.zaen_ZA
dc.date.accessioned2017-11-24T07:57:52Z
dc.date.available2017-11-24T07:57:52Z
dc.date.issued2017-10-22
dc.description.abstractAIM. We aimed to develop a prediction model for the diagnosis of gestational diabetes and to evaluate the performance of published prediction tools on our population. METHODS. We conducted a cohort study on nondiabetic women < 26 weeks gestation at a level 1 clinic in Johannesburg, South Africa. At recruitment, participants completed a questionnaire and random basal glucose and HbA1c were evaluated. A 75 g 2-hour OGTT was scheduled between 24–28 weeks gestation, as per FIGO guidelines. A score was derived using multivariate logistic regression. Published scoring systems were tested by deriving ROC curves. RESULTS. In 554 women, RBG, BMI, and previous baby ≥ 4000 g were significant risk factors included for GDM, which were used to derive a nomogram-based score. The logistic regression model for prediction of GDM had R2 0.143, Somer’s Dxy rank correlation 0.407, and Harrell’s c-score 0.703. HbA1c did not improve predictive value of the nomogram at any threshold (e.g,. at probability > 10%, 25.6% of cases were detected without the HbA1c, and 25.8% of cases would have been detected with the HbA1c). The 9 published scoring systems performed poorly. CONCLUSION. We propose a nomogram-based score that can be used at first antenatal visit to identify women at high risk of GDM.en_ZA
dc.description.departmentInternal Medicineen_ZA
dc.description.departmentObstetrics and Gynaecologyen_ZA
dc.description.librarianam2017en_ZA
dc.description.sponsorshipThis study was partly supported by funding from the Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA), the South African Sugar Association (SASA), and Roche. The SASA and SEMDSA grants were awarded following peer review for scientific quality and priority assessment.en_ZA
dc.description.urihttps://www.hindawi.com/journals/jdren_ZA
dc.identifier.citationAdam, S & Rheeder, P 2017, 'Selective screening strategies for gestational diabetes : a prospective cohort observational study', Journal of Diabetes Research, vol. 2017, no. 284346, pp. 1-9.en_ZA
dc.identifier.issn2314-6745 (print)
dc.identifier.issn2314-6753 (online)
dc.identifier.other10.1155/2017/2849346
dc.identifier.urihttp://hdl.handle.net/2263/63336
dc.language.isoenen_ZA
dc.publisherHindawi Publishingen_ZA
dc.rights© 2017 Sumaiya Adam and Paul Rheeder. This is an open access article distributed under the Creative Commons Attribution License.en_ZA
dc.subjectDiagnosisen_ZA
dc.subjectWomenen_ZA
dc.subjectJohannesburg, South Africaen_ZA
dc.subjectGDMen_ZA
dc.subjectHyperglycemiaen_ZA
dc.subjectGlucoseen_ZA
dc.subjectPrevalenceen_ZA
dc.subjectMellitusen_ZA
dc.subjectEarly pregnancyen_ZA
dc.subjectAfrican populationen_ZA
dc.subjectRisk factorsen_ZA
dc.titleSelective screening strategies for gestational diabetes : a prospective cohort observational studyen_ZA
dc.typeArticleen_ZA

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