Download - Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks
![Page 1: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/1.jpg)
PREDICTION OF GESTATIONAL DIABETES MELLITUS BY MATERNAL FACTORS AND BIOMARKERS AT 11 TO 13 WEEKS
![Page 2: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/2.jpg)
OBJECTIVE: to develop a model forPrediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks
![Page 3: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/3.jpg)
Risk Factors:
●body mass index (BMI) >30 kg/m2, ●previous history of GDM or macrosomic baby ●family history of diabetes ●racial origin
![Page 4: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/4.jpg)
The aims of this study : (1) develop a model for prediction of GDM based on maternal history and characteristics; (2) maternal serum concentrationsof adiponectin, FSTL3 and SHBG at 11 to 13 weeksin pregnancies that subsequently develop GDM (3) estimate the performance of early screening forGDM by a combination of maternal factors and serumbiochemistry.
![Page 5: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/5.jpg)
Screening study population:women with 11+0 to 13+6 weeks of GA ● ultrasound scan to: (1) GA: CRL (2) major fetal abnormalities (3) NT ● PAPP-A, free ß- hcg
![Page 6: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/6.jpg)
The inclusion criteria:singleton pregnancy delivering a phenotypicallynormal neonate at or after 30 weeks of gestation.
![Page 7: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/7.jpg)
The exclusion criteria :1)pregnancies with pre-pregnancy dm type 1 2) those ending in termination, miscarriageor delivery before 30 weeks
![Page 8: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/8.jpg)
Screening and diagnosis of gestational diabetes mellitus:
*two-step approach *24 to 28 weeks of gestation *random plasma glucose if > 6.7 mmol/L : OGTT within 2 weeks.*diagnosis of GDM :FBS :6 mmol/L or the plasma glucose level 2 hr after the oral administration of 75 g glucose is 7.8 mmol/L or more (WHO)
![Page 9: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/9.jpg)
Methods:A prospective screening study on early prediction of pregnancy complications (n = 11, 464),including 297 (2.6%) cases of GDM was used to create the predictive model of GDM based on maternalcharacteristics. Maternal serum concentrations of adiponectin, follistatin-like-3 (FSTL3) and sex hormonebinding globulin (SHBG) were measured in a case-control study of 80 women who developed GDM and 300 controls.
![Page 10: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/10.jpg)
Questionnaire:
● maternal age ● racial origin ● cigarette smoking during pregnancy ● method of conception ● medical history ● family history of DM ● obstetric history including outcome of each pregnancy
![Page 11: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/11.jpg)
![Page 12: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/12.jpg)
![Page 13: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/13.jpg)
![Page 14: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/14.jpg)
![Page 15: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/15.jpg)
Results :In the screening study, maternal age, body mass index, racial origin, previous history of GDM and macrosomic neonate were significant independent predictors of future GDM. In the GDM group, compared to controls, the median multiple of the normal median adiponectin.and SHBG was lower (p <0.05), but FSTL3 was not significantly different. In screening for GDM by maternal characteristics, the detection rate was 61.6% at a false-positive rate of 20% and the detection increased to 74.1% by the addition of adiponectin and SHBG.
![Page 16: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/16.jpg)
Conclusion First-trimester screening for GDM
can be provided by a combination of maternal characteristics
and biomarkeras.
![Page 17: Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks](https://reader038.vdocuments.site/reader038/viewer/2022110212/5681426f550346895dae96a8/html5/thumbnails/17.jpg)
Thanks for your attention