Article ; Online: Fetal overgrowth in pregnancies complicated by diabetes: development of a clinical prediction index.
Archives of gynecology and obstetrics
2018 Volume 298, Issue 1, Page(s) 67–74
Abstract: Purpose: To develop an index to predict fetal overgrowth in pregnancies complicated by diabetes.: Methods: Data were derived from a cohort of 275 women with singleton gestations in a collaborative diabetes in pregnancy program. Regression analysis ... ...
| Abstract | Purpose: To develop an index to predict fetal overgrowth in pregnancies complicated by diabetes. Methods: Data were derived from a cohort of 275 women with singleton gestations in a collaborative diabetes in pregnancy program. Regression analysis incorporated clinical factors available in the first 20-30 weeks of pregnancy that were assigned beta-coefficient-based weights, the sum of which yielded a fetal overgrowth index (composite score). Results: Fifty-one (18.5%) pregnancies were complicated by fetal overgrowth. The derived index included five clinical factors: age ≤ 30, history of macrosomia, excessive gestational weight gain, enlarged fetal abdominal circumference, and fasting hyperglycemia. Area under the curve (AUC) for the index is 0.88 [95% confidence interval (CI) 0.82-0.92]. Cut-points were selected to identify "high-risk" and "low-risk" ranges (≥ 8 and ≤ 3) that have positive and negative predictive values of 84% (95% CI 70-98%) and 95% (95% CI 92-98%), respectively. The majority of women in our cohort (n = 182, 66%) had a "low-risk" index while 9% (n = 25) had a "high-risk" index. Sub-analyses of nulliparous women and women with gestational and pre-gestational diabetes revealed that the overgrowth index was equally or more predictive when applied separately to each of these groups. Conclusion: This fetal overgrowth index that incorporates five clinical factors provides a means of predicting fetal overgrowth and thereby serves as a tool for targeting the allocation of healthcare resources and treatment individualization. |
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| MeSH term(s) | Adult ; Birth Weight ; Blood Glucose/metabolism ; Cohort Studies ; Diabetes, Gestational/blood ; Diabetes, Gestational/metabolism ; Female ; Fetal Macrosomia/etiology ; Fetus ; Gestational Age ; Glucose Metabolism Disorders/blood ; Glucose Metabolism Disorders/complications ; Humans ; Hyperglycemia ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Weight Gain |
| Chemical Substances | Blood Glucose |
| Language | English |
| Publishing date | 2018-04-26 |
| Publishing country | Germany |
| Document type | Journal Article |
| ZDB-ID | 896455-5 |
| ISSN | 1432-0711 ; 0932-0067 |
| ISSN (online) | 1432-0711 |
| ISSN | 0932-0067 |
| DOI | 10.1007/s00404-018-4758-9 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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