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| Establishment of risk warning model of the adverse pregnancy outcomes of women with gestational diabetes mellitus complicated with preeclampsia |
| The First People's Hospital of Zunyi City (The Third Affiliated Hospital of Zunyi Medical University), Zunyi, Guizhou Province, 563000 |
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Abstract To study the establishment of risk warning model of the adverse pregnancy outcomes of pregnant women with gestational diabetes mellitus (GDM) complicated with preeclampsia (PE). Methods: The clinical data of pregnant women with GDM complicated with PE who had diagnosed and treated in hospital from June 2020 to December 2022 were selected in the study. These women were divided into group A (women with adverse pregnancy outcomes) and group B (women without adverse pregnancy outcomes) according to whether the adverse pregnancy outcome occurred or not. Univariate and multivariate analysis were used to analyze the risk factors of the adverse pregnancy outcomes of the women with GDM complicated with PE, and a risk prediction model was established based on these risk factors. Results: Among 136 pregnant women with GDM complicated with PE, there were 47 (34.7%) women in group A. There were no significant differences in the age, the education level, the gravidity, the rates of primipara and regular antenatal examination, the levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), and serum creatinine (CR), and the 24h proteinuria quantization value of the women between the two groups (P>0.05). The body mass index (BMI) value, the levels of fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), visfatin and alanine aminotransferase (ALT) of the women in group A were significantly higher than those of the women in group B. The level of albumin (ALB) was significantly lower than that of the women in group B (all P<0.05). Logistic regression analysis showed that the higher BMI level, the lower ALB level, and the higher ALT and HbAlc levels of the women with GDM complicated with PE were the independent risk factors of their adverse pregnancy outcomes (P<0.05). A risk prediction model was esterbilished based on the BMI value and the levels of ALB, ALT and HbAlc. The area under receiver operating characteristic (ROC) curve of this risk prediction model for predicting the adverse pregnancy outcomes of the women with GDM complicated with PE was 0.972, the standard error and its 95% confidence interval of which was 0.012 (0.949-0.995), and the sensitivity and the specificity of which were 89.4% and 95.5%. Conclusion: There incidence of the adverse pregnancy outcomes of the pregnant women with GDM complicated with PE is high, among which, the abnormal BMI, ALB, ALT, and HbAlc of the women are the independent risk factors of their adverse pregnancy outcomes. The risk model established based on the independent risk factors as the main independent variables has certain predictive ability for the adverse pregnancy outcomes of the women, which can provide evidences for the pregnancy health education and the primary prevention of the adverse pregnancy outcomes of the women.
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