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| Establishment of the macrosomia delivery risk prediction model of pregnant women with gestational diabetes mellitus |
| Hangzhou Obstetrics and Gynecology Hospital of Zhejiang Province, Hangzhou Maternal and Child Health Care Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, 310008 |
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Abstract To explore the risk factors of the macrosomia delivery of pregnant women with gestational diabetes mellitus (GDM), and to establish the relative risk prediction model of macrosomia. Methods: The clinical data of 218 pregnant women with GDM who were registered and delivered in hospital from January to December 2022 were collected retrospectively, including 27 cases with macrosomia in study group and 191 cases with normal weight of the newborns in control group. The risk factors of the macrosomia delivery of the women with GDM were analyzed by logistic regression analysis. R software was used to establish the nomogram model of macrosomia GDM, and a calibration curve was drawn. Results: Among 218 pregnant women with GDM, 27 cases delivered macrosomia, with an incidence of 12.4%. The BMI28kg/m2 before pregnancy (OR=5.410, 95%CI 2.142-11.938), the weight gain during pregnancy >14kg (OR=3.056, 95%CI 1.4277.016), the prolonged of the gestational weeks (OR=2.724, 95%CI 1.180-5.794), the fasting blood glucose level ≥4.7mmol/L during the third trimester of pregnancy (OR=3.218，95%CI 1.049-5.801), the triglycerides (TG) level ≥2.9mmol/L (OR=1.841, 95%CI 1.132-4.017) of the women with GDM were the independent risk factors of their macrosomia, and a nomogram model for predicting the macrosomia occurrence of the pregnant women with GDM was established based on these independent risk factors. The area under the curve (AUC) of the model curve for predicting the macrosomia was 0.921 (95%CI 0.896-0.938), and the sensitivity and the specificity of which were 83.7% and 86.9%, and the AUC, and the sensitivity and the specificity indicated that the accuracy of the model was acceptable. Conclusion: The pregnant women with GDM complicated with macrosomia are related to their obesity before pregnancy, excessive weight gain during pregnancy, prolonged gestational weeks, and the elevated levels of TG and FBG. The prediction model for the macrosomia is well differentiated, and which can scientifically, intuitively and simply identify the risk of macrosomia of the pregnant women with GDM.
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