Optimal maternal neck and waist circumference cutoff values for prediction of gestational diabetes mellitus at the first trimester in Turkish population; a prospective cohort study

Abstract

Aims: To investigate if the maternal neck (NC) and waist (WC) circumferences measured in the first trimester of pregnancy have a predictive value in diagnosing gestational diabetes mellitus (GDM).

Materials and methods: In this prospective study NC and WC of pregnant women were measured at 11–14th weeks. GDM was evaluated with a two-step oral glucose tolerance test at 24–28th weeks.

Result: A total of 525 women were recruited; 49(9%) developed GDM. NC was positively correlated with WC (r: 0.583, p < .001), BMI (r: 0.533, p < .001), age (r: 0.123, p = .002), parity (r: 0.170, p < .001), and 50 g OGTT levels (r: 0.206, p < .001). Regarding the area under receiver operating characteristic (ROC) curve (AUC) analysis of NC and WC for predicting GDM were 0.585 (95% confidence interval (CI): 0.50–0.66, p = .043), and 0.693 (95%CI: 0.61–0.76, p < .001). The optimal cut off level of maternal NC was >38.5 cm, with 69% sensitivity and 45% specificity, and WC was >84.50 cm with a sensitivity of 78% and a specificity of 54%. Increased WC >84.50 cm (OR: 3.58, 95% CI:1.77–7.27; p < .001) and age >25 (OR: 3.05, 95% CI:1.38–6.72; p = .006) were independent predictors for the development of GDM adjusted for age, gravidity, parity, BMI, and NC.

Conclusion: Maternal NC and WC were significantly higher in women with GDM; however, only maternal WC was a significant predictive marker for GDM in low-risk pregnant women.

摘要

目的：探讨妊娠前三个月测得的产妇颈围（NC）和腰围（WC）对诊断妊娠期糖尿病（GDM）的预测价值。

材料和方法：在这项前瞻性的研究中, 对孕妇11-14周的NC和WC进行测量。GDM在24-28周时通过两步口服葡萄糖耐量试验进行评估。

结果：招募了525名女性；49名（9%）发展为GDM。NC与WC(r: 0.583, p<.001), BMI (r: 0.533, p<.001), 年龄 (r: 0.123, p=.002), 分娩次数 (r: 0.170, p<.001)和50g OGTT (r: 0.206, p<.001)的水平呈正相关。预测GDM的NC和WC的ROC曲线下面积（AUC）为0.585（95%的置信区间（CI）: 0.50–0.66, p=.043）, 0.693 （95%CI: 0.61–0.76, p<.001）。孕妇NC的最佳截断值为38.5cm, 敏感性为69%, 特异性为45%； WC的最佳截断值为84.50cm, 敏感性为78%, 特异性为54%。腰围 >84.50cm (OR: 3.58, 95% CI:1.77–7.27; p<.001) 和年龄 >25 (OR: 3.05, 95% CI:1.38–6.72; p=.006)（调整年龄、妊娠次数、胎次、BMI和NC)的增加是GDM发展的独立预测因子。

结论：妊娠期糖尿病患者的NC和WC显著增加, 然而, 在低风险的孕妇中, 只有产妇的腰围是GDM的重要预测指标。

Keywords:

• Gestational diabetes mellitus
• neck circumference
• waist circumference
• first-trimester pregnancy
• prediction

Disclosure statement

No potential conflict of interest was reported by the author(s).