Development and validation of a Non-INvaSive Pregnancy RIsk ScoRE (INSPIRE) for the screening of high-risk pregnant women for gestational diabetes mellitus in Pakistan

Author:

Naz SabahatORCID,Jamal Samreen,Jaffar Ali,Azam Iqbal,Chandir Subhash,Qureshi Rahat,Babar Neelofur,Wali Aisha Syed,Iqbal RomainaORCID

Abstract

IntroductionThe prevalence of gestational diabetes mellitus (GDM) is on the rise in low-income and middle-income countries, such as Pakistan. Therefore, the development of a risk score that is simple, affordable and easy to administer is needed. Our study aimed to develop a Non-INvaSive Pregnancy RIsk ScoRE (INSPIRE) for GDM screening in Pakistani pregnant women based on risk factors reported in the literature.MethodsUsing a cross-sectional study design, we enrolled 500 pregnant women who attended antenatal clinics at one tertiary and two secondary care hospitals in Karachi between the 28th and 32nd weeks of gestation. We randomly divided data into derivation (n=404; 80%) and validation datasets (n=96; 20%). We conducted interviews to collect information on sociodemographic factors and family history of diabetes, measured mid-upper arm circumference (MUAC) and reviewed the medical records of women for obstetric history and oral glucose tolerance test (OGTT) results. We performed a multivariable logistic regression analysis to obtain coefficients of selected predictors for GDM in the derivation dataset. Calibration was estimated using Pearson’s χ2 goodness of fit test while discrimination was checked using the area under the curve (AUC) in the validation dataset.ResultsOverall, the GDM prevalence was 26% (n=130). INSPIRE was based on six predictors: maternal age, MUAC, family history of diabetes, a history of GDM, previous bad obstetrical outcome and a history of macrosomia. INSPIRE achieved a good calibration (Pearson’s χ2=29.55, p=0.08) and acceptable discrimination with an AUC of 0.721 (95% CI 0.61 to 0.83) with a sensitivity of 74.1% and specificity of 59.4% in the validation dataset.ConclusionWe developed and validated an INSPIRE that efficiently differentiates Pakistani pregnant women at high risk of GDM from those at low risk, thus reducing the unnecessary burden of the OGTT test.

Publisher

BMJ

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3