Fetal cardiac function by mitral and tricuspid annular plane systolic excursion using spatio-temporal image correlation M-mode and left cardiac output in fetuses of pregestational diabetic mothers

A model for predicting gestational diabetes mellitus in early pregnancy: a prospective study in Thailand

Objective

To develop a predictive model using the risk factors of gestational diabetes mellitus (GDM) and construct a predictive nomogram for GDM risk in women during early pregnancy.

Methods

A prospective study was conducted in two tertiary hospitals among pregnant women with gestational age ≤14 weeks. Early GDM was diagnosed if an abnormal 100 g oral glucose tolerance test was detected using the Carpenter and Coustan criteria after an abnormal 50 g glucose challenge test. The factors included in the model were ACOG risk factors; maternal age; family history of hypertensive disorder in pregnancy; family history of dyslipidemia; gravida; parity; histories of preterm birth, early fetal death, abortion, stillbirth, and low birth weight; and glycated hemoglobin (HbA1c) levels. The predictive models for early GDM were analyzed using multiple logistic regression analyses. The nomograms were constructed, and their discrimination ability and predictive accuracy were tested.

Results

Of the 553 pregnant women, 54 (9.8%) were diagnosed with early GDM. In the integrated model, there was a history of GDM (adjusted odds ratio [aOR], 5.15; 95% confidence interval [CI], 1.82–14.63; P=0.004), HbA1c threshold ≥5.3% (aOR, 2.61; 95% CI, 1.44–4.74; P=0.002), and family history of dyslipidemia (aOR, 2.68; 95% CI, 1.37–5.21; P=0.005). The integrated nomogram model showed that a history of GDM had a high impact on the risk of early GDM. Its discrimination and mean absolute error were 0.76 and 0.009, respectively.

Conclusion

Application of the predictive model and nomogram will help healthcare providers investigate the probability of early GDM, especially in resource-limited countries.

Fetal Interventricular Septum Volume Evaluated by Three-Dimensional Ultrasound Using Spatiotemporal Image Correlation and Virtual Organ Computer-Aided Analysis in Fetuses From Pre-Gestational Diabetes Mellitus Pregnant Women

BACKGROUND

To assess the interventricular septum (IVS) volume of fetuses from pre-gestational diabetes mellitus (DM) pregnant women by 3-dimensional ultrasound using spatiotemporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL) methods.

METHODS

This was a prospective cross-sectional study of 45 fetuses from pre-gestational DM and 45 fetuses from healthy pregnant women (controls). Only singleton pregnancies between 20 and 34 + 6 weeks of gestation were included. The fetal IVS volumes were obtained off-line using STIC and VOCAL methods. To analyze differences among variables, the Student’s t-test and Mann-Whitney U test were used. The correlation among continuous variables was determine using Spearman’s correlation test (r).

RESULTS

The median of fetal IVS volume was significantly higher in pre-gestational DM than in healthy pregnant women (0.3 cm³ vs. 0.2 cm³, p = 0.032). A strong positive correlation was observed between fetal IVS volume and gestational age at the time of ultrasound examination (r = 0.75, R² = 0.48, p < 0.0001) and between fetal IVS volume and estimated fetal weight (r = 0.63, R² = 0.37, p < 0.0001). No significant correlation was noted between fetal IVS volume and glycated hemoglobin levels (r = −0.16, R² = 0.01, p = 0.540) in the pre-gestational DM pregnant women.

CONCLUSIONS

Significant differences were observed in fetal IVS volumes between pre-gestational and healthy mothers, with higher values in the fetuses of pre-gestational DM pregnant women.