Early identification of gestational diabetes mellitus (GDM) risk remains a challenge in nulliparous women of advanced maternal age (AMA). A retrospective cohort study published in Frontiers in Endocrinology evaluated early-pregnancy clinical and laboratory markers associated with GDM risk in this population.
The study included 354 nulliparous women aged 35 years or older, comprising 140 with GDM and 214 without GDM. Diagnosis was based on a 75 g oral glucose tolerance test performed at 24-28 weeks using International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Clinical and laboratory parameters measured at 10-13 weeks of gestation were compared. Multivariable logistic regression was used to identify independent risk factors.
Compared with those without GDM, women who developed GDM had higher body mass index, fasting blood glucose (FBG), white blood cell (WBC) count, neutrophil count (NEU), and higher rates of urinary glucose (U-GLU) positivity (P<0.05). In multivariable analysis, U-GLU positivity (aOR 7.91; 95% CI 2.67-23.46), higher FBG (aOR 2.23 per mmol/L; 95% CI 1.13-4.38), elevated NEU (aOR 1.21 per 10⁹/L; 95% CI 1.05-1.40), elevated WBC (aOR 1.15 per 10⁹/L; 95% CI 1.01-1.30), and assisted reproductive technology use (aOR 1.63; 95% CI 1.02-2.59) were identified as independent factors. The model showed an area under the curve of 0.70 (95% CI 0.65–0.76), with a sensitivity of 57.1% and a specificity of 76.2%.
These findings identify early-pregnancy markers observed in women who later developed GDM in this cohort. Further validation in larger, multicenter studies is required to assess clinical utility.
