ArticleJournal of diabetes investigation2026
Dual-center prospective validation of an early second-trimester predictive model integrating BMI trajectories and pathophysiological biomarkers for gestational diabetes risk stratification.
Article in Journal of diabetes investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo develop and validate an early second-trimester predictive model integrating body mass index (BMI) trajectories and pathophysiological biomarkers for gestational diabetes mellitus (GDM) risk stratification, with the aim of reducing weight-monitoring frequency while maintaining predictive accuracy.
methodsIn this prospective dual-center cohort study, 1,450 pregnant women (<12 weeks gestation) without preexisting diabetes were enrolled from two Beijing maternal-child hospitals. Serial anthropometric (BMI at 6-10, 12-14, 15-19, and 24-28 weeks) and metabolic biomarkers (fasting glucose, C-peptide, lipids, uric acid) were analyzed. GDM was diagnosed via 75 g OGTT at 24-28 weeks. Multivariable logistic regression identified predictors using a 7:3 training-test split. Model performance was assessed by area under the ROC curve (AUC), calibration, and decision curve analysis.
resultsGDM incidence was 26.1% (378/1,450). Significant weight/BMI disparities emerged as early as 6-10 weeks (GDM vs NGT: +2.3 kg, P < 0.0001), escalating through gestation. The final model incorporated age (OR = 1.07/year, 95% CI = 1.03-1.11), 12-14-week BMI (OR = 1.06/kg/m
conclusionsThis dual-center model pioneers GDM risk stratification by 12-14 weeks using clinically accessible metrics, reducing weight-monitoring frequency without compromising prognostic value. While AUC limitations (0.68-0.69) suggest unmeasured contributors, its operational simplicity and robust negative predictive capacity support implementation in resource-constrained settings. The findings redefine antenatal care paradigms by shifting focus to early metabolic dysregulation rather than late diagnostic thresholds.
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