Diagnostic accuracy of maternal serum multiple marker screening for early detection of gestational diabetes mellitus in the absence of a gold standard test
Abstract Background Gestational diabetes mellitus (GDM) is associated with adverse diabetic complications for both mother and child during pregnancy. The common Gold Standard (GS) for diagnosis of GDM is 75 g oral glucose tolerance test (OGTT) during 24–28 gestational weeks which seems a little late...
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doaj-264ed3a845fa40d9b410d9ec494949c22020-11-25T02:44:19ZengBMCBMC Pregnancy and Childbirth1471-23932020-06-012011910.1186/s12884-020-03068-7Diagnostic accuracy of maternal serum multiple marker screening for early detection of gestational diabetes mellitus in the absence of a gold standard testMaedeh Amini0Anoshirvan Kazemnejad1Farid Zayeri2Ali Montazeri3Aliakbar Rasekhi4Azam Amirian5Nourossadat Kariman6Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares UniversityDepartment of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares UniversityProteomics Research Centre and Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical SciencesHealth Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECRDepartment of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares UniversityDepartment of Midwifery, School of Nursing and Midwifery, Jiroft University of Medical SciencesDepartment of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical SciencesAbstract Background Gestational diabetes mellitus (GDM) is associated with adverse diabetic complications for both mother and child during pregnancy. The common Gold Standard (GS) for diagnosis of GDM is 75 g oral glucose tolerance test (OGTT) during 24–28 gestational weeks which seems a little late for any proper intervention. This study aimed to employ the Bayesian latent class models (LCMs) for estimating the early diagnostic power of combination of serum multiple marker in detecting GDM during 14–17 weeks of gestation. Methods Data from a sample of 523 pregnant women who participated in gestational diabetes screening tests at health centers affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran from 2017 to 2018 were used. The beta-human chorionic gonadotropin (β-hCG), unconjugated estriol (uE3), and alfa-fetoprotein (AFP) values were extracted from case records for all participants. The Bayesian LCMs were applied for estimating sensitivity, specificity, and area under receiver operating characteristic curve (AUC) of combining the three biomarkers’ results in the absence of GS, adjusting for maternal age and body mass index. Results The mean (standard deviation) maternal age of the participants was 28.76 (±5.33) years. Additionally, the mean (standard deviation) BMI was 24.57 (±3.22) kg/m2. According to the Bayesian model, the cSensitivity, cSpecificity, and cAUC for the optimal composite diagnostic test were estimated as 94% (95% credible interval (CrI) [0.91–0.99]), 86% (95% CrI [0.80–0.92]), and 0.92 (95% CrI [0.87–0.98]), respectively. Conclusions Overall, the findings revealed that the combination of uE3, AFP, and β-hCG results might be considered as an acceptable predictor for detecting GDM with a rather high level of accuracy in the early second trimester of pregnancy without a GS.http://link.springer.com/article/10.1186/s12884-020-03068-7Gestational diabetes mellitusBeta-human chorionic gonadotropinUnconjugated estriolAlfa-fetoproteinBody mass indexSensitivity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maedeh Amini Anoshirvan Kazemnejad Farid Zayeri Ali Montazeri Aliakbar Rasekhi Azam Amirian Nourossadat Kariman |
spellingShingle |
Maedeh Amini Anoshirvan Kazemnejad Farid Zayeri Ali Montazeri Aliakbar Rasekhi Azam Amirian Nourossadat Kariman Diagnostic accuracy of maternal serum multiple marker screening for early detection of gestational diabetes mellitus in the absence of a gold standard test BMC Pregnancy and Childbirth Gestational diabetes mellitus Beta-human chorionic gonadotropin Unconjugated estriol Alfa-fetoprotein Body mass index Sensitivity |
author_facet |
Maedeh Amini Anoshirvan Kazemnejad Farid Zayeri Ali Montazeri Aliakbar Rasekhi Azam Amirian Nourossadat Kariman |
author_sort |
Maedeh Amini |
title |
Diagnostic accuracy of maternal serum multiple marker screening for early detection of gestational diabetes mellitus in the absence of a gold standard test |
title_short |
Diagnostic accuracy of maternal serum multiple marker screening for early detection of gestational diabetes mellitus in the absence of a gold standard test |
title_full |
Diagnostic accuracy of maternal serum multiple marker screening for early detection of gestational diabetes mellitus in the absence of a gold standard test |
title_fullStr |
Diagnostic accuracy of maternal serum multiple marker screening for early detection of gestational diabetes mellitus in the absence of a gold standard test |
title_full_unstemmed |
Diagnostic accuracy of maternal serum multiple marker screening for early detection of gestational diabetes mellitus in the absence of a gold standard test |
title_sort |
diagnostic accuracy of maternal serum multiple marker screening for early detection of gestational diabetes mellitus in the absence of a gold standard test |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2020-06-01 |
description |
Abstract Background Gestational diabetes mellitus (GDM) is associated with adverse diabetic complications for both mother and child during pregnancy. The common Gold Standard (GS) for diagnosis of GDM is 75 g oral glucose tolerance test (OGTT) during 24–28 gestational weeks which seems a little late for any proper intervention. This study aimed to employ the Bayesian latent class models (LCMs) for estimating the early diagnostic power of combination of serum multiple marker in detecting GDM during 14–17 weeks of gestation. Methods Data from a sample of 523 pregnant women who participated in gestational diabetes screening tests at health centers affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran from 2017 to 2018 were used. The beta-human chorionic gonadotropin (β-hCG), unconjugated estriol (uE3), and alfa-fetoprotein (AFP) values were extracted from case records for all participants. The Bayesian LCMs were applied for estimating sensitivity, specificity, and area under receiver operating characteristic curve (AUC) of combining the three biomarkers’ results in the absence of GS, adjusting for maternal age and body mass index. Results The mean (standard deviation) maternal age of the participants was 28.76 (±5.33) years. Additionally, the mean (standard deviation) BMI was 24.57 (±3.22) kg/m2. According to the Bayesian model, the cSensitivity, cSpecificity, and cAUC for the optimal composite diagnostic test were estimated as 94% (95% credible interval (CrI) [0.91–0.99]), 86% (95% CrI [0.80–0.92]), and 0.92 (95% CrI [0.87–0.98]), respectively. Conclusions Overall, the findings revealed that the combination of uE3, AFP, and β-hCG results might be considered as an acceptable predictor for detecting GDM with a rather high level of accuracy in the early second trimester of pregnancy without a GS. |
topic |
Gestational diabetes mellitus Beta-human chorionic gonadotropin Unconjugated estriol Alfa-fetoprotein Body mass index Sensitivity |
url |
http://link.springer.com/article/10.1186/s12884-020-03068-7 |
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