Development and internal validation of a clinical score to predict neonatal hypoglycaemia in women with gestational diabetes

• Published in: Endocrine 2024, Vol.85 (3), p.1206-1212
• Main Authors: Silva, Bruna, Pereira, Catarina A., Cidade-Rodrigues, Catarina, Chaves, Catarina, Melo, Anabela, Gomes, Vânia, Silva, Vânia Benido, Araújo, Alexandra, Machado, Cláudia, Saavedra, Ana, Figueiredo, Odete, Martinho, Mariana, Almeida, Maria Céu, Morgado, Ana, Almeida, Margarida, Cunha, Filipe M.
• Format: Article
• Language: English
• Subjects: Diabetes; Diabetes mellitus; Endocrinology; Gestational diabetes; Humanities and Social Sciences; Hypoglycemia; Internal Medicine; Medicine; Medicine & Public Health; multidisciplinary; Neonates; Original Article; Pre-eclampsia; Pregnancy complications; Regression analysis; Risk factors; Science
• ISSN: 1559-0100; 1355-008X; 1559-0100
• DOI: 10.1007/s12020-024-03815-2

Introduction Gestational diabetes (GD) is a risk factor for neonatal hypoglycaemia (NH), but other factors can increase this risk. Objectives To create a score to predict NH in women with GD. Methods Retrospective study of women with GD with a live singleton birth between 2012 and 2017 from the Portuguese GD registry. Pregnancies with and without NH were compared. A logistic regression was used to study NH predictors. Variables independently associated with NH were used to score derivation. The model’s internal validation was performed by a bootstrapping. The association between the score and NH was assessed by logistic regression. Results We studied 10216 pregnancies, 410 (4.0%) with NH. The model’s AUC was 0.628 (95%CI: 0.599–0.657). Optimism-corrected c-index: 0.626. Points were assigned to variables associated with NH in proportion to the model’s lowest regression coefficient: insulin-treatment 1, preeclampsia 3, preterm delivery 2, male sex 1, and small-for-gestational-age 2, or large-for-gestational-age 3. NH prevalence by score category 0-1, 2, 3, 4, and ≥5 was 2.3%, 3.0%, 4.5%, 6.0%, 7.4%, and 11.5%, respectively. Per point, the OR for NH was 1.35 (95% CI: 1.27–1.42). A score of 2, 3, 4, 5 or ≥6 (versus ≤1) had a OR for NH of 1.67 (1.29–2.15), 2.24 (1.65–3.04), 2.83 (2.02–3.98), 3.08 (1.83–5.16), and 6.84 (4.34–10.77), respectively. Conclusion Per each score point, women with GD had 35% higher risk of NH. Those with ≥6 points had 6.8-fold higher risk of NH compared to a score ≤1. Our score may be useful for identifying women at a higher risk of NH.