Prediction model comparison for gestational diabetes mellitus with macrosomia based on risk factor investigation

J Matern Fetal Neonatal Med. 2021 Aug;34(15):2481-2490. doi: 10.1080/14767058.2019.1668922. Epub 2019 Oct 1.

Abstract

Purpose: To establish a feasible prediction model for gestational diabetes mellitus (GDM) with macrosomia based on risk factors analysis.

Methods: A total of 1981 GDM pregnant women with macrosomia were enrolled in this retrospective study. The potential risk factors were revealed between the GDM women with and without macrosomia based on questionnaire and clinical data analysis. Then, prediction models including logistic regression (LR), decision tree (DT), support vector machine (SVM) and artificial neural networks (ANN) were constructed using these risk factors. Effect evaluation was performed based on model forecasting ability and model practicability such as accuracy, true positive (TP) rate, false positive (FP) rate, recall, F-measure, and receiver operating characteristic curve (ROC).

Results: The risk factors analysis showed that factors such as triglyceride (TG), high-density lipoprotein-cholesterol (HDL-c) and ketone body were risk factors for GDM with macrosomia. Then, the forecasting model was constructed, respectively. Based on these risk factors as variables, the overall classification accuracy of the four forecasting models was 86%. DT model had the highest overall classification accuracy. SVM model had advantages over the other three models in terms of TP rate. Among the comparison parameters including overall ROC curve, ANN model was the highest, followed by LR model.

Conclusion: Among four forecasting models, ANN might be the optimal predication model, which had a certain practical value for the clinical screening of GDM women combined with macrosomia. Furthermore, HDL-c, TG, and ketone body might be potential risk factors for GDM with macrosomia.

Keywords: Gestational diabetes mellitus; macrosomia; prediction model; risk factors.

MeSH terms

  • Diabetes, Gestational* / epidemiology
  • Female
  • Fetal Macrosomia / epidemiology
  • Fetal Macrosomia / etiology
  • Humans
  • Pregnancy
  • Pregnancy Complications*
  • Retrospective Studies
  • Risk Factors