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To investigate the association between early pregnancy blood routine indicators and fasting blood glucose (FPG) levels with gestational diabetes mellitus (GDM) and their predictive value.
A total of 1 422 early pregnant women enrolled in a prospective dynamic birth cohort at Gansu Provincial Maternal and Child Health Hospital from 2018 to 2022 were included. Baseline data and early pregnancy laboratory indicators were collected, and GDM occurrence was followed up and recorded. Logistic regression was used to analyze the relationship between early pregnancy white blood cell count (WBC),lymphocyte count (LYMPH), hemoglobin (HGB), and FPG levels with the confirmed GDM outcome. Restricted cubic spline (RCS) analysis was conducted to investigate whether there was a nonlinear relationship between WBC, FPG, and GDM. Additionally, subgroups were analyzed based on age, parity, and other factors. Finally, the predictive value of various early pregnancy indicators for GDM was assessed using receiver operating characteristic (ROC) curves.
Among the 1 422 early pregnant women, 154 developed GDM in mid-pregnancy. After adjusting for covariates such as age, pre-pregnancy BMI, and parity, logistic regression analysis revealed that the risk of developing GDM for the highest quartile levels of WBC, LYMPH, HGB, and FPG was 1.774 times (95%CI: 1.088-2.893), 1.712 times (95%CI: 1.035-2.833), 1.597 times (95%CI: 1.004-2.555), and 6.459 times (95%CI: 3.612-11.151) that of the lowest quartile group, respectively, with all differences being statistically significant (P<0.05). RCS analysis indicated a positive linear dose-response relationship between early pregnancy WBC, FPG, and the risk of GDM. In subgroup analysis, overweight and obese women showed an increased risk of GDM with elevated early pregnancy WBC (OR=1.212,95%CI: 1.106-1.445) and FPG (OR=6.758, 95%CI: 3.407-14.989). The combination of early pregnancy WBC, FPG, HGB, age, and pre-pregnancy BMI provided the best predictive value for GDM (AUC=0.736, 95%CI: 0.695-0.776).
Clinical practitioners should focus on early pregnancy WBC and FPG levels, as well as the conditions of advanced maternal age and overweight/obesity, to implement timely health interventions for primary prevention of GDM.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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