Maternal Adiposity in the First Trimester Pregnancy as a Predictor of Gestational Diabetes Mellitus: A Prospective Cohort Study.

OBJECTIVES

To evaluate the predictive ability of first-trimester ultrasound measurements of maternal adiposity for predicting gestational diabetes mellitus (GDM).

METHODS

Abdominal adiposity measurements by transabdominal ultrasound were performed, including subcutaneous fat thickness (SFT), visceral fat thickness (VFT), and preperitoneal fat thickness (PFT), measured at 3 specific regions: the umbilicus, suprapubic area, and anterior surface of the liver. Two additional values were calculated based on these measurements: total abdominal fat thickness (TAT), which was determined as the sum of SFT1 and VFT, and body fat index (BFI), which was calculated using the formula: BFI = PFT (mm) × SFT3 (mm)/maternal height (cm). Multiple logistic regression and receiver operating characteristic (ROC) analysis were used to evaluate the predictive ability.

RESULTS

A total of 330 pregnant women were enrolled with a prevalence of GDM of 23.0%. Multivariate logistic regression analysis showed that none of the fat parameters were significantly associated with GDM. However, for body mass index (BMI) ≥25 kg/m2, only the BFI showed a statistically significant association with GDM (odds ratio [OR] 2.75 [1.54-4.92]), with an area under the ROC curve (AUC) of 0.677. In the subgroup with BMI < 23 kg/m2, only SFT at the umbilicus was significantly associated with GDM (OR 3.21 [1.08-9.53]) using a cut-off value of ≥15.4 mm, with a sensitivity of 73.7%, a negative predictive value of 93.8%, and an AUC of 0.668.

CONCLUSIONS

Both BFI and SFT at the umbilical region demonstrate moderate discriminatory predictive performance for this condition across BMI-stratified subgroups.