Risk warning model for adverse pregnancy outcomes in gestational diabetes mellitus patients and evaluate its efficacy based on placental growth factor,blood lipid and glycosylated hemoglobin

Wang Baoyi; Ma Yingying; Li Zhihong; Li Yan; Ma Huihan

doi:10.3969/j.issn.1671-6450.2025.10.016

Abstract：Objective To establish a risk warning model for adverse pregnancy outcomes in patients with gestational diabetes mellitus(GDM)based on placental growth factor(PLGF),blood lipids,and glycosylated hemoglobin(HbA1c)and evaluate its efficacy.Methods A total of 100 GDM patients admitted to the Department of Obstetrics and Gynecology of Langfang People's Hospital from August 2022 to August 2024 were selected as the study subjects.Based on the presence or absence of adverse pregnancy outcomes,they were divided into an occurrence group(41 cases)and a non-occurrence group(59 cases).Differences in clinical data between the two groups were analyzed,and significant variables were included in a multivariate Logistic regression model to identify influencing factors for adverse pregnancy outcomes in GDM patients.A no-mogram model was constructed based on these factors,and the ROC curve was used to analyze the predictive efficacy of the model.Results Among 100 GDM patients,41(41.00％)experienced adverse pregnancy outcomes.The occurrence group was older and had a higher proportion of alcohol consumption history.Serum PLGF levels,white blood cell count(WBC),to-tal cholesterol(TC),triglyceride(TG),and HbA 1c were higher in the occurrence group than in the non-occurrence group(t=2.135,3.988,6.281,2.128,5.138,3.080,5.849,all P＜0.05).Multivariate Logistic regression analysis showed that older age,higher PLGF,TC,TG,and HbA1c were independent risk factors for adverse pregnancy outcomes in GDM patients[OR(95％CI)=1.250(1.037-1.570),1.057(1.019-1.096),4.967(1.916-12.881),4.241(1.431-12.571),1.905(1.085-3.344)],while high PLGF was a protective factor[OR(95％CI)=0.946(0.912-0.982),P＜0.05].ROC analysis showed that the AUC values for age,PLGF,TC,TG,HbA1c,and the nomogram model were 0.631,0.804,0.778,0.703,0.803,and 0.941,respectively,indicating that age,PLGF,TC,TG,and HbA1c have certain predictive value for adverse pregnancy outcomes in GDM patients,and the nomogram model has high predictive value.At the cutoff value,the sensitivity of age,PLGF,TC,TG,HbA1c,and the nomo-gram model were 0.390,0.746,0.610,0.634,0.634,and 0.966,respectively,and the specificity were 0.814,0.732,0.864,0.746,0.932,and 0.805,respectively.Internal validation using the Bootstrap method(B=1000)showed that the prediction curve of the nomogram model closely aligned with the ideal curve,indicating good predictive ability.The decision curve analysis showed that the net benefit rate of the model was＞0 within the threshold probability range of 0.04 to 1.Conclusions In-creased age,TC,TG,and HbA1c are independent risk factors for adverse pregnancy outcomes in GDM patients,while in-creased PLGF is a protective factor.The risk warning model for adverse pregnancy outcomes in GDM patients based on PLGF,blood lipids,and HbA1c demonstrates good predictive efficacy and can assist in clinical intervention and treatment.