Development and validation of a First Trimester Clinical Risk Score (FTRS) for predicting gestational diabetes mellitus in a low-resource setting: an observational cohort study
- 1Department of Obstetrics and Gynaecology, IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be) University, Bhubaneswar, Odisha India
- 2Department of Obstetrics and Gynaecology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha India
- 3Department of Pharmacology, IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be) University, Bhubaneswar, Odisha India
Abstract
Background: Several models have been developed for early prediction of gestational diabetes mellitus (GDM) during the first trimester; however, many rely on biochemical markers or are unsuitable for low-resource settings. This study aimed to develop and validate a simple first-trimester clinical risk score (FTRS) for early prediction of GDM using routinely available clinical variables.
Methods: In this prospective cohort study, 730 pregnant women presenting before 14 weeks’ gestation at a tertiary care teaching hospital in Eastern India were enrolled. GDM was diagnosed using the Diabetes in Pregnancy Study Group India (DIPSI) criteria based on a 75-g oral glucose challenge test performed at three time points during pregnancy. Eight clinical predictors were evaluated using multivariable Poisson regression. Equal- weighted and weighted FTRS models were developed and assessed using receiver operating characteristic (ROC) curve analysis.
Results: GDM developed in 271 (37.1%) participants. Eight clinical predictors were incorporated into the FTRS. The equal-weighted score (cut-off ≥ 3) achieved an area under the ROC curve (AUC) of 0.74, with 66.8% sensitivity and 82.9% specificity. The weighted score (cut-off ≥ 10) showed slightly better performance, with an AUC of 0.77, 70.2% sensitivity, and 83.4% specificity.
Conclusion: The first-trimester clinical risk score (FTRS) is a simple, practical, and non-invasive tool for early prediction of GDM using routinely available clinical variables. Its ease of application makes it particularly suitable for early risk stratification and targeted screening in low-resource settings.
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BibTeX
@article{dash2026development,
title = {{Development and validation of a First Trimester Clinical Risk Score (FTRS) for predicting gestational diabetes mellitus in a low-resource setting: an observational cohort study}},
author = {Sasmita Dash and Mohini and Manika Bose and Asima Das},
journal = {Diabetology \& Metabolic Syndrome},
year = {2026},
month = aug,
doi = {10.1186/s13098-026-02257-2},
url = {https://doi.org/10.1186/s13098-026-02257-2},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Development and validation of a First Trimester Clinical Risk Score (FTRS) for predicting gestational diabetes mellitus in a low-resource setting: an observational cohort study
AU - Sasmita Dash
AU - Mohini
AU - Manika Bose
AU - Asima Das
PY - 2026
DA - 2026/08/07
JO - Diabetology & Metabolic Syndrome
DO - 10.1186/s13098-026-02257-2
UR - https://doi.org/10.1186/s13098-026-02257-2
AB - Background: Several models have been developed for early prediction of gestational diabetes mellitus (GDM) during the first trimester; however, many rely on biochemical markers or are unsuitable for low-resource settings. This study aimed to develop and validate a simple first-trimester clinical risk score (FTRS) for early prediction of GDM using routinely available clinical variables. Methods: In this prospective cohort study, 730 pregnant women presenting before 14 weeks’ gestation at a tertiary care teaching hospital in Eastern India were enrolled. GDM was diagnosed using the Diabetes in Pregnancy Study Group India (DIPSI) criteria based on a 75-g oral glucose challenge test performed at three time points during pregnancy. Eight clinical predictors were evaluated using multivariable Poisson regression. Equal- weighted and weighted FTRS models were developed and assessed using receiver operating characteristic (ROC) curve analysis. Results: GDM developed in 271 (37.1%) participants. Eight clinical predictors were incorporated into the FTRS. The equal-weighted score (cut-off ≥ 3) achieved an area under the ROC curve (AUC) of 0.74, with 66.8% sensitivity and 82.9% specificity. The weighted score (cut-off ≥ 10) showed slightly better performance, with an AUC of 0.77, 70.2% sensitivity, and 83.4% specificity. Conclusion: The first-trimester clinical risk score (FTRS) is a simple, practical, and non-invasive tool for early prediction of GDM using routinely available clinical variables. Its ease of application makes it particularly suitable for early risk stratification and targeted screening in low-resource settings.
SN - 1758-5996
ER -