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Gestational Diabetes Research and Management · Journal article
The Russian Archives of Internal Medicine · August 13, 2026
Encouraging direction, but not yet definitive.
This retrospective case-control study examined first-trimester fasting glucose and HbA1c as predictors of GDM in 600 pregnant women, finding a combined model with AUC 0.849 (sensitivity 90.0%, specificity 78.2%). The work is observational and single-centre, lacking prospective validation or comparison to standard screening, and does not establish whether early identification and intervention change clinical outcomes.
Retrospective case-control cohort study. Pregnant women attending first antenatal visit at Multidisciplinary City Hospital No. 2 in Astana; 300 with GDM and 300 with physiological pregnancy. Eligibility criteria not specified.. Intervention: First-trimester fasting glucose and HbA1c measurement (observational markers, not an intervention).. Compared with: Comparison between GDM and control groups; no comparator screening strategy reported.. n = 600. Multidisciplinary City Hospital No. 2 in Astana (single centre)..
GDM group had significantly higher obesity rate: 31.0% vs. 9.0% in control (p<0.001) Preeclampsia incidence 7.3% in GDM vs. 3.3% in control; GDM increased preeclampsia risk more than twofold (OR=2.295; 95% CI: 1.067–4.934) Fasting glucose >4.49 mmol/L: sensitivity 71.6%, specificity 76.6%, AUC=0.787 (95% CI: 0.745–0.825)
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
First-trimester HbA1c and fasting glucose may help identify pregnancies at higher GDM risk earlier than standard OGTT (24–28 weeks), potentially enabling earlier preventive interventions. However, this retrospective study does not demonstrate that early screening improves maternal or fetal outcomes, and external validation is needed before recommending changes to standard antenatal screening protocols.
A retrospective case-control study identifying first-trimester metabolic markers predictive of GDM with moderate diagnostic accuracy (AUC 0.849 for combined model), but lacking prospective validation, blinding, or hard clinical outcome data to support practice change.
As stated by the source record.
Quoted from the source exactly as published.
First-trimester HbA1c and fasting glucose may help identify pregnancies at higher GDM risk earlier than standard OGTT (24–28 weeks), potentially enabling earlier preventive interventions. However, this retrospective study does not demonstrate that early screening improves maternal or fetal outcomes, and external validation is needed before recommending changes to standard antenatal screening protocols.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
To identify early clinical and metabolic predictors of gestational diabetes mellitus (GDM) and preeclampsia in the first trimester of pregnancy and to justify the need for a personalized screening strategy. Materials and Methods: A retrospective case-control cohort study was conducted at the Multidisciplinary City Hospital No. 2 in Astana (n=600). The main group consisted of 300 pregnant women with GDM, and the control group comprised 300 women with physiological pregnancy. Anthropometric data (BMI), medical history, and laboratory indicators (fasting glucose, HbA1c) recorded at registration (up to 12 weeks) were analyzed. Statistical analysis included the Mann-Whitney U-test, odds ratio (OR) calculation, and ROC analysis. Results: Patients with GDM had significantly higher BMI (obesity in 31.0 % vs. 9.0 %, p<0.001) and age. The incidence of preeclampsia in the GDM group was 7.3 % vs. 3.3 % in the control group; it was established that GDM increases the risk of preeclampsia by more than two times(OR=2.295; 95 % CI: 1.067–4.934). ROC analysis revealed high diagnostic value of individual markers in the first trimester. Fasting glucose at a threshold of >4.49 mmol/L showed a sensitivity of 71.6 % and specificity of 76.6 % (AUC=0.787; 95 % CI: 0.745–0.825). Glycated hemoglobin (HbA1c) at a level >5.27 % demonstrated a sensitivity of 63.9 % and high specificity of 85.7 % (AUC=0.792; 95 % CI: 0.653–0.894). The developed combined prognostic model (HbA1c + fasting glucose) showed the highest predictive value with an area under the ROC curve (AUC) of 0.849, providing a sensitivity of 90.0 % and specificity of 78.2 %. Conclusion: Glycated hemoglobin and fasting glycemia in the first trimester are independent predictors of GDM and associated preeclampsia. Implementing a risk score assessment at the first antenatal visit allows for the identification of a group for early initiation of personalized prevention, without waiting for the standard OGTT timing (24–28 weeks), which may reduce the incidence of obstetric complications.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.