Diabetes after pregnancy: a study protocol for the derivation and validation of a risk prediction model for 5-year risk of diabetes following pregnancy.

Prediction model Pregnancy Prognosis Risk Study protocol Type 2 diabetes mellitus

Journal

Diagnostic and prognostic research
ISSN: 2397-7523
Titre abrégé: Diagn Progn Res
Pays: England
ID NLM: 101718985

Informations de publication

Date de publication:
08 Mar 2021
Historique:
received: 26 07 2020
accepted: 08 02 2021
entrez: 8 3 2021
pubmed: 9 3 2021
medline: 9 3 2021
Statut: epublish

Résumé

Pregnancy offers a unique opportunity to identify women at higher future risk of type 2 diabetes mellitus (DM). In pregnancy, a woman has greater engagement with the healthcare system, and certain conditions are more apt to manifest, such as gestational DM (GDM) that are important markers for future DM risk. This study protocol describes the development and validation of a risk prediction model (RPM) for estimating a woman's 5-year risk of developing type 2 DM after pregnancy. Data will be obtained from existing Ontario population-based administrative datasets. The derivation cohort will consist of all women who gave birth in Ontario, Canada between April 2006 and March 2014. Pre-specified predictors will include socio-demographic factors (age at delivery, ethnicity), maternal clinical factors (e.g., body mass index), pregnancy-related events (gestational DM, hypertensive disorders of pregnancy), and newborn factors (birthweight percentile). Incident type 2 DM will be identified by linkage to the Ontario Diabetes Database. Weibull accelerated failure time models will be developed to predict 5-year risk of type 2 DM. Measures of predictive accuracy (Nagelkerke's R The derived RPM may help identify women at high risk of developing DM in a 5-year period after pregnancy, thus facilitate lifestyle changes for women at higher risk, as well as more frequent screening for type 2 DM after pregnancy.

Sections du résumé

BACKGROUND BACKGROUND
Pregnancy offers a unique opportunity to identify women at higher future risk of type 2 diabetes mellitus (DM). In pregnancy, a woman has greater engagement with the healthcare system, and certain conditions are more apt to manifest, such as gestational DM (GDM) that are important markers for future DM risk. This study protocol describes the development and validation of a risk prediction model (RPM) for estimating a woman's 5-year risk of developing type 2 DM after pregnancy.
METHODS METHODS
Data will be obtained from existing Ontario population-based administrative datasets. The derivation cohort will consist of all women who gave birth in Ontario, Canada between April 2006 and March 2014. Pre-specified predictors will include socio-demographic factors (age at delivery, ethnicity), maternal clinical factors (e.g., body mass index), pregnancy-related events (gestational DM, hypertensive disorders of pregnancy), and newborn factors (birthweight percentile). Incident type 2 DM will be identified by linkage to the Ontario Diabetes Database. Weibull accelerated failure time models will be developed to predict 5-year risk of type 2 DM. Measures of predictive accuracy (Nagelkerke's R
DISCUSSION CONCLUSIONS
The derived RPM may help identify women at high risk of developing DM in a 5-year period after pregnancy, thus facilitate lifestyle changes for women at higher risk, as well as more frequent screening for type 2 DM after pregnancy.

Identifiants

pubmed: 33678196
doi: 10.1186/s41512-021-00095-6
pii: 10.1186/s41512-021-00095-6
pmc: PMC7938478
doi:

Types de publication

Journal Article

Langues

eng

Pagination

5

Subventions

Organisme : Physicians' Services Incorporated Foundation
ID : 19-23

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Auteurs

Stephanie H Read (SH)

Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, Ontario, M5S 1B2, Canada. Steph.Read@hotmail.com.
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. Steph.Read@hotmail.com.
Evidence and Access, Certara, London, UK. Steph.Read@hotmail.com.

Laura C Rosella (LC)

Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Public Health Ontario, Toronto, Ontario, Canada.

Howard Berger (H)

Division of Maternal-Fetal Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.

Denice S Feig (DS)

Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Sinai Health System, Toronto, Ontario, Canada.

Karen Fleming (K)

Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Padma Kaul (P)

Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.

Joel G Ray (JG)

Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Public Health Ontario, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Obstetrics and Gynaecology, St. Michael's Hospital, Toronto, Ontario, Canada.

Baiju R Shah (BR)

Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Division of Maternal-Fetal Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Lorraine L Lipscombe (LL)

Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, Ontario, M5S 1B2, Canada.
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Classifications MeSH