Assessing the Relationship between Gestational Glycemic Control and Risk of Preterm Birth in Women with Type 1 Diabetes: A Joint Modeling Approach.

Journal of Diabetes Research
Resmi GuptaRhonda D Szczesniak

Abstract

Characterizing maternal glucose sampling over the course of the entire pregnancy is an important step toward improvement in prediction of adverse birth outcome, such as preterm birth, for women with type 1 diabetes mellitus (T1DM). To characterize the relationship between the gestational glycemic profile and risk of preterm birth using a joint modeling approach. A joint model was developed to simultaneously characterize the relationship between a longitudinal outcome (daily blood glucose sampling) and an event process (preterm birth). A linear mixed effects model using natural cubic splines was fitted to predict the longitudinal submodel. Covariates included mother's age at last menstrual period, age at diabetes onset, body mass index, hypertension, retinopathy, and nephropathy. Various association structures (value, value plus slope, and area under the curve) were examined before selecting the final joint model. We compared the joint modeling approach to the time-dependent Cox model (TDCM). A total of 16,480 glucose readings over gestation (range: 50-260 days) with 32 women (28%) having preterm birth was included in the study. Mother's age at last menstrual period and age at diabetes onset were statistically significant (beta ...Continue Reading

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Citations

May 6, 2021·Journal of Clinical and Translational Science·Emrah GeciliRhonda D Szczesniak

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