HOMA-IR

This study investigated the predictability of gestational diabetes mellitus (GDM) during the first trimester using insulin resistance indicators and anthropometric measurements, along with the impact of weight gain during pregnancy (WGDP). Among 227 singleton pregnancies, 8.8% developed GDM. HOMA-IR, BMI, and WGDP were independently associated with GDM. Key findings included: HOMA-IR >2.08 (OR 1.254, AUC 0.809) with 90% sensitivity and 61% specificity; BMI >25.95 kg/m2 (OR 1.157, AUC 0.723) with 80% sensitivity and 58% specificity; and WGDP >4.7 kg (OR 1.221, AUC 0.654) with 80% sensitivity and 46% specificity. Notably, even with a high HOMA-IR score (>3.1), GDM incidence was low (10.3%) when WGDP was <4.7 kg by weeks 24-28. The study concludes that first-trimester screening combining HOMA-IR, BMI, and WGDP can help identify GDM risk, and controlling weight gain may reduce GDM development, particularly in women with elevated BMI and HOMA-IR.