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目的:探讨妊娠期糖尿病(GDM)的早期预测模型,建立GDM风险评分表,预测疾病的发生风险。方法:回顾性分析2015年1月至2017年5月于南京大学附属鼓楼医院产检和生产的孕期糖耐量正常(NGT)孕妇和GDM孕妇共1 150例作为建模队列,采用多因素logistic回归分析建立GDM早期预测模型并制成GDM风险评分表。收集2017年6月至2018年6月的NGT和GDM孕妇共490例作为验证队列,采用模型受试者工作特征(ROC)曲线和Hosmer-Lemeshow检验对GDM风险评分表模型进行有效性验证。结果:(1)建模队列:GDM早期预测模型由孕早期GDM风险评分表和孕14~20周GDM风险补充评分表共同构成,包括孕妇年龄、身高、孕前体质指数、受教育程度、糖尿病家族史、月经史、既往剖宫产、GDM病史、多囊卵巢综合征病史、慢性高血压病史、孕早期空腹血糖、孕14~20周空腹血糖和甘油三酯共13项因素。(2)验证队列:模型ROC曲线显示孕早期GDM风险评分表的曲线下面积(AUC)为0.781(95%可信区间0.735~0.828),增添孕14~20周GDM风险补充评分表构成总评分表,AUC增加至0.850(95%可信区间0.811~0.889)。Hosmer-Lemeshow检验显示孕早期GDM风险评分表和总评分表模型有较好的拟合度。结论:基于GDM多种高危因素制定风险评分表可以作为一项早期预测GDM发生风险的可靠工具。“,”Objective:To explore predictive model for gestational diabetes mellitus (GDM) and develop a Risk Score to predict the risk of GDM early.Methods:The medical records of 1 150 normal glucose tolerance (NGT) and GDM pregnant women in Nanjing Drum Tower Hospital from January 2015 to May 2017 were analyzed retrospectively as the training cohort, and logistic regression analysis was used to establish early predictive model for GDM and develop GDM Risk Score. Then the medical records of 490 pregnant women with NGT and GDM from June 2017 to June 2018 were analyzed as the validation cohort, and receiver operator characteristics (ROC) curve as well as Hosmer-Lemeshow test was used to verify the effectiveness of GDM Risk Score.Results:(1) For the training cohort, the early prediction model of GDM consists of the GDM Risk Score during first trimester and 14 to 20 gestational weeks, including pregnant women age, height, pre-pregnancy body mass index, education background, family history of diabetes, menstrual history, history of cesarean delivery, GDM, polycystic ovary syndrome and hypertension, fasting plasma glucose (FPG) during first trimester, FPG and triglycerides during 14 to 20 gestational weeks amount to 13. (2) For the validation cohort, according to the ROC curve, the area under the curve (AUC) of the Risk Score during first trimester was 0.781 (95%CI 0.735 to 0.828), which increased to 0.850 (95%CI 0.811 to 0.889) after supplementing Risk Score during 14 to 20 gestational weeks; it was found that the model of GDM Risk Score during first trimester and 14 to 20 gestational weeks fit well through Hosmer-Lemeshow test.Conclusions:The GDM Risk Score based on risk factors of GDM appears to be a reliable screening tool to detect the risk of GDM earlier.