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Joint modeling of gestational glycemic control and the risk of preterm birth in women with type 1 diabetes mellitus (T1DM)

Annals of Epidemiology Aug 31, 2018

Gupta R, et al. - In this retrospective longitudinal cohort study of 114 women with T1DM, researchers used a univariate joint modelling (UJM) approach to characterize the link between glycemic control and risk of preterm birth. Mother’s age, age at diabetes onset, body mass index at conception, White’s classification of diabetes severity, chronic hypertension, retinopathy, and nephropathy were the covariates, selected through one-at-a time modeling. A final UJM was selected via testing various association structures, and compared with TDCM. Statistical significance of mother’s age and age at diabetes onset for the longitudinal sub-model indicated a tendency of having higher mean blood glucose levels in older women, and women with diabetes onset at an older age. In the event sub-model, statistical significance of the presence of nephropathy was found. Higher glucose rates over gestation corresponded to a decreased hazard of preterm birth. UJM vs TDCM had better model fit.
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