First trimester fetal heart rate tracing, a novel tool for prediction of gestational diabetes mellitus

Objective : To evaluate the predictive role of fi rst-trimester fetal heart rate (FHR) in early prediction of gestational diabetes mellitus (GDM). Background : Diabetes represents a clinical challenge, especially in pregnant women, where it is critical to monitor and assess both the maternal and the fetal well-being. Apart from women with pregestational diabetes (type-1 or type-2 diabetes mellitus), there is a growing rate of women who develop GDM. Patients and methods : This cohort study was conducted at Menou fi a University Hospitals and Menou fi a General Hospital from March 2020 to January 2022. The study participants were pregnant women at fi rst trimester who had attended the outpatient clinic (prenatal care). Each patient had undergone through history taking and physical examination and then had fi rst-trimester ultrasound scan where nuchal translucency, FHR, and crown rump length were recorded. Results : The best cutoff value of fi rst-trimester FHR in predicting GDM was more than or equal to 162 bpm, area under the curve ¼ 0.853, with sensitivity of 76% and speci fi city of 78.9%, positive predictive value 23.43, negative predictive value 76.57, and accuracy of 78%, while the results of multiple logistic regression analysis indicate that fi rst-trimester FHR was highly signi fi cant as a predictor for GDM ( P < 0.001) Conclusion : First-trimester FHR at cutoff value of more than or equal to 162 had moderate screening parameters for GDM.