Development and validation of a nomogram for predicting comorbid anxiety and depression in patients with gestational diabetes mellitus

Table 1 Self-Rating Anxiety Scale and Self-Rating Depression Scale scores of gestational diabetes mellitus patients, mean ± SD

Group	n	SAS	SDS
Comorbidity group	38	57.39 ± 4.88	58.50 ± 4.23
Control group	200	41.84 ± 4.73	44.64 ± 4.65
t value		18.489	18.230
P value		< 0.001	< 0.001

GDM: Gestational diabetes mellitus; SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale.

Table 2 Comparison of clinical and laboratory data between the two groups, mean ± SD

Factor		Comorbidity group (n = 38)	Control group (n = 200)	χ2/t value	P value
Age (years)		30.24 ± 2.31	28.60 ± 2.49	4.809	< 0.001
Gestational age (weeks)		25.92 ± 2.76	26.55 ± 2.19	-1.552	0.122
Pre-pregnancy BMI (kg/m2)		22.21 ± 1.84	22.02 ± 2.08	0.520	0.604
Pregnancy times (times)		3.31 ± 1.00	3.51 ± 1.10	-1.022	0.308
Number of births (times)		1.45 ± 0.39	1.54 ± 0.42	-1.186	0.237
Early pregnancy symptoms (n)	Yes	18	104	0.274	0.601
	No	20	96
Family history of diabetes (n)	Yes	7	40	0.050	0.823
	No	31	160
Other pregnancy syndrome (n)	Yes	10	36	1.416	0.234
	No	28	164
Previous abortion (n)	Yes	15	30	16.617	< 0.001
	No	23	170
Educational level (n)	Junior high school and below	21	49	11.819	0.001
	High school and above	17	151
Monthly household income (yuan) (n)	≤ 3000	4	14	1.565	0.457
	3001-6000	14	60
	> 6000	20	126
Occupational type (n)	Mental work	29	138	0.816	0.366
	Physical work	9	62
place of residence (n)	Towns	17	84	0.098	0.754
	Village	21	116
Planned pregnancy (n)	Yes	16	102	1.011	0.315
	No	22	98
Social support (n)	Low/moderate	26	75	12.489	< 0.001
	Satisfaction	12	125
FBG (mmol/L)		5.58 ± 1.23	5.27 ± 0.98	1.691	0.092
HbA1c (%)		7.36 ± 2.42	7.01 ± 1.53	0.858	0.396
UA (mmol/L)		282.25 ± 55.11	279.46 ± 54.57	0.289	0.773
Cr (μmol/L)		96.81 ± 9.54	94.97 ± 9.69	1.077	0.283
BNP (pg/mL)		100.38 ± 22.44	96.52 ± 21.21	1.020	0.309
TG (mmol/L)		1.50 ± 0.25	1.45 ± 0.20	1.066	0.292
TC (mmol/L)		4.21 ± 0.83	4.43 ± 0.72	-1.668	0.097
HDL-C (mmol/L)		1.32 ± 0.35	1.29 ± 0.37	0.429	0.668
LDL-C (mmol/L)		2.88 ± 0.51	2.75 ± 0.50	1.412	0.159
IR		2.23 ± 0.40	2.17 ± 0.47	0.759	0.449

BMI: Body mass index; FBG: Fasting blood glucoses; HbA1c: Glycated hemoglobin; UA: Uric acid; Cr: Creatinine; BNP: Brain natriuretic peptide; TG: Triglycerides; TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; IR: Insulin resistance.

Table 3 Single-factor screening of gestational diabetes mellitus patients with anxiety and depression disorder

Item	c	SE	Wald χ2	P value	OR (95%CI)
Age	0.375	0.087	18.646	< 0.001	1.455 (1.227-1.726)
Previous abortion	1.518	0.395	14.794	< 0.001	4.565 (2.106-9.897)
Educational level	1.477	0.368	16.090	< 0.001	4.380 (2.128-9.013)
Social support	1.392	0.379	13.482	< 0.001	4.024 (1.914-8.460)

OR: Odds ratio; CI: Confidence interval.

Table 4 Group assignment of participants

Variable	Name	Assignment
Dependent variable	Group	1 = comorbidity group, 0 = control group (reference)
Independent variable	Age	Measurement data are included according to actual value
	Previous abortion	1 = yes (risk factor), 2 = no (reference)
	Educational level	1 = junior high school and below (risk factor), 2 = high school and above(reference)
	Social support	1 = low/moderate social support (risk factor); 0 = satisfactory social support (reference)

Table 5 Multivariate logistic regression analysis of comorbid anxiety and depression in gestational diabetes mellitus patients

Item	β	SE	Wald χ2	P value	OR (95%CI)
Age	0.338	0.093	13.166	< 0.001	1.403 (1.168-1.684)
Previous abortion	1.621	0.469	11.927	0.001	5.057 (2.016-12.686)
Educational level	1.391	0.427	10.626	0.001	4.018 (1.741-9.272)
Social support	1.358	0.430	9.955	0.002	3.889 (1.673-9.042)

OR: Odds ratio; CI: Confidence interval.

Table 6 Predictive value of receiver operating characteristics analysis

Test variable	AUC	SE	P value	95%CI	Cut-off value	Youden index	Sensitivity	Specificity
Age	0.718	0.046	< 0.001	0.629-0.808	30.500	0.354	0.579	0.775
Previous abortion	0.635	0.054	0.008	0.530-0.740	1.500	0.270	0.395	0.875
Educational level	0.666	0.051	0.001	0.566-0.766	1.500	0.333	0.553	0.780
Social support	0.667	0.048	0.001	0.573-0.761	1.500	0.334	0.684	0.650
Joint prediction	0.853	0.033	< 0.001	0.789-0.917	0.859	0.601	0.816	0.785

AUC: Area under the curve; CI: Confidence interval.