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Relative importance of metabolic syndrome components for developing gestational diabetes



To assess the independent and joint contribution of the individual components of metabolic syndrome, and known risk factors for gestational diabetes (GDM), on risk of GDM.


Two thousand nine hundred and fifteen women from Australia and New Zealand, who participated in The Screening for Pregnancy Endpoints Study (SCOPE), were included. Using the SCOPE clinical data set and biomarkers obtained at 14–16 weeks’ gestation, a logistic regression model was fitted to the binary outcome GDM, with individual metabolic syndrome components (waist circumference, blood pressure, glucose, HDL-C, triglycerides), recruitment site, and other established factors associated with GDM. Hierarchical partitioning was used to assess the relative contribution of each variable.


Of the 2915 women, 103 women (3.5%) developed GDM. The deviance explained by the logistic regression model containing all variables was 18.65% and the AUC was 0.809. Seventy percent of the independent effect was accounted for by metabolic syndrome components. The highest independent relative contribution to GDM was circulating triglycerides (17 ± 3%), followed by waist circumference (13 ± 3%). Glucose and maternal BMI contributed 12 ± 2% and 12 ± 3%, respectively. The remaining factors had an independent relative contribution of < 10%.


Triglyceride concentrations had the highest independent relative importance for risk of GDM. Increased focus for lowering triglycerides as an important risk factor for GDM is warranted.

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Data availability

The SCOPE study, which commenced recruitment in 2004, did not seek specific consent from participants for sharing their data publicly. However, the SCOPE Consortium Scientific Advisory Board invites applications to use the collected data via email to the chairperson, via, Amy Aherne at ei.ccu@enreha.yma. Applicants will be asked to complete a Research Application Form specifying details for their planned study which will then be reviewed by the SCOPE Scientific Advisory Board. The SCOPE Consortium is keen to promote collaboration among researchers and to see our unique SCOPE database and pregnancy biobank used in studies which meet our ethics and consenting process. The SCOPE consortium is a member of the International Pregnancy Collaboration ( and has participated in several studies involving shared data. The SCOPE database is provided and maintained by MedSciNet AB (

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The authors wish to thank all of the SCOPE participants and the SCOPE research midwives in each centre; and Robyn North for her contributions in establishing the SCOPE study.


JAG is supported by an NHMRC Ideas Grant (GNT2000905). CTR is supported by a Matthew Flinders Fellowship from Flinders University and a NHMRC Investigator Grant (GNT1174971). The SCOPE database is provided and maintained by MedSciNet AB ( The Australian SCOPE study was funded by the Premier’s Science and Research Fund, South Australian Government ( The New Zealand SCOPE study was funded by the New Enterprise Research Fund, Foundation for Research Science and Technology; Health Research Council (04/198); Evelyn Bond Fund, Auckland District Health Board Charitable Trust. The funding bodies had no direct involvement in execution of the study.

Author information




GAD, CTR, and LMM designed the original SCOPE study; JAG, SYL, EJK, LEG, and CTR designed the current research study; SYL and EJK analysed the data; JAG drafted the manuscript; all authors provided intellectual input and reviewed the manuscript; JAG had primary responsibility for the content. Final approval of the version to be published (all authors).

Corresponding author

Correspondence to Jessica A. Grieger.

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The authors have no conflict of interest.

Ethical approval

Ethical approval was obtained from local ethics committees [New Zealand AKX/02/00/364, Australia REC 1712/5/2008] and all women provided written informed consent.

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All participants signed an informed consent form which was approved by the ethics committee (New Zealand AKX/02/00/364, Australia REC 1712/5/2008).

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Grieger, J.A., Leemaqz, S.Y., Knight, E.J. et al. Relative importance of metabolic syndrome components for developing gestational diabetes. Arch Gynecol Obstet (2021).

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  • Gestational diabetes
  • Pregnancy
  • Metabolic syndrome
  • Risk factors
  • Lipids
  • Triglycerides