International Journal of Medical Sciences

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19 February 2019

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Int J Med Sci 2017; 14(2):123-127. doi:10.7150/ijms.17321

Research Paper

Prediction of Gestational Diabetes Mellitus by Unconjugated Estriol Levels in Maternal Serum

Junguk Hur1, Eun-Hee Cho2, Kwang-Hyun Baek3, Kyung Ju Lee4,5✉

1. Department of Biomedical Sciences, University of North Dakota, Grand Forks, North Dakota, USA.
2. Department of Internal Medicine, Kangwon National University, Chuncheon, Republic of Korea;
3. Department of Biomedical Science, CHA University, Gyeonggi-Do, Republic of Korea;
4. Integrative Medicine Center, College of Medicine, Korea University, Seoul, Republic of Korea;
5. Department of Epidemiology and Medical informatics, Graduate School of Public Health, College of Medicine, Korea University, Seoul, Republic of Korea.


The aim of this study was to evaluate the association between maternal serum estriol levels, which are routinely measured in the first trimester of pregnancy, and adverse pregnancy outcomes including gestational diabetes. We performed a retrospective chart analysis of women who delivered between July 1, 2007, and December 31, 2009, at Kangnam CHA Medical Center in Seoul, Korea. Only patients with available estriol measurements during their pregnancies and complete follow-up data were included in the study. The effect of estriol on the incidence of adverse pregnancy outcomes was examined using multinomial logistic regression analysis with age and pre-pregnancy body mass index (BMI) as covariates. The total number of subjects was 1,553, the mean age was 32.9 ± 3.7 years, and the mean pre-pregnancy BMI was 21.2 ± 3.0 kg/m2. Unconjugated estriol > 95th percentile of the screened population or unconjugated estriol ≥ 2.0 MoM (Multiple of the Median) was significantly associated with an increased risk for developing gestational diabetes mellitus (GDM), after adjusting for age and pre-pregnancy maternal weight. High levels of unconjugated estriol in the maternal serum during the early second trimester of pregnancy are a useful predictor of GDM development.

Keywords: Estriol, pregnancy outcomes, gestational diabetes.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
How to cite this article:
Hur J, Cho EH, Baek KH, Lee KJ. Prediction of Gestational Diabetes Mellitus by Unconjugated Estriol Levels in Maternal Serum. Int J Med Sci 2017; 14(2):123-127. doi:10.7150/ijms.17321. Available from