Gestational diabetes mellitus (GDM) is a common complication during pregnancy with an increasing prevalence worldwide. Early prediction of GDM and its associated adverse outcomes is crucial for timely intervention and improved maternal and fetal health. The objective of this review is to provide a comprehensive summary of contemporary evidence on biomarkers, focusing on their potential to predict the development of GDM and serve as predictors of maternal, fetal, and neonatal outcomes in women with GDM. A literature search was conducted in the PubMed database using relevant terms. Original research articles published in English between 1 January 2015, and 30 June 2024, were included. A two-stage screening process was employed to identify studies on biomarkers for GDM diagnosis and prognosis and to evaluate the evidence for each biomarker’s diagnostic performance and its potential prognostic correlation with GDM. Various biochemical markers, including adipokines, inflammatory markers, insulin resistance markers, glycemic markers, lipid profile markers, placenta-derived markers, and other related markers, have shown promise in identifying women at risk of developing GDM and predicting adverse pregnancy outcomes. Several promising markers with high predictive performance were identified. However, no single biomarker has demonstrated sufficient accuracy to replace the current diagnostic criteria for GDM. The complexity of multiple pathways in GDM pathogenesis highlights the need for a multi-marker approach to improve risk stratification and guide personalized management strategies. While significant progress has been made in GDM biomarker research, further studies are required to refine and validate these markers for clinical use and to develop a comprehensive, evidence-based approach to GDM prediction and management that can improve maternal and child health outcomes.

Background: In 2014, the Thai government launched a free-of-charge long-acting reversible contraception (LARC) program for Thai female adolescents. However, its acceptance had not been reported. Therefore, this study aimed to describe contraceptive use among women of reproductive age before and after the program was implemented. Methods: This retrospective cross-sectional study was carried out from the medical records of 9000 women of reproductive age, who attended the Family Planning Clinic at Maharaj Nakorn Chiang Mai Hospital between 2009 and 2018. The Chi-square test was used to compare the contraceptive methods administered before and after the program was implemented, and binary logistic regression was used to find the factors associated with implant use after completion of the program. Results: Depot medroxy progesterone acetate (DMPA) injection was the most popular contraceptive method used among 40.9% of the women. The rates of subdermal implant use were increased significantly after the program was implemented (2.3–9.3%, p < 0.001). Implant use for adolescents aged less than 20 years increased from 2.6% to 56.4%, while DMPA was the most popular method used among adult women at 36.4%. Factors associated significantly with implant use after implement of the program included age of less than 20 years (aOR = 4.17 (CI: 1.84–9.44); p = 0.001) and nulliparity (aOR = 8.55 (CI: 3.77–19.39); p < 0.001). Conclusion: This study showed a significant increase in contraceptive implant use after the free-LARC program for adolescents had been applied. Statement of implications: Contraceptive implant is the most effective hormonal reversible contraception. Its use rate is low among all age groups, but increased clearly after the free-of-charge program was applied for adolescents.

Objective: To assess the predictive performance of first-trimester HbA1c, both as an individual marker and in combination with clinical risk factors, for subsequent development of GDM. Methods: A prospective cohort study was conducted at a single tertiary center in Thailand. Singleton pregnant women between 10 and 14 weeks of gestation were consecutively recruited. Women with pregestational diabetes mellitus were excluded. Baseline clinical characteristics were systematically recorded, and blood samples were obtained for HbA1c measurement. GDM was diagnosed at 24– 28 weeks of gestation using the standard two-step approach, 100-g OGTT with NDDG thresholds. The predictive performance of HbA1c alone and in combination with clinical risk factors was evaluated using ROC curve analysis. Results: Among 302 participants, 98 (32.5%) were diagnosed with GDM. Women who developed GDM were of more advanced maternal age and had higher pre-pregnancy BMI and body weight. They also more frequently reported a family history of diabetes mellitus and dyslipidemia. First-trimester HbA1c levels were significantly elevated in the GDM group. HbA1c alone demonstrated modest discriminatory performance (AUC=0.675). Incorporation of HbA1c into a multivariable model with maternal age and BMI improved predictive accuracy (AUC=0.726). At an probability cutoff 0.245, the combined model achieved a sensitivity of 80.6% and a specificity of 51.0%. Conclusion: First-trimester HbA1c levels are significantly elevated among women who subsequently develop GDM. Although HbA1c alone provides modest discriminatory capacity, integrating HbA1c with maternal age and pre-pregnancy BMI substantially enhances predictive performance. These findings support the application of this straightforward combined model for early pregnancy risk stratification.