{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:03:17Z","timestamp":1785322997839,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Universal screening for gestational diabetes mellitus (GDM) is performed at 24\u201328 gestational weeks, but recommendations for earlier risk stratification differ across guidelines. Overweight pregnant women (body mass index [BMI] 25.0\u201329.9 kg\/m2) without established major GDM risk factors constitute a clinical gray zone for which current guidelines provide no explicit directive. We evaluated the first-trimester diagnostic performance of two composite anthropometric indices\u2014the Body Roundness Index (BRI) and A Body Shape Index (ABSI)\u2014for subsequent IADPSG-defined GDM within this specific clinical niche. Methods: This prospective single-center cohort study enrolled 198 consecutive overweight pregnant women without major GDM risk factors at 11 + 0 to 13 + 6 gestational weeks; 186 participants completed the 75 g OGTT at 24\u201328 weeks and were analyzed. Anthropometric measurements were obtained by trained nurses blinded to outcome. Glucose was assayed by hexokinase enzymatic reference method (intra-assay CV \u2264 1.5%). Discrimination, calibration, reclassification (NRI, IDI), decision curve analysis, and three independent internal validation procedures were performed. Results: GDM prevalence was 18.28% (34\/186). BRI achieved an AUC of 0.905 (95% CI 0.835\u20130.974) and ABSI an AUC of 0.889 (95% CI 0.815\u20130.963), both significantly greater than BMI (AUC 0.705; DeLong p &lt; 0.001). The optimal BRI cutoff of 4.45\u2014interpreted as a cohort-specific analytic anchor rather than a transferable clinical threshold\u2014yielded 85.3% sensitivity and 90.8% specificity. Adding BRI to BMI improved discrimination by 45.6% (IDI). Bootstrap optimism remained below 0.01 across all models. Conclusions: Following internal validation through bootstrap optimism correction and cross-validation, first-trimester BRI and ABSI provided strong supplementary risk stratification for GDM in overweight pregnant women without major risk factors. External validation in independent populations is required before clinical implementation.<\/jats:p>","DOI":"10.3390\/diagnostics16152384","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:13:47Z","timestamp":1785320027000},"page":"2384","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body Roundness Index and A Body Shape Index as First-Trimester Risk-Stratification Markers for Gestational Diabetes in Overweight Pregnant Women Without Established Major Risk Factors: A Prospective Single-Center Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9861-6767","authenticated-orcid":false,"given":"\u00d6mer Osman","family":"Ero\u011flu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5049-1415","authenticated-orcid":false,"given":"Cans\u0131n","family":"Ero\u011flu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1950-9041","authenticated-orcid":false,"given":"Sait","family":"Erbey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2964-729X","authenticated-orcid":false,"given":"Murat","family":"Polat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4989-4970","authenticated-orcid":false,"given":"Bilge","family":"Erbey","sequence":"additional","affiliation":[{"name":"Independent Researcher, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3812-3455","authenticated-orcid":false,"given":"Mehmet Alican","family":"Sapmaz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4381-6099","authenticated-orcid":false,"given":"\u00c7a\u011fanay","family":"Soysal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Ankara Etlik City Hospital, Ankara 06170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1056\/NEJMoa0707943","article-title":"Hyperglycemia and adverse pregnancy outcomes","volume":"358","author":"Metzger","year":"2008","journal-title":"N. 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