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Primary lifestyle interventions to manage GDM, including second trimester dietary and exercise guidance, have met with limited success due to late implementation, poor adherence and generic guidelines. In this study, we aimed to build a preconception-based GDM predictor to enable early intervention. We also assessed the associations of top predictors with GDM and adverse birth outcomes. Our evolutionary algorithm-based automated machine learning (AutoML) model was implemented with data from 222 Asian multi-ethnic women in a preconception cohort study, Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO). A stacked ensemble model with a gradient boosting classifier and linear support vector machine classifier (stochastic gradient descent training) was derived using genetic programming, achieving an excellent AUC of 0.93 based on four features (glycated hemoglobin A1c (HbA1c), mean arterial blood pressure, fasting insulin, triglycerides\/HDL ratio). The results of multivariate logistic regression model showed that each 1 mmol\/mol increase in preconception HbA1c was positively associated with increased risks of GDM (p = 0.001, odds ratio (95% CI) 1.34 (1.13\u20131.60)) and preterm birth (p = 0.011, odds ratio 1.63 (1.12\u20132.38)). Optimal control of preconception HbA1c may aid in preventing GDM and reducing the incidence of preterm birth. Our trained predictor has been deployed as a web application that can be easily employed in GDM intervention programs, prior to conception.<\/jats:p>","DOI":"10.3390\/ijerph19116792","type":"journal-article","created":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T12:48:31Z","timestamp":1654087711000},"page":"6792","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Automated Machine Learning (AutoML)-Derived Preconception Predictive Risk Model to Guide Early Intervention for Gestational Diabetes Mellitus"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6640-4284","authenticated-orcid":false,"given":"Mukkesh","family":"Kumar","sequence":"first","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 138632, Singapore"},{"name":"Bioinformatics Institute, Agency for Science Technology and Research, Singapore 138632, Singapore"},{"name":"Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 119077, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li Ting","family":"Ang","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 138632, Singapore"},{"name":"Bioinformatics Institute, Agency for Science Technology and Research, Singapore 138632, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5078-3934","authenticated-orcid":false,"given":"Hang","family":"Png","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 138632, Singapore"},{"name":"Bioinformatics Institute, Agency for Science Technology and Research, Singapore 138632, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maisie","family":"Ng","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 138632, Singapore"},{"name":"Bioinformatics Institute, Agency for Science Technology and Research, Singapore 138632, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7768-037X","authenticated-orcid":false,"given":"Karen","family":"Tan","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 138632, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"See Ling","family":"Loy","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynaecology Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore"},{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1945-0266","authenticated-orcid":false,"given":"Kok Hian","family":"Tan","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynaecology Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore"},{"name":"Division of Obstetrics and Gynecology, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry Kok Yen","family":"Chan","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynaecology Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore"},{"name":"Department of Reproductive Medicine, KK Women\u2019s and Children\u2019s Hospital, Singapore 229899, Singapore"},{"name":"Cancer and Stem Cell Biology, Duke-NUS Medical School, Singapore 169857, Singapore"},{"name":"Human Potential Translational Research Programme, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4643-0618","authenticated-orcid":false,"given":"Keith M.","family":"Godfrey","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Centre, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton SO17 1BJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiao-yng","family":"Chan","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 138632, Singapore"},{"name":"Human Potential Translational Research Programme, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yap Seng","family":"Chong","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 138632, Singapore"},{"name":"Human Potential Translational Research Programme, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan G.","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 138632, Singapore"},{"name":"Human Potential Translational Research Programme, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore"},{"name":"Department of General Practice and Primary Health Care, University of Helsinki, 00100 Helsinki, Finland"},{"name":"Folkh\u00e4lsan Research Center, 00250 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5338-6248","authenticated-orcid":false,"given":"Mengling","family":"Feng","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 119077, Singapore"},{"name":"Institute of Data Science, National University of Singapore, Singapore 119077, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neerja","family":"Karnani","sequence":"additional","affiliation":[{"name":"Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore 138632, Singapore"},{"name":"Bioinformatics Institute, Agency for Science Technology and Research, Singapore 138632, 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