Can the Finnish Diabetes Risk Score (FINDRISC) identify gestational diabetes?: A multicenter cross-sectional study in Türkiye

Gestational diabetes mellitus (GDM) is a common pregnancy complication with short- and long-term adverse outcomes for mother and child. The Finnish Diabetes Risk Score (FINDRISC) is a simple, validated questionnaire for type 2 diabetes risk, but its ability to identify GDM is not well established. In this multicenter cross-sectional study, 797 pregnant women at 24 to 28 weeks of gestation who attended 3 tertiary hospitals in Istanbul, Türkiye, between June and September 2024 completed the Turkish FINDRISC at the same visit as their routine GDM screening. GDM was diagnosed by the 1-step (75-g oral glucose tolerance test [OGTT]) or two-step (50-g glucose challenge test followed by 100-g OGTT) approach. Univariable and multivariable logistic regression and receiver operating characteristic analysis were performed. GDM was diagnosed in 104 women (13.0%). The FINDRISC score was higher in women with GDM (median 8 [interquartile range 6-12] vs 7 [4-10]; P = .001); each 1-point increase was associated with 8% higher odds of GDM (OR 1.08; 95% confidence interval, 1.03-1.13). The area under the receiver operating characteristic curve was 0.599 (95% confidence interval, 0.542-0.655). At the optimal cutoff (≥8 points), sensitivity was 62.5%, specificity 53.2%, positive predictive value 16.7%, negative predictive value 90.4%, and negative likelihood ratio 0.70; 37.5% of GDM cases scored below this cutoff. A cutoff of ≥4 points yielded 88.5% sensitivity but would have avoided OGTT in only 22.0% of women. In multivariable analysis, age ≥ 35 years (adjusted OR 2.40), body mass index > 30 kg/m2 (adjusted OR 2.88), and non-daily fruit/vegetable intake (adjusted OR 1.70) were independently associated with GDM. When administered at 24 to 28 weeks, FINDRISC showed poor discrimination for concurrently diagnosed GDM. Its negative predictive value largely reflects the low prevalence of GDM, and no cutoff combined acceptable sensitivity with a meaningful reduction in OGTTs. FINDRISC should not replace universal OGTT screening; pregnancy-specific risk models evaluated prospectively in early pregnancy are needed.