Abstract
Serum markers measured early in pregnancy have been associated with the later diagnosis of gestational diabetes mellitus (GDM). This study aims to explore the performance of a panel of first-trimester biochemical markers for the prediction of GDM. A case-control study was performed that included 12 women who developed GDM and 60 controls matched for maternal and gestational age at blood collection. Levels of pregnancy-associated plasma protein A (PAPP-A), soluble endoglin, pregnancy protein 13, and adiponectin (Adipo) were measured on residual sera used in first-trimester screening for Down syndrome. Data were analyzed by nonparametric methods. A receiver operating characteristic curve was used to calculate the detection rate (DR) obtained with a panel of significant predictors for GDM. Multiples of the median values for Adipo and PAPP-A were significantly reduced in GDM cases versus matched controls. Combination of Adipo and PAPP-A yielded a DR of 63.6% at a false-positive rate of 10%. Addition of body mass index (BMI) to this panel increased DR to 72.7%. This study suggests that first-trimester screening with Adipo, PAPP-A, and BMI may effectively identify women at high risk for the development of GDM.
Highlights
During pregnancy, women must adapt her body systems to support nutrient and oxygen supply for the growth of the fetus and subsequent lactation [1]
Inappropriate adaptation of maternal physiology may lead to complications of pregnancy, such as gestational diabetes mellitus (GDM)
After quantifying glucose homeostasis based on different parameters [fasting glucose, random glucose or oral glucose tolerance tests (OGTT) following glucose overload], GDM can be predicted if specific cut-offs are reached, and therapeutic programs are recommended
Summary
Women must adapt her body systems to support nutrient and oxygen supply for the growth of the fetus and subsequent lactation [1]. GDM is usually developed after the 2nd trimester of pregnancy, between the 24th and the 28th week of gestation [1, 3], and it can trigger serious and long-term consequences for fetal and maternal health, in particular, those on metabolism and cardiovascular physiology [4].
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