Abstract

Introduction: Gestational diabetes (GDM), defined as hyperglycemia with onset or initial recognition during pregnancy, has a rising prevalence paralleling the rise in type 2 diabetes (T2DM) and obesity. GDM is associated with short-term and long-term consequences for both mother and child. Therefore, it is crucial we efficiently identify all cases and initiate early treatment, reducing fetal exposure to hyperglycemia and reducing GDM-related adverse pregnancy outcomes. For this reason, GDM screening is recommended as part of routine pregnancy care. The current screening method, the oral glucose tolerance test (OGTT), is a lengthy, cumbersome and inconvenient test with poor reproducibility. Newer biomarkers that do not necessitate a fasting sample are needed for the prompt diagnosis of GDM. The aim of this scoping review is to highlight and describe emerging protein biomarkers that fulfill these requirements for the diagnosis of GDM. Materials and Methods: This scoping review was conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for scoping reviews using Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing & Allied Health Literature (CINAHL), PubMed, Embase and Web of Science with a double screening and extraction process. The search included all articles published in the literature to July 2020. Results: Of the 3519 original database citations identified, 385 were eligible for full-text review. Of these, 332 (86.2%) were included in the scoping review providing a total of 589 biomarkers studied in relation to GDM diagnosis. Given the high number of biomarkers identified, three post hoc criteria were introduced to reduce the items set for discussion: we chose only protein biomarkers with at least five citations in the articles identified by our search and published in the years 2017–2020. When applied, these criteria identified a total of 15 biomarkers, which went forward for review and discussion. Conclusions: This review details protein biomarkers that have been studied to find a suitable test for GDM diagnosis with the potential to replace the OGTT used in current GDM screening protocols. Ongoing research efforts will continue to identify more accurate and practical biomarkers to take GDM screening and diagnosis into the 21st century.

Highlights

  • Gestational diabetes (GDM) is defined as hyperglycemia with onset or initial recognition during pregnancy [1]

  • By contrast to systematic reviews, this approach was found to be more appropriate for a comprehensive search reflecting the vast number of biomarkers with a potential to diagnose GDM at the same time, enabling us to provide an in-depth analysis of selected key biomarkers [19]

  • A total of 53 articles were excluded

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Summary

Introduction

Gestational diabetes (GDM) is defined as hyperglycemia with onset or initial recognition during pregnancy [1]. Short-term complications include preeclampsia and pregnancy-induced hypertension, increased risk of delivery by cesarean section, macrosomia, and neonatal hypoglycemia [3,4]. Long-term complications include increased risk of type 2 diabetes mellitus (T2DM), obesity and cardiovascular complications for both mother and offspring [5,6]. Studies have established that effective treatment of GDM reduces the rate of short-term perinatal complications and improves the quality of life of the mother [7,8]. Given this evidence, it is of utmost importance that we identify those at risk and accurately diagnose GDM [9]. Current diagnostic strategies use the oral glucose tolerance test (OGTT)

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