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Research paper
Published online: 2021-08-13
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Potential role of biochemical placentation markers — pregnancy associated plasma protein-A and human chorionic gonadotropin for early gestational diabetes screening — a pilot study

Vesselina Evtimova Yanachkova1, Radiana Staynova2, Ivan Bochev13, Zdravko Kamenov4
DOI: 10.5603/GP.a2021.0129
·
Pubmed: 34541644
Affiliations
  1. Department of Endocrinology, Specialized Hospital for Active Treatment of Obstetrics and Gynaecology “Dr Shterev”, Sofia, Bulgaria
  2. Department of Pharmaceutical Sciences, Faculty of Pharmacy, Medical University of Plovdiv, 15 A Vassil Aprilov Blvd, 4002 Plovdiv, Bulgaria
  3. Department of Molecular Immunology, Institute of Biology and Immunology of Reproduction, Bulgarian Academy of Sciences, Sofia, Bulgaria
  4. Department of Internal Medicine, Medical University -Sofia, Sofia, Bulgaria;Clinic of Endocrinology, University Hospital, Sofia, Bulgaria

open access

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ORIGINAL PAPERS Obstetrics
Published online: 2021-08-13

Abstract

Objectives: Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications. The universal screening for GDM is usually performed between 24-28 weeks’ gestation. This often delays the diagnosis and could increase the risk of adverse pregnancy outcomes. Some of the biochemical placental markers — pregnancy associated plasma protein A (PAPP-A) and free-β human chorionic gonadotropin (hCG), probably could provide a diagnostic value for GDM. The aim of our study was to assess if PAPP-A and hCG values were different among pregnant women with and without GDM and respectively, to tested their place in the early GDM screening.

Material and methods: We conducted a retrospective, case-control study by reviewing the clinical database records of 662 pregnant women. The analysis includes the data for a two-year period. The patients included in the observation were divided into two groups — GDM group (n = 412) and Euglycemic group (n = 250). Early screening for GDМ between 9–12 weeks’ gestation was performed in 173 of the women in the interventional group due to: registered fasting plasma glucose (FPG) above 5.1 mmol/L, obesity, macrosomia in previous pregnancies or family history for diabetes mellitus. The remaining 239 women underwent universal screening at 24–28 weeks’ gestation. Mean serum levels of PAPP-A, hCG, FPG, and body mass index (BMI) were measured between 10–13 gestational weeks. Serum levels of PAPP-A and hCG are presented as multiples of the normal median (MoM), adjusted by maternal baseline characteristics and demographics.

Results: In patients who developed GDM during pregnancy, compared with the control group, we have found significantly lower MoM values of PAPP-A (p < 0.0001), higher levels of FPG (р < 0.0001) and higher BMI (р < 0.0001). Median hCG MoM was similar in both group of pregnant women.

Conclusion: Our findings suggest that low-normal to low reference range values of PAPP-A might be associated with higher risk for GDM. PAAP-A levels can be used as an additional factor to recommend early screening for GDM.

Abstract

Objectives: Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications. The universal screening for GDM is usually performed between 24-28 weeks’ gestation. This often delays the diagnosis and could increase the risk of adverse pregnancy outcomes. Some of the biochemical placental markers — pregnancy associated plasma protein A (PAPP-A) and free-β human chorionic gonadotropin (hCG), probably could provide a diagnostic value for GDM. The aim of our study was to assess if PAPP-A and hCG values were different among pregnant women with and without GDM and respectively, to tested their place in the early GDM screening.

Material and methods: We conducted a retrospective, case-control study by reviewing the clinical database records of 662 pregnant women. The analysis includes the data for a two-year period. The patients included in the observation were divided into two groups — GDM group (n = 412) and Euglycemic group (n = 250). Early screening for GDМ between 9–12 weeks’ gestation was performed in 173 of the women in the interventional group due to: registered fasting plasma glucose (FPG) above 5.1 mmol/L, obesity, macrosomia in previous pregnancies or family history for diabetes mellitus. The remaining 239 women underwent universal screening at 24–28 weeks’ gestation. Mean serum levels of PAPP-A, hCG, FPG, and body mass index (BMI) were measured between 10–13 gestational weeks. Serum levels of PAPP-A and hCG are presented as multiples of the normal median (MoM), adjusted by maternal baseline characteristics and demographics.

Results: In patients who developed GDM during pregnancy, compared with the control group, we have found significantly lower MoM values of PAPP-A (p < 0.0001), higher levels of FPG (р < 0.0001) and higher BMI (р < 0.0001). Median hCG MoM was similar in both group of pregnant women.

Conclusion: Our findings suggest that low-normal to low reference range values of PAPP-A might be associated with higher risk for GDM. PAAP-A levels can be used as an additional factor to recommend early screening for GDM.

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Keywords

gestational diabetes mellitus; PAPP-A; early screening

About this article
Title

Potential role of biochemical placentation markers — pregnancy associated plasma protein-A and human chorionic gonadotropin for early gestational diabetes screening — a pilot study

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-08-13

DOI

10.5603/GP.a2021.0129

Pubmed

34541644

Keywords

gestational diabetes mellitus
PAPP-A
early screening

Authors

Vesselina Evtimova Yanachkova
Radiana Staynova
Ivan Bochev
Zdravko Kamenov

References (21)
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