Can First Trimester Plasma Protein A Level Predict Gestational Diabetes Mellitus

Abstract

Aim: Gestational diabetes mellitus (GDM), a condition with multifactorial etiology and adverse perinatal consequences, affects approximately 15% of pregnancies globally, with higher prevalence in certain populations, such as Türkiye. The role of pregnancy-associated plasma protein-A (PAPP-A) on GDM risk remains unclear. This prospective study aimed to assess whether first-trimester maternal PAPP-A levels are predictive of GDM. Material and Method: This study involved 573 singleton pregnancies in women aged 18 to 45 years, conducted at a tertiary maternity hospital. PAPP-A and free β-hCG were assessed, and GDM screening was carried out using a 75 g oral glucose tolerance test. Comprehensive statistical analyses were applied to evaluate the findings. Results: Of the participants, 28.09% were diagnosed with GDM. GDM group exhibited significantly lower PAPP-A MoM levels compared to controls (p=0.042). ROC analysis revealed limited predictive utility, with a PAPP-A threshold of 0.99 demonstrating 52.3% sensitivity and 51.7% specificity. Logistic regression identified low PAPP-A levels, advanced maternal age, and higher body mass index (BMI) as independent GDM risk factors. Conclusion: While the findings underscore a potential association between PAPP-A levels and GDM, the predictive capacity of PAPP-A alone is modest. Future research should explore integrated predictive models incorporating PAPP-A and other biomarkers for improved early GDM screening.

Keywords

• Gestational diabetes
• pregnancy-associated plasma protein-A
• pregnancy

Kaynakça

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