First trimester pregnancy‐associated plasma protein‐A in pregnancies complicated by subsequent gestational diabetes

Beneventi, Fausta; Simonetta, Margherita; Lovati, Elisabetta; Albonico, Giulia; Tinelli, Carmine; Locatelli, Elena; Spinillo, Arsenio

doi:10.1002/pd.2733

Cited by 63 publications

(63 citation statements)

References 37 publications

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“…There were, however, only two (1.2%) women with GDM in our study who required insulin, a much lower frequency compared with other study populations (12%-100%). 8,9,11,18,23,[26][27][28][29] Although both women had a lower PAPP-A MoM than women with non-insulin-treated GDM or non-GDM group, such a small proportion is insufficient to determine whether PAPP-A MoM differs significantly between women with insulin-treated GDM and non-insulintreated women with GDM. The low frequency of insulin treatment in our study population may imply that the majority of affected Chinese women had mild GDM and may also explain why our study population did not exhibit changes in PAPP-A MoM during the first trimester.…”

Section: Discussionmentioning

confidence: 96%

“…This is consistent with the results of three other studies 18,26,27 but contradicts others. 8,9,11,23,28,29 These published series are summarised in Table 5. 8,9,11,18,23,[26][27][28][29] There are several possible explanations for the different results of these studies, including ours.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 In Hong Kong, all women undergo firsttrimester screening for Down syndrome using a combination of maternal age, maternal free β-human chorionic gonadotrophin (β-HCG), pregnancy-associated plasma protein-A (PAPP-A), and fetal nuchal translucency (NT) thickness at 11-13+6 weeks of gestation. Studies have shown that low free β-HCG and PAPP-A levels in the first trimester are associated with pregnancy complications.…”

Section: Introductionmentioning

confidence: 99%

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Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese women

Wong

et al. 2015

Hong Kong Med J

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Introduction:Several studies have shown that women with pre-existing diabetes mellitus have significantly lower pregnancy-associated plasma protein-A levels than those without. This study aimed to evaluate whether first-trimester pregnancyassociated plasma protein-A multiple of median is associated with gestational diabetes mellitus in Chinese pregnant women. Methods:This prospectively collected case series was conducted in a regional hospital in Hong Kong. All consecutive Chinese women with a singleton pregnancy who attended the hospital for their first antenatal visit (before 14 weeks' gestation) from April to July 2014 were included. Pregnancyassociated plasma protein-A multiple of median was compared between the gestational diabetic (especially for early-onset gestational diabetes) and non-diabetic groups. The correlation between pregnancy-associated plasma protein-A level and glycosylated haemoglobin level in women with gestational diabetes was also examined. Results:Of the 520 women recruited, gestational diabetes was diagnosed in 169 (32.5%). Among them, 43 (25.4%) had an early diagnosis, and 167 (98.8%) with the disease were managed by diet alone. The gestational diabetic group did not differ significantly to the non-diabetic group in pregnancyassociated plasma protein-A (0.97 vs 0.99, P=0.40) or free β-human chorionic gonadotrophin multiple of median (1.05 vs 1.02, P=0.29). Compared with the non-gestational diabetic group, women with early diagnosis of gestational diabetes had a non- Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese womenNew knowledge added by this study • This is the first study to assess the association of first-trimester pregnancy-associated plasma protein-A multiple of median (PAPP-A MoM) with gestational diabetes mellitus (GDM) in a Chinese population. PAPP-A MoM was not predictive of development of non-insulin-dependent GDM in Chinese women.• There was no correlation between PAPP-A MoM and glycosylated haemoglobin level in Chinese women with GDM. PAPP-A levels were not useful to predict and identify poor glycaemic control in women with GDM.• There was a high prevalence of GDM (32.5%) in the Chinese population. Implications for clinical practice or policy • PAPP-A and β-human chorionic gonadotrophin do not seem to be predictive of non-insulin-dependent GDM.Other predictive model that comprises the maternal and clinical risk factors in Chinese women is warranted to identify women at risk of GDM.• Further studies that employ the new diagnostic criteria for GDM are warranted to examine the potential of first-trimester biochemical markers to predict GDM as well as their influence on the prevalence of GDM in the Chinese population.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese women

Wong

et al. 2015

Hong Kong Med J

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“…One study, of a small number of cases, 7 showed a significant reduction in both concentrations of PAPP-A and free hCG, whilst other studies 12,18 found either no significant effect or found a significant reduction only for PAPP-A. 19 The current study aims to investigate whether the presence of confirmed GDM has any impact on the first trimester aneuploidy screening markers foetal nuchal translucency (NT), maternal serum free hCG or PAPP-A.…”

Section: Introductionmentioning

confidence: 99%

The association between gestational diabetes mellitus and first trimester aneuploidy screening markers

Spencer

Cowans

2013

Ann Clin Biochem

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Objective: To establish whether maternal serum first trimester concentrations of PAPP-A and free hCG are altered in pregnancies that subsequently are diagnosed by an oral glucose tolerance test (OGTT) with gestational diabetes mellitus (GDM). Methods: Over the period 2009 and 2011, the results for women who had first trimester screening for aneuploidy were matched with those having an oral glucose tolerance test at 22-26 weeks for suspected GDM. Free hCG, PAPP-A and NT MoMs were compared amongst the group having an OGTT with confirmed GDM and those in which GDM was not confirmed. A second comparison group consisted of all non-aneuploidy singleton pregnancies in which no OGTT was performed. Results: During the three-year period, 27,660 singleton pregnancies were screened of which 7429 cases had an OGTT of which 870 cases were classed as GDM by WHO criteria. There was a significant 7-9% reduction in both PAPP-A and free hCG MoM in the GDM group compared with either the OGTT non-GDM group or the remaining pregnancies with no known risk factors for evidence of GDM. There was no difference in the NT measurements. Conclusions: First trimester concentrations of PAPP-A and free hCG are reduced in pregnancies that subsequently are diagnosed with GDM and may be useful in further screening algorithms for this disorder although the sensitivity alone is quite poor.

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“…2013 yılında İtalya'da yapılan bir araştırmada, serum PAPP-A değerlerinin gestasyonel diyabet ile ilişkisi araştırılmış ve düşük PAPP-A değerlerinin gestasyonel diyabet ile ilişkisi istatistiksel olarak güçlü bulunmuştur (17) . 2011 yılında yayınlanan bir başka çalış-mada, ilk trimester düşük PAPP-A seviyelerinin gelişebilecek gestasyonel diyabet ile ilişkisi gösteril-miştir (18) . Pedersen ve ark.…”

Section: Discussionunclassified

Role of Pregnancy Associated Plasma Protein (PAPP-A) and Free Human Chorionic Gonadotropin (B-HCG) in Predicting Adverse Pregnancy Outcomes

Yıldız¹,

Şahin²

2015

IKSST

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First trimester pregnancy‐associated plasma protein‐A in pregnancies complicated by subsequent gestational diabetes

Abstract: First trimester PAPP-A concentrations were lower among pregnant women with subsequent gestational diabetes than in the control group.

Cited by 63 publications

References 37 publications

Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese women

Association between pregnancy-associated plasma protein-A levels in the first trimester and gestational diabetes mellitus in Chinese women

The association between gestational diabetes mellitus and first trimester aneuploidy screening markers

Role of Pregnancy Associated Plasma Protein (PAPP-A) and Free Human Chorionic Gonadotropin (B-HCG) in Predicting Adverse Pregnancy Outcomes

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