First trimester serum afamin concentrations are associated with the development of pre-eclampsia and gestational diabetes mellitus in pregnant women

Clin Chim Acta. 2018 Jan;476:160-166. doi: 10.1016/j.cca.2017.11.031. Epub 2017 Nov 27.


Objective: Aim of this study was to assess the prognostic capability of afamin to predict pregnancy complications.

Method: First-trimester screening was consecutively performed in 4948 pregnant women, of whom 474 women developed pregnancy complications [gestational hypertension (n=84), pre-eclampsia (n=30), intrauterine growth restriction (n=107), preterm birth (n=44), and gestational diabetes mellitus (n=209)]. To each woman with pregnancy complications an uncomplicated pregnancy was matched for body mass index. Afamin serum concentrations were measured in 948 pregnant women at the first-trimester screening.

Results: Median afamin concentrations were significantly higher in women developing pre-eclampsia or gestational diabetes mellitus when compared to women with uncomplicated pregnancies (76mg/L vs. 65mg/L, p=0.001 and 80mg/L vs. 69mg/L, p<0.001). There was no difference in median afamin values between all other pregnancy complications and their matched controls. Increased afamin (i.e. >65mg/L) was a strong and independent predictor for the development of pre-eclampsia (risk ratio, 24.58; 95%CI, 2.82-214.12; p=0.004) as well as gestational diabetes mellitus (risk ratio, 2.07; 95%CI, 1.33-3.22; p=0.001).

Conclusion: In this large nested case-control study increased afamin concentrations were a strong and independent predictor for pre-eclampsia and gestational diabetes mellitus, suggesting a potential role of afamin as predictive marker for pregnancy-related metabolic disorders.

Keywords: Afamin; Gestational diabetes mellitus; Pre-eclampsia; Pregnancy complications.

MeSH terms

  • Adult
  • Carrier Proteins / blood*
  • Case-Control Studies
  • Diabetes, Gestational / blood*
  • Female
  • Glycoproteins / blood*
  • Humans
  • Pre-Eclampsia / blood*
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Trimester, First / blood*
  • Serum Albumin, Human
  • Young Adult


  • AFM protein, human
  • Carrier Proteins
  • Glycoproteins
  • Serum Albumin, Human