The predictive value of the first trimester combined test for gestational diabetes mellitus

Ginekol Pol. 2022 Jul 27. doi: 10.5603/GP.a2022.0036. Online ahead of print.


Objectives: To investigate the predictive importance of first trimester combined test markers pregnancy-associated plasma protein-A (PAPP-A), human chorionic gonadotropin β (β-hCG) and nuchal translucency (NT) for gestational diabetes mellitus (GDM).

Material and methods: Pregnant women which both first trimester combined test and GDM screening were performed during antenatal follow-up were included in this retrospective case-control study. The cases were divided into two groups as GDM screening positive and negative. Demographic, clinical and laboratory data of both groups were compared. Predictive tests were applied to the first trimester combined test data for the detection of GDM.

Results: A total of 378 patients, 171 (45.2%) in the control group and 207 (54.8%) in the GDM group. The age (control:30.9 ± 5.2; GDM:30.5 ± 5.1; p = 0.844) and NT (control:1.254 ± 0.289; GDM:1.319 ± 0.299; p = 0.074) data of the groups were statistically similar. MoM PAPP-A (GDM:0.967 ± 0.685; control:1.191 ± 0.624; p < 0.001) and MoM f-βhCG (GDM:0.9 ± 0.602; control:1.103 ± 0.746; p = 0.001) levels of the GDM group were lower than the control group. In the binary logistic regression model, MoM PAPP-A and MoM f-βhCG variables were found to be effective on GDM. In the ROC analysis of these variables, the MoM PAPP-A (0.654) had the highest area under the curve. According to the optimum cut-off point (≤ 0.885) of the MoM PAPP-A, we found a sensitivity of 66.7% and a specificity of 65.50% for predicting GDM.

Conclusions: Our study showed that serum PAPP-A and f-βhCG MoM values, which are among the first trimester combined test parameters, can be used in the early pregnancy period for the prediction of GDM.

Keywords: chorionic gonadotropin; gestational diabetes; nuchal translucency; pregnancy-associated plasma protein-A.