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Prenat Diagn. 2011 Jun;31(6):523-8. doi: 10.1002/pd.2733. Epub 2011 Mar 14.

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

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Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy.



To compare routine first trimester biochemical and ultrasound markers in pregnancies complicated by gestational diabetes with those of a control group.


First trimester data including the screening test for Down syndrome were retrieved from a computer data base. Clinical data were recorded at delivery. A multivariate quantile regression model was used to analyze the association between first trimester data and subsequent clinical outcomes in a case-control study design.


In the group of women who developed second trimester gestational diabetes, both first trimester median (1494 vs 2225 mU/L, P < 0.001) and adjusted multiple of median pregnancy-associated plasma protein-A (PAPP-A) concentrations (1.2 vs 0.7, P < 0.001) were significantly lower than in the control group. Differences between observed and expected crown-to-rump length expressed in mm was lower in women destined to develop gestational diabetes than in the control group (0.2 vs 1.4 mm, P < 0.005). In multivariate models, first trimester maternal PAPP-A concentrations correlated independently and inversely to pregestational body mass index (BMI, P = 0.004), subsequent gestational diabetes (P < 0.001) and pregnancy complications (P = 0.036).


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

[Indexed for MEDLINE]

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