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

OBJECTIVES: To investigate the predictive importance of first trimester combined test markers pregnancy-associated plasma protein-A (PAPP-A), human chorionic gonadotropin ß (ß-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; ontrol:1.191 ± 0.624; p < 0.001) and MoM f-ßhCG (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-ßhCG 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-ßhCG MoM values, which are among the first trimester combined test parameters, can be used in the early pregnancy period for the prediction of GDM.

The effect of fetal gender on the biochemical markers of the first-trimester screening.

OBJECTIVES: To determine the effects of fetal gender on the maternal levels of first-trimester screening biochemical markers, such pregnancy-related plasma protein A (PAPP-A) and beta-human chorionic gonadotropin (ß-hCG). METHODS: In this retrospective study, we assessed 267 cases of singleton pregnancies, who underwent first trimester screening tests and delivered between January 2016 and January 2019 at our hospital. Multiple of median (MoM) levels of PAPP-A and free ß-hCG, and the neonatal genders according to the birth records were compared and analyzed. Additionally, patients with small for gestational age (SGA) newborns, preeclampsia, and placental ablation, called ischemic placental diseases, were classified into a separate group and their PAPP-A and free ß-hCG MoM values and fetal genders were compared. RESULTS: There was no significant relationship between the mean values of PAPP-A (1.07±0.6) and free ß-hCG (1.23±1.14) and the fetal gender (males: 137, 51.3%; females: 130, 48.7%), respectively (p=0.833; p=0.075). In 41 cases (15.4%) with ischemic placental disease, free ß-hCG values was significantly higher in the fetal females (19 cases; 46.3%) than males (22 cases; 53.7%), (1.53±1.02 and 0.77±0.53, respectively), (p=0.004). CONCLUSION: Pregnancy-related plasma protein A and free ß-hCG values were not affected by the fetal gender. However, the significant relationship observed between free ß-hCG MoM levels and fetal gender in patients with ischemic placental diseases suggests the need for larger studies on this topic.