Publication:

Association of serum pregnancy associated plasma protein: a with gestational diabetes mellitus

Background Gestational diabetes mellitus is defined as diabetes diagnosed during pregnancy that is not clearly overt diabetes. GDM has many adverse consequences on the health of mother and fetus.

Methods This cohort study was carried out involving 77 women of 11 to14-week pregnant attending in the Gynecology & Obstetrics and Fetomaternal Medicine OPD, BSMMU from September 2020 to August 2021.

Results Respondents were divided into two groups. Low PAPP-A group ( 0.5MoM). In low PAPP-A group, out of 16 respondents, 8 (42.1%) developed GDM and remaining 8(13.8%) were euglycemic. Whereas, in normal PAPP-A group, out of 61 respondents, majority 50 (86.2%) were euglycemic and only 11 (57.9%) women developed GDM. A total 19 (24.68%) respondents developed GDM from both low and normal PAPP-A group. ROC analysis of PAPP-A level for detection of GDM, a AUC value of 0.889 (95% CI 0.818-0.960) found which was statistically significant. A cut off value of ≤16.80 showed the highest Youden index (0.652) with 89.4% sensitivity and 81% specificity, the accuracy was 83.35. Moreover, a cut off value ≤16.80 showed PPV and NPV of 62.1% and 95.9%, respectively. PAPP-A level of GDM detected (10.32±5.56) µg/ml was significantly lower from non GDM mothers (25.08 ±9.85) µg/ml, where p<0. 001.

Conclusions Study finding revealed that maternal serum PAPP-A level was lower in 11-14 weeks of pregnancy who subsequently developed GDM. So, a low PAPP-A level (<0.5 MoM) in 11-14 weeks of pregnancy is associated for development of GDM.