Publication:

Accuracy of glycosylated fibronectin-based cut-off levels for predicting gestational diabetes mellitus

Background Gestational diabetes mellitus (GDM) is a common metabolic complication of pregnancy and is associated with adverse maternal and neonatal outcomes. Early identification of women at risk remains challenging, as routine screening is typically performed in mid-pregnancy. This study aimed to assess the accuracy of first-trimester maternal serum glycosylated fibronectin cut-off levels for predicting GDM.

Methods A prospective cohort study was conducted at the Department of Obstetrics and Gynecology at Dhaka Medical College Hospital, Dhaka, Bangladesh, from December 2020 to November 2021. Ninety-five pregnant women with singleton pregnancies between 10 and 15 weeks of gestation were enrolled. Maternal serum glycosylated fibronectin was measured using ELISA. Participants were followed until delivery and GDM was diagnosed using WHO criteria at 24-28 weeks. Statistical analysis was performed using SPSS version 23.

Results Most participants were aged 21–30 years (66.3%) and overweight (75.8%). Women who developed GDM had significantly higher mean glycosylated fibronectin levels than non-GDM women (226.7±73.3 vs. 114.2±57.9 µg/ml; p<0.001). Among women with glycosylated fibronectin ≥145.0 µg/ml, 83.3% developed GDM, whereas only 16.7% of GDM cases occurred below this threshold. Mean body mass index was also significantly higher among women with elevated glycosylated fibronectin levels (p=0.01).

Conclusions Elevated first-trimester maternal serum glycosylated fibronectin is strongly associated with subsequent development of GDM and may serve as an effective early screening biomarker for identifying high-risk pregnancies.