title: First trimester pregnancy-associated plasma protein-A in pregnancies complicated by subsequent gestational diabetes.
abstract: OBJECTIVE
  To compare routine first trimester biochemical and ultrasound markers in pregnancies complicated by gestational diabetes with those of a control group.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  First trimester PAPP-A concentrations were lower among pregnant women with subsequent gestational diabetes than in the control group.
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Fausta
authors.initials: F
authors.lastname: Beneventi
authors.forename: Margherita
authors.initials: M
authors.lastname: Simonetta
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Lovati
authors.forename: Giulia
authors.initials: G
authors.lastname: Albonico
authors.forename: Carmine
authors.initials: C
authors.lastname: Tinelli
authors.forename: Elena
authors.initials: E
authors.lastname: Locatelli
authors.forename: Arsenio
authors.initials: A
authors.lastname: Spinillo
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011262:Pregnancy Trimester, Second / Q000097:blood / Q000502:physiology; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis / Q000378:metabolism* / Q000502:physiology; D011296:Prenatal Diagnosis / Q000379:methods; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors
chemical_list: D011266:Pregnancy-Associated Plasma Protein-A