title: Impact of type 1 diabetes and glycemic control on fetal aneuploidy biochemical markers.
abstract: OBJECTIVE
  To determine the influence of type 1 diabetes mellitus (T1DM) on the first trimester serum markers of fetal aneuploidy; pregnancy-associated plasma protein-A (PAPP-A) and free beta subunit of human chorionic gonadotropin (free β-hCG) and to evaluate the influence of glycemic control on these parameters in the pregnant diabetic women.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Data were extracted from electronic obstetric and laboratory databases at two Danish University Hospitals.
  
  
  METHODS
  Based on 36 415 pregnancies without T1DM (non-T1DM) and 331 pregnancies with T1DM; β-hCG and PAPP-A were obtained at 8+0 to 14+2 gestational weeks.
  
  
  METHODS
  Medians for PAPP-A and free β-hCG were generated and multiple of the normal gestation-specific median (MoM) values were calculated for each separate pregnancy. After adjustment for maternal weight, ethnicity and smoking status, MoM values were compared across the T1DM and non-T1DM groups, respectively. Additionally, the relationship between PAPP-A MoM and HgbA1C was examined in 348 T1DM pregnancies by Spearman's rank correlation. MAIN OUTCOME MEASURES. Difference in biochemical marker levels between T1DM and non-T1DM.
  
  
  RESULTS
  PAPP-A was 0.86 MoM in T1DM pregnancies and 1.01 MoM in non-T1DM pregnancies, p < 0.0001. Conversely, free β-hCG was not altered in T1DM pregnancies (T1DM 0.99 MoM, non-T1DM 0.98 MoM; p=0.14). There was a significant inverse correlation between HgbA1C and PAPP-A (rho=-0.12, p=0.02).
  
  
  CONCLUSIONS
  In T1DM pregnancies, PAPP-A MoM values were lower than in non-T1DM pregnancies. This suggests that correction should be considered in first trimester biochemical screening for fetal aneuploidy in T1DM women.
authors.affiliation: Department of Clinical Biochemistry.
authors.forename: Helen N
authors.initials: HN
authors.lastname: Madsen
authors.affiliation: Department of Fetal Medicine.
authors.forename: Charlotte K
authors.initials: CK
authors.lastname: Ekelund
authors.affiliation: Department of Clinical Biochemistry.
authors.forename: Niels
authors.initials: N
authors.lastname: Tørring
authors.affiliation: Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, Aarhus.
authors.forename: Per G
authors.initials: PG
authors.lastname: Ovesen
authors.affiliation: Department of Clinical Biochemistry.
authors.forename: Lennart
authors.initials: L
authors.lastname: Friis-Hansen
authors.affiliation: Center for Pregnant Women with Diabetes.|Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Lene
authors.initials: L
authors.lastname: Ringholm
authors.affiliation: Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, Aarhus.
authors.forename: Olav B
authors.initials: OB
authors.lastname: Petersen
mesh_terms: D000328:Adult; D000782:Aneuploidy; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D025063:Chromosome Disorders / Q000097:blood / Q000175:diagnosis*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011296:Prenatal Diagnosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D006442:Glycated Hemoglobin; D011266:Pregnancy-Associated Plasma Protein-A; C517652:hemoglobin A1c protein, human