Prediction of Gestational Diabetes by Measuring the Levels of Pregnancy Associated Plasma Protein-A (PAPP-A) During Gestation Weeks 11-14

Background: the present study aimed to determine the association between pregnancy- associated plasma protein a (papp-a) and gestational diabetes methods (gdm) to detect a risk factor for predicting gdm at gestational weeks 11-14. methods: this analytical prospective study recruited 284 pregnant women presenting to six healthcare centers of qazvin, iran from february to december 2016. papp-a was measured at gestational weeks 11-14 and glucose tolerance test was conducted at gestational weeks 24-28. the participants were assigned into two groups of exposure (reduced papp-a) and non-exposure (normal papp-a). the association between gdm and papp-a was studied. the number of women in exposure group were 201 and 83 in the non-exposure group. differences between groups were assessed by the mann–whitney, chi-square, t test, logistic regression analysis and roc curve with a significance level of 0.05. results: twenty eight (33.73%) patients of the exposure group and 17 (8.46%) of non-exposure group developed gdm. there was a significant difference between the two groups in terms of gdm (p<0.001) and the risk of gdm was 3.98 fold higher in the exposure group (reduced pappa mu/l) than that of the non-exposure group (ci=2.39-6.65, p<0.001). also, 53.3% of the exposure group and 46.7% of the nonexposure group were diagnosed with gdm (p=0.02). there was a significant difference in gdm between the groups and the risk of gdm was 1.85 times higher in the exposure group (reduced pappa mom) than that in the control group (ci=1.09-3.15, p=0.020). according to the roc curve results, papp-a and mom are acceptable indicators for predicting gdm. conclusion: a low papp-a level (mom, mu/l) as a new risk factor for gdm can help early prediction and prevent maternal and fetal complication by timely treatment.