First trimester maternal serum free [beta]-human chorionic gonadotropin and pregnancy-associated plasma protein A in pregnancies complicated by diabetes mellitus

• Published in: BJOG : an international journal of obstetrics and gynaecology 2012-03, Vol.119 (4), p.410
• Main Authors: Savvidou, MD, Syngelaki, A, Muhaisen, M, Emelyanenko, E, Nicolaides, KH
• Format: Article
• Language: English
• Subjects: Diabetes; Obstetrics; Plasma; Pregnancy; Proteins; Risk factors
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/j.1471-0528.2011.03253.x

Please cite this paper as: Savvidou M, Syngelaki A, Muhaisen M, Emelyanenko E, Nicolaides K. First trimester maternal serum free β-human chorionic gonadotropin and pregnancy-associated plasma protein A in pregnancies complicated by diabetes mellitus. BJOG 2012;119:410-416. Objective To investigate whether markers of first trimester screening for aneuploidies, including fetal nuchal translucency (NT), maternal serum free β-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein A (PAPP-A), are altered in women with pre-existing type-1 and type-2 diabetes mellitus, and in women that subsequently develop gestational diabetes mellitus (GDM). Design Retrospective analysis of prospective combined screening for aneuploidies in singleton pregnancies at 11+0-13+6weeks of gestation. Setting Antenatal clinic. Population Singleton pregnancies at 11+0-13+6weeks of gestation resulting in the delivery of phenotypically normal neonates. The study included 194 women with type-1 diabetes, 122 women with type-2 diabetes, 779 women who developed GDM and 41007 non-diabetic controls. Methods Maternal free β-hCG and PAPP-A levels were expressed as multiples of the respective normal median (MoM), and fetal NT was expressed as a difference from the expected median (Δ). Main outcome measures Comparison of median MoM maternal free β-hCG and PAPP-A, and fetal NT, in the four outcome groups. Results There were no significant differences between the groups in median ΔNT and maternal free β-hCG MoM. Maternal median PAPP-A in type-2 diabetes, compared with the non-diabetic group, was reduced (0.75 MoM, IQR 0.50-1.09 MoM versus 1.00 MoM, IQR 0.68-1.42 MoM; P