Introduction: GDM (Gestational diabetes mellitus) is the most common metabolic complication in pregnancy and is related to maternal and fetal mortality and morbidity. On this background, simple and effective detection strategy for GDM in the early pregnancy is needed. The pathophysiology of GDM takes place weeks to months before diagnosis and factors associated with this pathogenesis exist in blood before the clinical diagnosis of GDM. In GDM, the placenta endures changes such as increased hyper-vascularization and dysfunction of blood stream of the placental villi. PAPP-A (Pregnancy Associated Plasma Protein) is produced by the placental syncytiotrophoblast and commonly assess in prenatal screening at 11-14 weeks of gestation for prediction some aneuploidies such as chromosomal trisomy like 21. The aim of the present study was to assess whether serum PAPP-A concentrations can predict GDM or show improved value for predicting GDM when combined with maternal factors.
Methods: In this review article we comprehensively studied more than 20 article of PubMed/MEDLINE, Web of science from 2015 to 2021.
Results: 15 studies show that there is a significant relationship between PAPP-A and GDM and 5 studies didn’t find anything significant. First trimester MoM level of PAAP-A marker was lower in women who later developed GDM 0/7(0/5-1/2) compared to women who remained norm glycemic throughout pregnancy 1/2 (0/8-1/6).
Conclusion: According to these studies we can conclude that women diagnosed with GDM have lower first trimester levels of PAPP-A than women who remain normoglycemic throughout pregnancy. Measurement of first trimester biomarker that represents the metabolic change may allow for early detection and management of GDM. This biomarker may use as indicators of the presence of abnormal glucose metabolism at the start of pregnancy and could aid in the identification of women at risk for GDM development
Keywords: Gestational diabetes, pregnancy associated plasma protein