Early pregnancy prediction of gestational diabetes mellitus risk using prenatal screening biomarkers in nulliparous women

Brittney M Snyder; Rebecca J Baer; Scott P Oltman; Jennifer G Robinson; Patrick J Breheny; Audrey F Saftlas; Wei Bao; Andrea L Greiner; Knute D Carter; Larry Rand; Laura L Jelliffe-Pawlowski; Kelli K Ryckman

doi:10.1016/j.diabres.2020.108139

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Early pregnancy prediction of gestational diabetes mellitus risk using prenatal screening biomarkers in nulliparous women

Journal article

Peer reviewed

Early pregnancy prediction of gestational diabetes mellitus risk using prenatal screening biomarkers in nulliparous women

Brittney M Snyder, Rebecca J Baer, Scott P Oltman, Jennifer G Robinson, Patrick J Breheny, Audrey F Saftlas, Wei Bao, Andrea L Greiner, Knute D Carter, Larry Rand, …

Diabetes research and clinical practice, Vol.163, pp.108139-108139

05/2020

DOI: 10.1016/j.diabres.2020.108139

PMCID: PMC7269799

PMID: 32272192

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https://www.ncbi.nlm.nih.gov/pmc/articles/7269799View

Open Access

Abstract

To evaluate the clinical utility of first and second trimester prenatal screening biomarkers for early pregnancy prediction of gestational diabetes mellitus (GDM) risk in nulliparous women. We conducted a population-based cohort study of nulliparous women participating in the California Prenatal Screening Program from 2009 to 2011 (n = 105,379). GDM was ascertained from hospital discharge records or birth certificates. Models including maternal characteristics and prenatal screening biomarkers were developed and validated. Risk stratification and reclassification were performed to assess clinical utility of the biomarkers. Decreased levels of first trimester pregnancy-associated plasma protein A (PAPP-A) and increased levels of second trimester unconjugated estriol (uE ) and dimeric inhibin A (INH) were associated with GDM. The addition of PAPP-A only and PAPP-A, uE , and INH to maternal characteristics resulted in small, yet significant, increases in area under the receiver operating characteristic curve (AUC) (maternal characteristics only: AUC 0.714 (95% CI 0.703-0.724), maternal characteristics + PAPP-A: AUC 0.718 (95% CI 0.707-0.728), maternal characteristics + PAPP-A, uE , and INH: AUC 0.722 (0.712-0.733)); however, no net improvement in classification was observed. PAPP-A, uE , and INH have limited clinical utility for prediction of GDM risk in nulliparous women. Utility of other readily accessible clinical biomarkers in predicting GDM risk warrants further investigation.

Pregnancy

Adult

Biomarkers - blood

Cohort Studies

Diabetes, Gestational - diagnosis

Female

Humans

Prenatal Diagnosis - methods

Details

Title: Subtitle: Early pregnancy prediction of gestational diabetes mellitus risk using prenatal screening biomarkers in nulliparous women
Creators: Brittney M Snyder - University of Iowa
Rebecca J Baer - University of California, San Francisco
Scott P Oltman - University of California, San Francisco
Jennifer G Robinson - University of Iowa
Patrick J Breheny - University of Iowa
Audrey F Saftlas - University of Iowa
Wei Bao - University of Iowa
Andrea L Greiner - University of Iowa
Knute D Carter - University of Iowa
Larry Rand - University of California, San Francisco
Laura L Jelliffe-Pawlowski - University of California, San Francisco
Kelli K Ryckman - University of Iowa
Resource Type: Journal article
Publication Details: Diabetes research and clinical practice, Vol.163, pp.108139-108139
DOI: 10.1016/j.diabres.2020.108139
PMID: 32272192
PMCID: PMC7269799
NLM abbreviation: Diabetes Res Clin Pract
ISSN: 0168-8227
eISSN: 1872-8227
Grant note: T32 HL087738 / NHLBI NIH HHS
Language: English
Date published: 05/2020
Academic Unit: Stead Family Department of Pediatrics; Epidemiology; Biostatistics; Obstetrics and Gynecology; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
Record Identifier: 9984193399002771

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