Journal article
First trimester prenatal screening biomarkers and gestational diabetes mellitus: A systematic review and meta-analysis
PLoS One, Vol.13(7), e0201319
07/26/2018
DOI: 10.1371/journal.pone.0201319
PMCID: PMC6062092
PMID: 30048548
Abstract
Biomarkers commonly assessed in prenatal screening have been associated with a number of adverse perinatal and birth outcomes. However, it is not clear whether first trimester measurements of prenatal screening biomarkers are associated with subsequent risk of gestational diabetes mellitus (GDM). We aimed to systematically review and statistically summarize studies assessing the relationship between first trimester prenatal screening biomarker levels and GDM development. We comprehensively searched PubMed/MEDLINE, EMBASE, CINAHL, and Scopus (from inception through January 2018) and manually searched the reference lists of all relevant articles. We included original, published, observational studies examining the association of first trimester pregnancy associated plasma protein-A (PAPP-A) and/or free β-human chorionic gonadotropin (free β-hCG) levels with GDM diagnosis. Mean differences were calculated comparing PAPP-A and free β-hCG multiples of median (MoM) levels between women who developed GDM and those who did not and were subsequently pooled using two-sided random-effects models. Our meta-analysis of 13 studies on PAPP-A and nine studies on free β-hCG indicated that first trimester MoM levels for both biomarkers were lower in women who later developed GDM compared to women who remained normoglycemic throughout pregnancy (MD -0.17; 95% CI -0.24, -0.10; MD -0.04; 95% CI -0.07-0.01). There was no evidence for between-study heterogeneity among studies on free β-hCG (I2 = 0%). A high level of between-study heterogeneity was detected among the studies reporting on PAPP-A (I2 = 90%), but was reduced after stratifying by geographic location, biomarker assay method, and timing of GDM diagnosis. Our meta-analysis indicates that women who are diagnosed with GDM have lower first trimester levels of both PAPP-A and free β-hCG than women who remain normoglycemic throughout pregnancy. Further assessment of the predictive capacity of these biomarkers within large, diverse populations is needed.
Details
- Title: Subtitle
- First trimester prenatal screening biomarkers and gestational diabetes mellitus: A systematic review and meta-analysis
- Creators
- Brittney M Donovan - University of Iowa, EpidemiologyNichole L NideyElizabeth A JasperJennifer G Robinson - University of Iowa, EpidemiologyWei Bao - University of Iowa, EpidemiologyAudrey F Saftlas - University of Iowa, EpidemiologyKelli K Ryckman - University of Iowa, Epidemiology
- Resource Type
- Journal article
- Publication Details
- PLoS One, Vol.13(7), e0201319
- DOI
- 10.1371/journal.pone.0201319
- PMID
- 30048548
- PMCID
- PMC6062092
- NLM abbreviation
- PLoS One
- ISSN
- 1932-6203
- eISSN
- 1932-6203
- Publisher
- Public Library of Science
- Copyright
- ©2018 Donovan et al.
- Grant note
- Funding: The authors received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist.
- Language
- English
- Date published
- 07/26/2018
- Academic Unit
- Stead Family Department of Pediatrics; Epidemiology; Addiction Medicine; Craniofacial Anomalies Research Center; Internal Medicine
- Record Identifier
- 9983739400302771
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