Association of Pregnancy-Associated Plasma Protein A (PAPP-A) and Gestational Diabetes


1 M.Sc. student of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 PHD, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 PHD of Laboratory Sciences, Faculty of Paramedical, Qazvin University of Medical Sciences, Iran.

4 Assistant professor, Department of Biostatistics, Faculty of Medicine, Qazvin University of Medical Sciences, Iran.


Introduction: Gestational diabetes mellitus is the most common medical complication during pregnancy that negatively affects the health of mother and fetus and neonate. Gestational diabetes mellitus occurs in 3-5% of pregnancies. Early detection of gestational diabetes can prevent of these complications. This study was performed with aim to determine the association between pregnancy-associated plasma protein A (PAPP-A) and gestational diabetes to detect a risk factor for predicting gestational diabetes.
Methods: This prospective analytical study was performed on 250 pregnant women referring to six healthcare centers of Qazvin from February to October 2016. PAPP-A was measured at 11-14 gestational weeks, then 75 gr glucose tolerance test was performed on the samples at 24-27 gestational weeks. The association between gestational diabetes and PAPP-A was studied. Data were analyzed by SPSS software (version 21) and Chi-square, t-test, Mann-Whitney, relative risk, and logistic regression. PResults: Twenty-four subjects (30.8%) of patients with decreased PAPPA and 15 (8.7%) of patients with normal PAPP-A were diagnosed with gestational diabetes. Chi-square test showed significant difference between two groups based in terms of gestational diabetes (P<0.001). The risk of gestational diabetes in the patients with decreased PAPP-A was 3.90 times more than control group (CI=1.87-8.14, P<0.001)
Conclusion: Low level of PAPP-A at gestation weeks of 11-14 can be a possible risk factor for the incidence of gestational diabetes. Therefore, it can be used as an early detection test for preventing the fetal and maternal adverse effects.


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